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https://www.readbyqxmd.com/read/29202745/the-association-of-n-terminal-pro-brain-type-natriuretic-peptide-with-hemodynamics-and-functional-capacity-in-therapy-naive-precapillary-pulmonary-hypertension-results-from-a-cohort-study
#1
T M Berghaus, J Kutsch, C Faul, W von Scheidt, M Schwaiblmair
BACKGROUND: N-terminal pro-brain-type natriuretic peptide (NT-proBNP) is currently used as a surrogate marker for disease severity in pulmonary hypertension (PH). However, NT-proBNP tends to have a high variability and may insufficiently correlate with hemodynamics and exercise capacity. METHODS: To investigate the association of NT-proBNP with hemodynamics and cardio-pulmonary exercise testing (CPET) in 84 therapy-naive patients with precapillary PH. RESULTS: NT-proBNP levels were significantly correlated with hemodynamics and CPET parameters except for cardiac index, diffusion capacity, PaO2 at peak exercise, and peak minute ventilation...
December 4, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29167118/exercise-facilitates-early-recognition-of-cardiac-and-vascular-remodeling-in-chronic-thrombo-embolic-pulmonary-hypertension-in-a-novel-cteph-swine-model
#2
Kelly Stam, Richard W B van Duin, Andre Uitterdijk, Zongye Cai, Dirk J Duncker, Daphne Merkus
Chronic thrombo-embolic pulmonary hypertension (CTEPH) develops in 4% of patients after pulmonary embolism and is accompanied by an impaired exercise tolerance, which is ascribed to the increased right ventricular (RV) afterload and a ventilation/perfusion (V/Q) mismatch in the lungs. This study investigated changes in arterial PO2 and hemodynamics in response to graded treadmill exercise during development and progression of CTEPH in a swine model. Swine were chronically instrumented and received multiple pulmonary embolisms by (i) microsphere infusion (Spheres) over five weeks, (ii) endothelial dysfunction by administration of eNOS inhibitor L-N(ω)-Nitroarginine methyl ester (LNAME) during seven weeks, (iii) combined pulmonary embolisms and endothelial dysfunction (LNAME+Spheres), or (iv) served as sham-operated controls (Sham)...
November 22, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29161579/correlation-between-lung-perfusion-blood-volume-and-spect-images-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-by-balloon-pulmonary-angioplasty
#3
Hirofumi Koike, Eijun Sueyoshi, Ichiro Sakamoto, Masataka Uetani, Tomoo Nakata, Kouji Maemura
OBJECTIVES: We evaluated the reperfusion by balloon pulmonary angioplasty (BPA) in lung PBV and SPECT images. METHODS: In total, 17 patients and 57 sessions were evaluated. Pre-BPA and post-BPA lung PBV and SPECT/CT images, based on both anatomical segments and physiologic regions (upper/middle/lower) were compared. RESULTS: BPA had a positive effect on most hypoperfused/unperfused segments/regions. There was generally a high rate of agreement between PBV measurements and SPECT/CT...
November 11, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/29159269/pulmonary-artery-dysfunction-in-chronic-thromboembolic-pulmonary-hypertension
#4
Hidetoshi Chibana, Nobuhiro Tahara, Naoki Itaya, Takashi Ishimatsu, Masahiro Sasaki, Motoki Sasaki, Takaharu Nakayoshi, Masanori Ohtsuka, Shinji Yokoyama, Ken-Ichiro Sasaki, Takafumi Ueno, Yoshihiro Fukumoto
Background: Unresolved thromboemboli in the pulmonary arteries (PA) is known to cause chronic thromboembolic pulmonary hypertension (CTEPH). However, it remains unknown if vascular dysfunction in pulmonary arteries exists in patients with CTEPH. Methods and results: We enrolled 7 female patients with CTEPH in this study, who have stable pulmonary hemodynamics after balloon pulmonary angioplasty (age; 73.6 ± 3.0 years old, mean right atrial pressure; 4.1 ± 0...
December 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/29157517/balloon-pulmonary-angioplasty-for-chronic-thromboembolic-pulmonary-hypertension
#5
REVIEW
Ehtisham Mahmud, Omid Behnamfar, Lawrence Ang, Mitul P Patel, David Poch, Nick H Kim
Chronic thromboembolic pulmonary hypertension (CTEPH) is associated with several risk factors but is most frequently seen as a rare consequence of an acute pulmonary embolism. Surgical pulmonary thromboendarterectomy (PTE) is potentially curative for CTEPH with the best outcomes seen for the treatment of primarily proximal, accessible lobar or segmental disease. For surgically inoperable patients, percutaneous balloon pulmonary angioplasty (BPA) is feasible and has good short- to mid-term efficacy outcomes...
