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Right heart catheterization

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https://www.readbyqxmd.com/read/28918335/modern-diagnosis-of-chronic-thromboembolic-pulmonary-hypertension
#1
Aileen Kharat, Anne-Lise Hachulla, Stéphane Noble, Frédéric Lador
Chronic thromboembolic pulmonary hypertension (CTEPH) should be suspected in patients presenting persistent dyspnea three months after a pulmonary embolism or in patients presenting with acute pulmonary embolism and suggestive images on the CT-scan. For these patients, a specific diagnostic work-up should be performed. First step consists of the ventilation/perfusion (V/Q) scan which is a good screening test due to its high sensitivity and high negative predictive value. Pulmonary angiography remains the gold standard approach for the confirmation of the diagnosis and pre-surgical evaluation of CTEPH...
September 9, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28912262/diastolic-pressure-difference-to-classify-pulmonary-hypertension-in-the-assessment-of-heart-transplant-candidates
#2
Stephen P Wright, Yasbanoo Moayedi, Farid Foroutan, Suhail Agarwal, Geraldine Paradero, Ana C Alba, Jay Baumwol, Susanna Mak
BACKGROUND: The diastolic pressure difference (DPD) is recommended to differentiate between isolated postcapillary and combined pre-/postcapillary pulmonary hypertension (Cpc-PH) in left heart disease (PH-LHD). However, in usual practice, negative DPD values are commonly calculated, potentially related to the use of mean pulmonary artery wedge pressure (PAWP). We used the ECG to gate late-diastolic PAWP measurements. We examined the method's impact on calculated DPD, PH-LHD subclassification, hemodynamic profiles, and mortality...
September 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28912260/decoupling-between-diastolic-pulmonary-artery-pressure-and-pulmonary-capillary-wedge-pressure-as-a-prognostic-factor-after-continuous-flow-ventricular-assist-device-implantation
#3
Teruhiko Imamura, Ben Chung, Ann Nguyen, Daniel Rodgers, Gabriel Sayer, Sirtaz Adatya, Nitasha Sarswat, Gene Kim, Jayant Raikhelkar, Takeyohi Ota, Tae Song, Colleen Juricek, Viktoriya Kagan, Valluvan Jeevanandam, Mandeep Mehra, Daniel Burkhoff, Nir Uriel
BACKGROUND: A cohort of heart failure (HF) patients receiving left ventricular assist devices (LVADs) has decoupling of their diastolic pulmonary artery pressure and pulmonary capillary wedge pressure. However, the clinical implications of this decoupling remain unclear. METHODS AND RESULTS: In this prospective study, patients with LVADs underwent routine invasive hemodynamic ramp testing with right heart catheterization, during which LVAD speeds were adjusted. Inappropriate decoupling was defined as a >5 mm Hg difference between diastolic pulmonary artery pressure and pulmonary capillary wedge pressure...
September 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28912040/inaccuracy-of-right-atrial-pressure-estimates-through-inferior-vena-cava-indices
#4
Corrado Magnino, Pierluigi Omedè, Eleonora Avenatti, Davide Presutti, Andrea Iannaccone, Michela Chiarlo, Claudio Moretti, Fiorenzo Gaita, Franco Veglio, Alberto Milan
The precision of echocardiography in estimating pulmonary pressures has been debated. A value of right atrial pressure (RAP) is needed for pulmonary pressure estimation, and it could be partly responsible for the estimation error. Several schemes based on the inferior vena cava (IVC) are commonly used in clinical practice and in experimental studies for RAP estimation. However, the majority lack proper validation, and thus far, no study has compared them all. In this prospective, blinded study, a comprehensive transthoracic echocardiography was performed on 200 patients referred for right heart catheterization...
July 31, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28902643/prevalence-and-characteristics-of-coronary-artery-anomalies-in-children-with-congenital-heart-disease-diagnosed-with-coronary-angiography
#5
Münevver Tuğba Temel, Mehmet Enes Coşkun, Osman Başpınar, Abdullah Tuncay Demiryürek
OBJECTIVE: Aim of the present study was to determine the prevalence of coronary artery anomalies in children with congenital heart disease. METHODS: Data of 1138 consecutive patients who were referred for cardiac catheterization and angiography for assessment of coronary anomaly between January 2005 and December 2009 were retrospectively analyzed. Total of 515 patients whose coronary arteries could be examined through left ventricle and aortic root injection were included in the study...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28895507/functional-impact-of-exercise-pulmonary-hypertension-in-patients-with-borderline-resting-pulmonary-arterial-pressure
#6
Rudolf K F Oliveira, Mariana Faria-Urbina, Bradley A Maron, Mario Santos, Aaron B Waxman, David M Systrom
Borderline resting mean pulmonary arterial pressure (mPAP) is associated with adverse outcomes and affects the exercise pulmonary vascular response. However, the pathophysiological mechanisms underlying exertional intolerance in borderline mPAP remain incompletely characterized. In the current study, we sought to evaluate the prevalence and functional impact of exercise pulmonary hypertension (ePH) across a spectrum of resting mPAP's in consecutive patients with contemporary resting right heart catheterization (RHC) and invasive cardiopulmonary exercise testing...
