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Right heart catheterization

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https://www.readbyqxmd.com/read/28736291/clinical-and-hemodynamic-correlates-and-prognostic-value-of-ve-vco2-slope-in-patients-with-heart-failure-with-preserved-ejection-fraction-and-pulmonary-hypertension
#1
Sebastiaan H C Klaassen, Licette C Y Liu, Yoran M Hummel, Kevin Damman, P van der Meer, Adriaan A Voors, Elke S Hoendermis, Dirk J van Veldhuisen
BACKGROUND: Impaired exercise capacity is one of the hallmarks of heart failure with preserved ejection fraction (HFpEF), but the clinical and hemodynamic correlates and prognostic value of exercise testing in patients with HFpEF is unknown. METHODS: Patients with HFpEF (Left ventricular ejection fraction [LVEF] ≥ 45%) and pulmonary hypertension, underwent cardiopulmonary exercise test (CPX) to measure maximal (peak VO2) and sub maximal (ventilatory equivalent for carbon dioxide [VE/VCO2] slope) exercise capacity...
July 20, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28734831/effects-of-all-oral-anti-viral-therapy-on-hvpg-and-systemic-hemodynamics-in-patients-with-hepatitis-c-virus-associated-cirrhosis
#2
Sabela Lens, Edilmar Alvarado, Zoe Mariño, María-Carlota Londoño, Elba LLop, Javier Martinez, Jose Ignacio Fortea, Luís Ibañez, Xavier Ariza, Anna Baiges, Adolfo Gallego, Rafael Bañares, Angela Puente, Agustín Albillos, Jose Luís Calleja, Xavier Torras, Virginia Hernández-Gea, Jaume Bosch, Cándid Villanueva, Xavier Forns, Juan Carlos García-Pagán
BACKGROUND & AIMS: Patients with hepatitis C virus (HCV)-associated cirrhosis and clinical significant portal hypertension (CSPH, hepatic venous pressure gradient [HVPG] 10 mmHg or greater), despite achieving sustained virological response (SVR) to therapy, remain at risk of liver decompensation. We investigated hemodynamic changes following SVR in patients with CSPH and whether liver stiffness measurements (LSMs) can rule out the presence of CSPH. METHODS: We performed a multicenter prospective study of 226 patients with HCV-associated cirrhosis and CSPH who had SVR to interferon-free therapy at 6 Liver Units in Spain...
July 19, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28729141/effects-of-transjugular-intrahepatic-portosystemic-shunt-tips-on-blood-volume-distribution-in-patients-with-cirrhosis
#3
Troels M Busk, Flemming Bendtsen, Jens H Henriksen, Stefan Fuglsang, Jens O Clemmesen, Fin S Larsen, Søren Møller
BACKGROUND: Cirrhosis is accompanied by portal hypertension with splanchnic and systemic arterial vasodilation, and central hypovolaemia. A transjugular intrahepatic portosystemic shunt (TIPS) alleviates portal hypertension, but also causes major haemodynamic changes. AIMS: To investigate effects of TIPS on regional blood volume distribution, and systemic haemodynamics. METHODS: Thirteen cirrhotic patients had their regional blood volume distribution determined with gamma-camera technique before and after TIPS...
June 27, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28728933/predictors-of-mortality-in-pulmonary-sarcoidosis
#4
Gamze Kirkil, Elyse E Lower, Robert P Baughman
OBJECTIVES: To assess the prognostic strength of factors in predicting respiratory death in a large cohort of sarcoidosis patients with at least eight years' follow-up. METHODS: We collected age, sex, self-declared race, time of death, spirometry, diffusing capacity for carbon monoxide, chest x-ray stage, extent of fibrosis on high resolution computer tomography (HRCT), and presence of pre-capillary pulmonary hypertension (PH). The gender, age, physiology (GAP) index and Walsh's criteria for high versus low risk were calculated...
July 17, 2017: Chest
https://www.readbyqxmd.com/read/28715904/considerations-for-optimal-management-of-patients-with-pulmonary-arterial-hypertension-a-multi-stakeholder-roundtable-discussion
#5
Sean M Studer, Martha Kingman, Luis Calo, H Eric Cannon, Jeffrey D Dunn, Thomas James, Sonya J Lewis, Robert J Gilkin, Janis A Pruett
A roundtable panel of national and regional managed care decision makers and providers met to discuss pulmonary arterial hypertension (PAH) and strategies for management. As a rare, complex disease with high economic costs and potentially devastating outcomes, PAH necessitates that managed care providers balance optimal care with efficient use of healthcare resources. PAH specialists are recognized by health plans as knowledgeable experts and integral partners in managing patients and resources. The diagnosis of PAH must be confirmed by a right heart catheterization...