January 2018: Interventional Cardiology Clinics
https://www.readbyqxmd.com/read/29143501/-the-place-of-balloon-pulmonary-angioplasty-in-the-management-of-chronic-thromboembolic-pulmonary-hypertension
#6
Aileen Kharat, Béatrice Duxbury, Anne-Lise Hachull, Stéphane Noble, Hélène Bouvaist, Paola M Soccal, Frédéric Lador
Chronic thromboembolic pulmonary hypertension (CTEPH) is uncommon. Its diagnosis should not be delayed as its prognosis is poor if not treated. In most cases, an acute pulmonary embolism is found in the medical history of the patient. Once suspected, a specific work-up should be performed in a pulmonary hypertension (PH) center. The ventilation/perfusion scan has a central role in this workup but the emergence of non invasive imaging technologies provides morphological and functional information which take part in the therapeutic decision making, such as operability...
November 15, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29143104/left-ventricular-end-diastolic-dimension-and-septal-e-are-predictors-of-cardiac-index-at-rest-while-tricuspid-annular-plane-systolic-excursion-is-a-predictor-of-peak-oxygen-uptake-in-patients-with-pulmonary-hypertension
#7
Yoshihisa Nakano, Naoki Okumura, Shiro Adachi, Shigetake Shimokata, Fumitaka Tajima, Yoshihiro Kamimura, Toyoaki Murohara, Takahisa Kondo
Little is known regarding a correlation of hemodynamics at rest or exercise capacity with echocardiographic parameters in patients with pulmonary hypertension (PH). To clarify these potential correlations, we performed transthoracic echocardiography, right heart catheterization, and cardiopulmonary exercise testing in 53 patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). Left ventricular end-diastolic dimension (LVDd), early diastolic velocity of the septal mitral annulus (septal e'), tricuspid regurgitation peak gradient (TRPG), and tricuspid annular plane systolic excursion (TAPSE) were significantly correlated with cardiac index (LVDd; r = 0...
November 15, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29122755/renin-angiotensin-system-regulates-pulmonary-arterial-smooth-muscle-cell-migration-in-chronic-thromboembolic-pulmonary-hypertension
#8
Yun Xia Zhang, Ji Feng Li, Yuan Hua Yang, Zhen Guo Zhai, Song Gu, Yan Liu, Ran Miao, Ping Ping Zhong, Ying Wang, Xiao Xi Huang, Chen Wang
Pulmonary arterial smooth muscle cell (PASMC) migration plays a key role in vascular remodeling which occurs during development of chronic thromboembolic pulmonary hypertension (CTEPH). Activation of the renin-angiotensin system (RAS) contributes to vascular remodeling observed in many diseases including idiopathic pulmonary arterial hypertension. However, the role of RAS imbalance in CTEPH has not been characterized. Here, we hypothesize that RAS imbalance regulates vascular remodeling by promoting PASMC migration in CTEPH...
November 9, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/29107511/red-blood-cells-distribution-width-as-a-potential-prognostic-biomarker-in-patients-with-pulmonary-arterial-hypertension-and-chronic-thromboembolic-pulmonary-hypertension
#9
Anna Smukowska-Gorynia, Iga Tomaszewska, Katarzyna Malaczynska-Rajpold, Justyna Marcinkowska, Anna Komosa, Magdalena Janus, Anna Olasinska-Wisniewska, Sylwia Slawek, Aleksander Araszkiewicz, Stanislaw Jankiewicz, Tatiana Mularek-Kubzdela
BACKGROUND: Red blood cells distribution width (RDW) predicts survival in cardiovascular diseases. Little is known about the variability of RDW level over time among patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). To our knowledge, RDW has never been analysed as a marker of response to specific treatment. MATERIALS AND METHODS: We retrospectively analysed 77 patients for: i) RDW measured during the last hospitalisation before death or during the last follow-up (RDWlast); ii) mean RDW from all hospitalisations during the entire follow-up of the patient (RDWmean); iii) maximum RDW of all hospitalisations of each patient (RDWmax)...
August 24, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29089339/wave-intensity-analysis-provides-novel-insights-into-pulmonary-arterial-hypertension-and-chronic-thromboembolic-pulmonary-hypertension
#10
Junjing Su, Charlotte Manisty, Kim H Parker, Ulf Simonsen, Jens Erik Nielsen-Kudsk, Soren Mellemkjaer, Susan Connolly, P Boon Lim, Zachary I Whinnett, Iqbal S Malik, Geoffrey Watson, Justin E Davies, Simon Gibbs, Alun D Hughes, Luke Howard
BACKGROUND: In contrast to systemic hypertension, the significance of arterial waves in pulmonary hypertension (PH) is not well understood. We hypothesized that arterial wave energy and wave reflection are augmented in PH and that wave behavior differs between patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). METHODS AND RESULTS: Right heart catheterization was performed using a pressure and Doppler flow sensor-tipped catheter to obtain simultaneous pressure and flow velocity measurements in the pulmonary artery...