July 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28887041/partial-anomalous-pulmonary-venous-connection-in-a-dog
#7
Chloe L Thorn, Naomi R Ford, Meg M Sleeper
A 2-year-old male intact Belgian Malinois was presented for exercise intolerance. A grade III/VI left basilar systolic murmur was detected. Echocardiography revealed moderate right atrial and ventricular dilation and increased pulmonic outflow velocity. Thoracic radiographs showed right heart enlargement and a dilated caudal vena cava. In addition, on the left lateral projection, an enlarged aberrant right cranial pulmonary lobar vein was suspected to be diverging ventrally from the course of the right cranial lobar bronchus and inserting more ventrally than normal in the region of the right atrium...
September 5, 2017: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
https://www.readbyqxmd.com/read/28877886/pulmonary-right-ventricular-resynchronization-in-congenital-heart-disease-acute-improvement-in-right-ventricular-mechanics-and-contraction-efficiency
#8
Jan Janoušek, Jan Kovanda, Miroslav Ložek, Viktor Tomek, Pavel Vojtovič, Roman Gebauer, Peter Kubuš, Miroslav Krejčíř, Joost Lumens, Tammo Delhaas, Frits Prinzen
BACKGROUND: Electromechanical discoordination may contribute to long-term pulmonary right ventricular (RV) dysfunction in patients after surgery for congenital heart disease. We sought to evaluate changes in RV function after temporary RV cardiac resynchronization therapy. METHODS AND RESULTS: Twenty-five patients aged median 12.0 years after repair of tetralogy of Fallot and similar lesions were studied echocardiographically (n=23) and by cardiac catheterization (n=5) after primary repair (n=4) or after surgical RV revalvulation for significant pulmonary regurgitation (n=21)...
September 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28877293/thermodilution-vs-estimated-fick-cardiac-output-measurement-in-clinical-practice-an-analysis-of-mortality-from-the-veterans-affairs-clinical-assessment-reporting-and-tracking-va-cart-program-and-vanderbilt-university
#9
Alexander R Opotowsky, Edward Hess, Bradley A Maron, Evan L Brittain, Anna E Barón, Thomas M Maddox, Laith I Alshawabkeh, Bradley M Wertheim, Meng Xu, Tufik R Assad, Jonathan D Rich, Gaurav Choudhary, Ryan J Tedford
Importance: Thermodilution (Td) and estimated oxygen uptake Fick (eFick) methods are widely used to measure cardiac output (CO). They are often used interchangeably to make critical clinical decisions, yet few studies have compared these approaches as applied in medical practice. Objectives: To assess agreement between Td and eFick CO and to compare how well these methods predict mortality. Design, Setting, and Participants: This investigation was a retrospective cohort study with up to 1 year of follow-up...
September 6, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28874164/radiation-free-cmr-diagnostic-heart-catheterization-in-children
#10
Kanishka Ratnayaka, Joshua P Kanter, Anthony Z Faranesh, Elena K Grant, Laura J Olivieri, Russell R Cross, Ileen F Cronin, Karin S Hamann, Adrienne E Campbell-Washburn, Kendall J O'Brien, Toby Rogers, Michael S Hansen, Robert J Lederman
BACKGROUND: Children with heart disease may require repeated X-Ray cardiac catheterization procedures, are more radiosensitive, and more likely to survive to experience oncologic risks of medical radiation. Cardiovascular magnetic resonance (CMR) is radiation-free and offers information about structure, function, and perfusion but not hemodynamics. We intend to perform complete radiation-free diagnostic right heart catheterization entirely using CMR fluoroscopy guidance in an unselected cohort of pediatric patients; we report the feasibility and safety...