May 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28715281/admission-for-copd-exacerbation-is-associated-with-the-clinical-diagnosis-of-pulmonary-hypertension-results-from-a-retrospective-longitudinal-study-of-a-veteran-population
#6
Sarah K Medrek, Amir Sharafkhaneh, Andrew M Spiegelman, Arnav Kak, Lavannya M Pandit
Patients with chronic obstructive pulmonary disease and pulmonary hypertension (PH-COPD) have an increased risk of hospitalizations and death compared to COPD alone. Identifying PH in COPD is challenging because performing right heart catheterization, the gold standard for PH diagnosis, is invasive and not routinely performed. Clinical characterization of COPD patients at risk who are progressing toward PH will aid therapeutic development at earlier stages of progressively fatal PH-COPD. We studied the records of 5,45,086 patients in a large Veterans Affairs healthcare network (2000-2012) with a primary discharge diagnosis of COPD based on encounters' ICD-9 codes and further stratified into those who received an additional ICD-9 code for a PH diagnosis...
July 17, 2017: COPD
https://www.readbyqxmd.com/read/28712955/clinical-impact-of-changes-in-hemodynamic-indices-of-contractile-function-during-treatment-of-acute-decompensated-heart-failure
#7
Kenneth C Bilchick, Eliany Mejia-Lopez, Peter McCullough, Khadijah Breathett, Jamie L Kennedy, Jose Tallaj, James Bergin, Salpy Pamboukian, Mohammad Abuannadi, Sula Mazimba
BACKGROUND: The objective was to determine the impact of improving right ventricular versus left ventricular stroke work indices (RVSWI v. LVSWI) during therapy for acute decompensated heart failure (ADHF). METHODS AND RESULTS: Cox proportional hazards regression and logistic regression was used to analyze key factors associated with outcomes in 175 patients (age 56.7 ± 13.6 years, 29.1% female) with hemodynamic data from the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (ESCAPE) trial...
July 13, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28708599/assessing-right-ventricular-function-in-pulmonary-hypertension-patients-and-the-correlation-with-the-new-york-heart-association-nyha-classification
#8
Xiaoke Shang, Shuna Xiao, Nianguo Dong, Rong Lu, Lijun Wang, Bin Wang, Yousan Chen, Liang Zhong, Mei Liu
This investigation aimed to compare the pressure-volume loop (PV loop) measurements in three less symptomatic categories (New York Heart Association classes , NYHA I, II, and III) of pulmonary hypertension (PH) patients since NYHA classification system performance is limited by the shortcomings discussed above.Thirty-six patients were enrolled in this study with PV loop measurement acquisition via micro-conductance catheters. Functional classification according to NYHA was determined with comprehensive assessing function and activity...
July 5, 2017: Oncotarget
https://www.readbyqxmd.com/read/28697895/a-neonatal-rat-model-of-increased-right-ventricular-afterload-by-pulmonary-artery-banding
#9
Shoubao Wang, Lincai Ye, Haifa Hong, Chao Tang, Minghui Li, Zhen Zhang, Jinfen Liu
OBJECTIVE: To construct a neonatal rat model of increased right ventricular (RV) afterload for studying the pathophysiological remodeling of the right ventricle in patients with congenital heart disease with increased RV afterload. METHODS: Surgery was performed within 6 hours after birth. Horizontal thoracotomy was performed by dissecting the intercostal muscles and splitting the sternum. The PA was then banded with 11-0 nylon thread. At postnatal day 7 (P7), constriction of PA was confirmed by echocardiography...