October 31, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29078111/markers-of-coagulation-activation-inflammation-and-fibrinolysis-as-predictors-of-poor-outcomes-after-pediatric-venous-thromboembolism-a-systematic-review-and-meta-analysis
#11
REVIEW
Ayesha Zia, Joy Russell, Ravi Sarode, Surendranath R Veeram, Shellie Josephs, Kendra Malone, Song Zhang, Janna Journeycake
BACKGROUND: Sequelae of venous thromboembolism (VTE) in children include recurrence, development of post thrombotic syndrome (PTS) when venous return from a limb is affected and chronic thromboembolic pulmonary hypertension (CTEPH) after pulmonary embolism. Identification of laboratory-based risk factors may be useful for individualized risk assessment for VTE sequelae. Coagulation activation and inflammation may contribute to their pathophysiology. We performed a systematic review to investigate the association between biomarkers of coagulation activation, inflammation and fibrinolysis and adverse VTE outcomes in children and young adults...
October 7, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29069014/decreased-haptoglobin-levels-inversely-correlated-with-pulmonary-artery-pressure-in-patients-with-pulmonary-arterial-hypertension-a-cross-sectional-study
#12
Hiroyuki Nakamura, Masaru Kato, Toshitaka Nakaya, Michihiro Kono, Shun Tanimura, Takahiro Sato, Yuichiro Fujieda, Kenji Oku, Hiroshi Ohira, Toshiyuki Bohgaki, Shinsuke Yasuda, Ichizo Tsujino, Masaharu Nishimura, Tatsuya Atsumi
We investigated the serum haptoglobin levels in patients with pulmonary arterial hypertension (PAH) based on the hypothesis that haptoglobin levels would reflect subclinical hemolysis due to microangiopathy in pulmonary arterioles.This cross-sectional study included 3 groups of patients attending Hokkaido University Hospital: PAH, chronic thromboembolic pulmonary hypertension (CTEPH), and connective tissue diseases (CTD) without PAH (CTD-non-PAH) group. Serum haptoglobin levels were measured by standardized turbidimetric immunoassay in all patients...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29057776/reduction-method-of-operator-and-medical-staff-radiation-exposure-in-balloon-pulmonary-angioplasty-for-chronic-thromboembolic-pulmonary-hypertension
#13
Hitoshi Miyazaki, Yoshiyuki Umezu, Kaede Sato, Kazuhisa Ogawa, Hiroshi Akamine
The purpose of this study is to investigate a reduction method of radiation exposure for operator and medical staff in balloon pulmonary angioplasty (BPA) for chronic thromboembolic pulmonary hypertension (CTEPH). We devised a new radiation protection, which is U-shaped acrylic supporting table with 0.35 mmPb unleaded radiation protection sheet. A human phantom was put on the bed of cardiac angiography system [C-arm angulation: posteroanterior (PA), L-arm angulation: left anterior oblique (LAO) 60°]. The ambient equivalent dose rate was measured under fluoroscopy with and without three radiation protections: U-shaped acrylic supporting table with 0...
2017: Nihon Hoshasen Gijutsu Gakkai Zasshi
https://www.readbyqxmd.com/read/29039836/-chronic-thromboembolic-pulmonary-hypertension-developed-in-a-female-patient-with-lupus-erythematosus-and-secondary-antiphospholipid-syndrome
#14
G A Movsisyan, T V Martynyuk, K V Mershin, N M Danilov, M A Satybaldyeva, T M Reshetnyak, R S Akchurin, E L Nasonov, I Ye Chazova
Chronic thromboembolic pulmonary hypertension (CTEPH) is one of the potentially curable forms of pulmonary hypertension, in which pulmonary thromboendarterectomy is the gold standard treatment. However, over the last decade, great attention has been given to a combined therapeutic approach including both drug therapy and surgical treatment and the application of endovascular technologies. This clinical case demonstrates the diagnostic difficulties of CTEPH and the opportunities of a comprehensive approach to therapy for the disease with mandatory assessment of preoperative surgical and medical treatment in order to improve the patient status and to prepare for surgery...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/29029716/balloon-pulmonary-angioplasty-in-chronic-thromboembolic-pulmonary-hypertension-new-horizons-in-the-interventional-management-of-pulmonary-embolism
#15
REVIEW
Michael D Rivers-Bowerman, Rebecca Zener, Arash Jaberi, Marc de Perrot, John Granton, John M Moriarty, Kong T Tan