September 6, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28866441/cardiac-magnetic-resonance-evaluation-of-left-ventricular-myocardial-strain-in-pulmonary-hypertension
#11
Kimberly Kallianos, Gabriel C Brooks, Kanae Mukai, Florent Seguro de Carvalho, Jing Liu, David M Naeger, Teresa De Marco, Karen G Ordovas
RATIONALE AND OBJECTIVES: We investigated the feasibility of detecting left ventricular (LV) cardiac magnetic resonance (CMR) strain abnormalities using feature-tracking in patients with pulmonary hypertension (PH). MATERIALS AND METHODS: CMR was performed in 16 patients with all groups of PH and in 13 controls. Global and regional peak circumferential strains (%) (which have been shown to be robust by CMR), peak diastolic strain rate (%/s), and dyssynchrony index (ms) were quantified with feature-tracking software...
August 30, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28855497/a-49-year-old-man-with-subacute-respiratory-failure-and-interstitial-lung-opacities
#12
Anastasiia A Rudkovskaia, Ying-Chun Lo, Virginia Brady, Jose Costa, Wassim H Fares
BACKGROUND Pulmonary arterial hypertension (PAH) results from proliferative vasculopathy involving all layers of the blood vessel. Similar findings may be present in pulmonary hypertension (PH) associated with microscopic tumor embolism, which are thought to be related to the phenomenon of pulmonary tumor thrombotic microangiopathy (PTTM). PTTM is associated with the activation of the coagulation system at the surface of the tumor emboli, resulting in stenosis or occlusion of the vessel. CASE REPORT A 49-year-old man with stage IV gastro-esophageal junction adenocarcinoma presented with complaints of cough and shortness of breath...
August 31, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28851621/pulmonary-arterial-hypertension-associated-with-systemic-lupus-erythematosus-results-from-the-french-pulmonary-hypertension-registry
#13
Eric Hachulla, Xavier Jais, Gaël Cinquetti, Pierre Clerson, Laurence Rottat, David Launay, Vincent Cottin, Gilbert Habib, Grégoire Prevot, Céline Chabanne, Eléna Foïs, Zahir Amoura, Luc Mouthon, Véronique Le Guern, David Montani, Gérald Simonneau, Marc Humbert, Vincent Sobanski, Olivier Sitbon
BACKGROUND: Pulmonary arterial hypertension (PAH) is a rare complication of systemic lupus erythematosus (SLE). METHODS: We identified all patients with SLE and PAH (SLE-PAH) who were enrolled in the French Pulmonary Hypertension Registry with a diagnosis confirmed by right heart catheterization (RHC). A control group of 101 patients with SLE without known PAH was selected from SLE expert centers participating in the Pulmonary Hypertension Registry. Survival was estimated by the Kaplan-Meier method...
August 26, 2017: Chest
https://www.readbyqxmd.com/read/28844500/right-atrial-function-and-prognosis-in-idiopathic-pulmonary-arterial-hypertension
#14
Michele D'Alto, Antonello D'Andrea, Giovanni Di Salvo, Giancarlo Scognamiglio, Paola Argiento, Emanuele Romeo, Giovanni Maria Di Marco, Agostino Mattera Iacono, Eduardo Bossone, Berardo Sarubbi, Maria Giovanna Russo
AIM: To determine whether right atrial (RA) function has prognostic value in patients with idiopathic pulmonary arterial hypertension (PAH). METHODS AND RESULTS: Overall, 104 patients (70 female, mean age 58±13years) with idiopathic PAH underwent standard Doppler echocardiography and strain and strain rate (SR) analysis before right heart catheterization. At a mean follow-up of 22±7months, 30 patients (29%) had clinical worsening. On Cox multivariable proportional-hazards regression analysis, RA reservoir function measured as peak longitudinal SR (hazard ratio [HR] 0...
August 24, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28843055/exercise-right-heart-catheterization-for-pulmonary-hypertension-identified-on-screening-echocardiography-in-adult-survivors-of-childhood-cancer-a-report-from-the-st-jude-lifetime-cohort
#15
Gregory T Armstrong, James J Tolle, Robert Piana, Aimee Santucci, James Leathers, Kirsten K Ness, Daniel A Mulrooney, Daniel M Green, Vijaya M Joshi, Leslie L Robison, Melissa M Hudson, Daniel Lenihan
Pulmonary hypertension, determined noninvasively by tricuspid regurgitant jet velocity on Doppler echocardiography, was previously identified in 25% of long-term survivors who received chest-directed radiotherapy. To validate noninvasively defined pulmonary hypertension, survivors (mean age 48 years), exposed to chest radiotherapy, underwent right heart catheterization with planned cardiopulmonary exercise testing during catheterization. Eight participants had an elevated mean pulmonary artery pressure at rest (≥25 mm Hg) or with subsequent exercise (>30 mm Hg), evidence of hemodynamically confirmed pulmonary hypertension by right heart catheterization...