June 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28690953/venous-diversion-surgery-revisited-a-baffling-situation
#10
Jessica R Klassen, Davinder S Jassal, Brett Memauri, Malek Kass, James W Tam, Jonathan Windram, David Ross, Nasir Shaikh
With the increasing number of survivors with congenital heart disease (CHD) reaching adulthood, it is important for the clinician to be familiar with the various surgical options performed in this growing patient population. We describe the case of a 65-year-old female who presented with hypoxia and right-to-left shunting following a surgical repair of an atrial septal defect (ASD) secundum and anomalous pulmonary veins with a partial atrial diversion procedure in childhood. The use of multimodality cardiovascular imaging using echocardiography, computed tomography, magnetic resonance imaging, and invasive cardiac catheterization was complementary in the preoperative diagnosis and management of this unique baffling situation...
June 6, 2017: Curēus
https://www.readbyqxmd.com/read/28690220/-investigation-and-analysis-for-current-situation-and-pathogenesis-relevant-to-pulmonary-hypertension
#11
Si Lei, Doudou Tang, Nianru Xu, Shangjie Wu
To investigate the demographic characteristics and the causes for pulmonary hypertension (PH) in adult patients.
 Methods: A total of 2 508 adult patients diagnosed as PH, who came from the Second Xiangya Hospital of Central South University from January 2010 to December 2014, were retrospectively investigated. All subjects underwent the clinical diagnosis, or the echocardiographic diagnosis, or thetraditional hemodynamic criteria by right heart catheterization (RHC). The patient's data including hospital numbers, gender, ages, primary diseases, etc, are collected and analyzed...
June 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28680580/plasma-acylcarnitines-are-associated-with-pulmonary-hypertension
#12
Nancy Luo, Damian Craig, Olga Ilkayeva, Michael Muehlbauer, William E Kraus, Christopher B Newgard, Svati H Shah, Sudarshan Rajagopal
Quantifying metabolic derangements in pulmonary hypertension (PH) by plasma metabolomics could identify biomarkers useful for diagnosis and treatment. The objective of this paper is to test the hypotheses that circulating metabolites are differentially expressed in PH patients compared with controls and among different hemodynamic subtypes of PH associated with left heart disease. We studied patients enrolled in the CATHGEN biorepository with PH (right heart catheterization mPAP ≥ 25 mmHg; n = 280)...
March 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28680573/treatment-response-in-patients-with-idiopathic-pulmonary-arterial-hypertension-and-a-severely-reduced-diffusion-capacity
#13
Cathelijne E van der Bruggen, Onno A Spruijt, Esther J Nossent, Pia Trip, J Tim Marcus, Frances S de Man, Harm Jan Bogaard, Anton Vonk Noordegraaf
Patients with idiopathic pulmonary arterial hypertension (IPAH) and a reduced diffusion capacity of the lung for carbon monoxide (DLCO) have a worse survival compared to IPAH patients with a preserved DLCO. Whether this poor survival can be explained by unresponsiveness to pulmonary hypertension (PH)-specific vasodilatory therapy is unknown. Therefore, the aim of this study was to evaluate the hemodynamic and cardiac response to PH-specific vasodilatory therapy in patients with IPAH and a reduced DLCO. Retrospectively, we studied treatment naïve hereditary and IPAH patients diagnosed between January 1990 and May 2015 at the VU University Medical Center...
March 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28680572/pulmonary-arterial-hypertension-in-the-usa-an-epidemiological-study-in-a-large-insured-pediatric-population
#14
Lin Li, Susan Jick, Stefanie Breitenstein, Gemzel Hernandez, Alexander Michel, David Vizcaya
Pulmonary arterial hypertension (PAH) is rare in children and few data are available in a pediatric general population. This study aims to calculate the annual incidence and prevalence of PAH and to describe these children in a large US population of patients aged under 18 years. Using the US MarketScan claims database we identified 695 children with PAH in 2010-2013. We calculated annual incidence rates and prevalence overall, by age and PAH type (idiopathic and non-idiopathic) using Byar's method. We also described characteristics, co-morbidities, treatment patterns, and diagnostic procedures for these children...
March 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28679970/clinical-significance-of-pulmonary-arterial-capacitance-calculated-by-echocardiography-in-patients-with-advanced-heart-failure
#15
Yuki Saito, Tomohito Ohtani, Hidetaka Kioka, Toshinari Onishi, Yasumasa Tsukamoto, Kei Nakamoto, Tatsunori Taniguchi, Satoshi Nakatani, Atsushi Hirayama, Yasushi Sakata
BACKGROUND: Advanced left heart failure (HF) often accompanies post-capillary pulmonary hypertension related to RV afterload. Although pulmonary arterial capacitance (PAC), a measure of pulmonary artery compliance, reflects right ventricular (RV) afterload, the clinical utility of PAC obtained by echocardiography (echo-PAC) is not well established in advanced HF.Methods and Results:We performed right heart catheterization in advanced HF patients (n=30), calculating echo-PAC as stroke volume/(tricuspid regurgitation pressure gradient-pulmonary regurgitation pressure gradient)...