Chronic thromboembolic pulmonary hypertension (CTEPH) is an underdiagnosed potential complication of acute or recurrent pulmonary thromboembolic disease. Multiple studies suggest that up to 5% of patients with acute pulmonary thromboembolic disease go on to develop CTEPH. The prognosis of untreated CTEPH is poor, but advances in medical and surgical treatments over the past few decades have improved patient outcomes. The gold standard and curative treatment for CTEPH is pulmonary endarterectomy; however, some patients are inoperable and others who have undergone pulmonary endarterectomy experience persistent or recurrent pulmonary hypertension despite medical therapy...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29029023/comprehensive-evaluation-of-the-effectiveness-and-safety-of-balloon-pulmonary-angioplasty-for-inoperable-chronic-thrombo-embolic-pulmonary-hypertension-long-term-effects-and-procedure-related-complications
#16
Tatsuo Aoki, Koichiro Sugimura, Shunsuke Tatebe, Masanobu Miura, Saori Yamamoto, Nobuhiro Yaoita, Hideaki Suzuki, Haruka Sato, Katsuya Kozu, Ryo Konno, Satoshi Miyata, Kotaro Nochioka, Kimio Satoh, Hiroaki Shimokawa
Aims: Although balloon pulmonary angioplasty (BPA) improves haemodynamics and short-term prognosis in patients with inoperable chronic thrombo-embolic pulmonary hypertension (CTEPH), the long-term effects of BPA, and procedure-related complications remain to be fully elucidated. Methods and results: From July 2009 to October 2016, we performed a total of 424 BPA sessions in 84 consecutive patients with inoperable CTEPH. We used 3D reconstructed computed tomography to determine target lesions of pulmonary arteries and optical computed tomography to select balloon size, if needed...
November 7, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29027516/-chronic-thromboembolic-pulmonary-hypertension-recognition-diagnosis-and-treatment
#17
D Ruigrok, P Symersky, P W G Elbers, S Kamminga, L J Meijboom, H J Bogaard
- Chronic thromboembolic pulmonary hypertension (CTEPH), characterised by pulmonary hypertension and persistent perfusion defects despite adequate anticoagulation, causes significant morbidity and mortality.- Persistent dyspnoea after acute pulmonary embolism is frequent and an indication for additional diagnostics. Only a minority of these patients develop CTEPH.- Echocardiography and perfusion scintigraphy are the cornerstone of diagnostics when suspecting CTEPH. Right-heart catheterisation and pulmonary angiography should confirm the diagnosis...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28993877/anxiety-depression-and-health-related-qol-in-patients-diagnosed-with-pah-or-cteph
#18
Elena Pfeuffer, Holger Krannich, Michael Halank, Heinrike Wilkens, Philipp Kolb, Berthold Jany, Matthias Held
BACKGROUND: Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are life-threatening diseases with a high burden of symptoms. Although depression, anxiety, and reduced health related quality of life (HRQOL) have also been reported, a comparative analysis which explores these traits and their underlying factors was lacking. METHODS: A retrospective analysis of depression, anxiety, and health related QOL was conducted using a Hospital anxiety and depression scale (HADS) as well as the SF-36 HRQOL questionnaire...
October 9, 2017: Lung
https://www.readbyqxmd.com/read/28981358/distinguishing-chronic-thromboembolic-pulmonary-hypertension-from-other-causes-of-pulmonary-hypertension-using-ct
#19
Alexandra Grosse, Claudia Grosse, Irene M Lang
OBJECTIVE: The purpose of this study was to discern imaging findings that separate chronic thromboembolic pulmonary hypertension (CTEPH) from other causes of pulmonary hypertension (PH). MATERIALS AND METHODS: A total of 143 patients with proven PH (group 1, pulmonary arterial hypertension; group 2, PH due to left heart disease; group 3, PH due to lung disease; group 4, CTEPH; and group 5, PH due to unclear or multifactorial mechanisms) underwent MDCT angiography...
December 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28966322/the-structure-of-a-chronic-total-occlusion-and-its-safe-treatment-in-a-patient-with-chronic-thromboembolic-pulmonary-hypertension
#20
Shun Minatsuki, Masaru Hatano, Hisataka Maki, Jiro Ando, Issei Komuro
A pouching defect, which is a type of angiographic classification in chronic thromboembolic pulmonary hypertension (CTEPH), is equivalent to a chronic total occlusion (CTO). Thus far, treating CTO involves high risk of the lung bleeding and is difficult because the structure and treating strategy have not been clarified, yet treating it has great potential to improve hemodynamic status and ventilation perfusion mismatch. Here, we describe a case of successfully treated the CTO. In this case, we treated it safely by two balloon pulmonary angiography (BPA) sessions...
October 21, 2017: International Heart Journal
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