August 26, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28839102/the-beginnings-of-cardiac-catheterization-and-the-resulting-impact-on-pulmonary-medicine
#16
John B West
The early history of cardiac catheterization has many interesting features. First, although it would be natural to assume that the procedure was initiated by cardiologists, two of the three people who shared the Nobel Prize for the discovery were pulmonologists, while the third was a urologist. The primary objective of the pulmonologists, André Cournand and Dickinson Richards, was to obtain mixed venous blood from the right heart so that they could use to use the Fick principle to calculate total pulmonary blood flow...
August 24, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28836315/inotropic-myocardial-reserve-deficiency-is-the-predominant-feature-of-exercise-haemodynamics-in-cardiac-amyloidosis
#17
Tor Skibsted Clemmensen, Henning Mølgaard, Jens Sörensen, Hans Eiskjaer, Niels Frost Andersen, Søren Mellemkjaer, Mads Jønsson Andersen, Lars Poulsen Tolbod, Hendrik J Harms, Steen Hvitfeldt Poulsen
AIMS: This study aimed to characterize invasive haemodynamics during exercise in subjects with cardiac amyloidosis (CA). METHODS AND RESULTS: The study population numbered 44 subjects. Group A (CA-positive, n = 24) comprised wild-type transthyretin patients (n = 10), familial transthyretin amyloidosis mutation carriers (ATTRm) with cardiac involvement (n = 5), and light-chain amyloidosis patients with cardiac involvement (n = 9). Group B (CA-negative, n = 20) comprised four healthy ATTRm subjects without cardiac involvement documented by (11) C-PIB positron emission tomography and 16 healthy controls...
August 24, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28832374/chronic-thromboembolic-pulmonary-hypertension-epidemiology-diagnosis-and-management
#18
Srikanth Yandrapalli, Sohaib Tariq, Jessica Kumar, Wilbert S Aronow, Ramin Malekan, William H Frishman, Gregg M Lanier
Chronic thromboembolic pulmonary hypertension (CTEPH), classified as WHO group 4 pulmonary hypertension (PH), is an interesting and rare pulmonary vascular disorder secondary to mechanical obstruction of the pulmonary vasculature from thromboembolism resulting in PH. The pathophysiology is complex, beginning with mechanical obstruction of the pulmonary arteries, which eventually leads to arteriopathic changes and vascular remodeling in the non-occluded arteries and in the distal segments of the occluded arteries mediated by thrombus non-resolution, abnormal angiogenesis, endothelial dysfunction, and various local growth factors...
August 18, 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28831765/validation-of-transpulmonary-thermodilution-variables-in-hemodynamically-stable-patients-with-heart-diseases
#19
Matthias Peter Hilty, Daniel Peter Franzen, Christophe Wyss, Patric Biaggi, Marco Maggiorini
BACKGROUND: Transpulmonary thermodilution is recommended in the treatment of critically ill patients presenting with complex shock. However, so far it has not been validated in hemodynamically stable patients with heart disease. METHODS: We assessed the validity of cardiac output, global end-diastolic volume index (GEDVI), an established marker of preload thought to reflect the volume of all four heart chambers, global ejection fraction (GEF) and cardiac function index (CFI) as variables of cardiac function, and extravascular lung water index (EVLWI) as indicator of pulmonary edema in 29 patients undergoing elective left and right heart catheterization including left ventricular angiography with stable coronary heart disease and normal cardiac function (controls, n = 11), moderate-to-severe aortic valve stenosis (AS, n = 10), or dilated cardiomyopathy (DCM, n = 8)...
August 22, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28821335/symptoms-are-more-useful-than-echocardiography-in-patient-selection-for%C3%A2-pulmonary-endarterectomy
#20
Laura Donahoe, Rachel Vanderlaan, John Thenganatt, Karen McRae, Anastasia Bykova, Jakov Moric, John Granton, Marc de Perrot
BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) is still largely underdiagnosed in the general population. Although transthoracic echocardiogram (TTE) is recommended to screen for CTEPH, it may not detect patients with chronic thromboembolic disease (CTED) and mild or exercise-induced pulmonary hypertension (PH) who could also benefit from pulmonary endarterectomy (PEA). METHODS: All patients referred to our CTEPH program with persistent mismatched perfusion defects on ventilation-perfusion (VQ) scan between January 2005 and June 2015 were divided into three groups according to TTE and right heart catheterization (RHC) as follows: (1) typical CTEPH group (PH on RHC and TTE), (2) TTE-negative (neg) CTEPH group (PH on RHC, but not TTE), or (3) CTED group (no PH on RHC and TTE)...
August 16, 2017: Annals of Thoracic Surgery
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