July 4, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28671932/associations-of-exercise-tolerance-with-hemodynamic-parameters-for-pulmonary-arterial-hypertension-and-for-chronic-thromboembolic-pulmonary-hypertension
#16
Yasunori Tsuboi, Hidekazu Tanaka, Ryo Nishio, Takuma Sawa, Daisuke Terashita, Kazuhiko Nakayama, Seimi Satomi-Kobayashi, Yoshitada Sakai, Noriaki Emoto, Ken-Ichi Hirata
PURPOSE: Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are the main subgroups of pulmonary hypertension (PH). Despite differences in their etiologies, both diseases are characterized by vascular remodeling, resulting in progressive right heart failure. Noninvasive periodic evaluation of exercise tolerance has become increasingly important. Cardiopulmonary exercise testing (CPET) and a 6-minute walk test (6MWT) are now both recommended for evaluating exercise tolerance, but there is insufficient knowledge about possible differences in the associations of exercise tolerance with right heart catheterization (RHC) data for patients with PAH and CTEPH...
June 30, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28670063/aorto-right-atrial-fistula-after-bentall-repair
#17
Charles E Howard, Carlos E Velasco, Christina P Roullard, Aldo Rafael
We describe a man with the Marfan syndrome and a prior ascending aortic aneurysm resection who presented with knee pain and concern of endocarditis. Transesophageal echocardiogram showed no vegetations, and computed tomography angiogram of the heart showed a possible pseudoaneurysm. Cardiac catheterization and aortogram revealed the diagnosis of an aorto-right atrial fistula, which was then operatively repaired. This case highlights the role that cardiac catheterization with aortogram can play in the detection of aorto-atrial fistula...
July 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28669955/-establishment-of-a-modified-rabbit-model-of-acute-lung-injury-induced-by-cardiopulmonary-bypass
#18
Quan Bao, Xiao-Yang Hong, Jing Tang, Gang Wang, Xi Chen, Zai-Sheng Qin
OBJECTIVE: To establish an modified rabbit model of the acute lung injury induced by cardiopulmonary bypass (CPB) with ascending aorta and right atrium catheterization and detect the changes in serum tumor necrosis factor-α (TNF-α) level after modeling. METHODS: Ten healthy adult male New Zealand rabbits were randomly selected to establish CPB models. The model establishment was deemed successful if the rabbits survived for over 4 h with stable heart beat after termination of CPB...
June 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28667725/right-atrial-diverticulosis-and-early-onset-arrhythmia-rare-cause-of-incessant-neonatal-arrhythmia
#19
Neeraj Aggarwal, Raja Joshi, Reena K Joshi, Mridul Agarwal
BACKGROUND: Atrial flutter not responding to medications could be secondary to structural malformations of heart. CASE CHARACTERISTICS: A 5-year-old child with resistant arrhythmia, with onset in neonatal period. OBSERVATIONS: Multiple right atrial diverticuli were detected on CT angiography and cardiac catheterization. Patient reverted to sinus rhythm following surgical excision of diverticuli. MESSAGE: In cases of intractable supraventricular tachycardia, structural anomalies of atrium should be suspected...
June 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28667665/the-relationship-between-portopulmonary-hypertension-and-splenectomy-mayo-clinic-experience-and-literature-review
#20
Justin M Segraves, Rodrigo Cartin-Ceba, Michael D Leise, Michael J Krowka
BACKGROUND & AIMS: Portopulmonary hypertension is a serious complication of portal hypertension that can lead to right heart failure and death. To our knowledge, an association between portopulmonary hypertension and prior splenectomy has not been described previously. The goals of this study were to describe the frequency of splenectomy in portopulmonary hypertension and compare selected parameters between portopulmonary hypertension subgroups. METHODS: Retrospective analysis of patients diagnosed with portopulmonary hypertension between 01/01/1988 - 06/30/2015 at Mayo Clinic, Rochester, MN...
July 1, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
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