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Right heart catheterization

Masato Nishimura, Toshiko Tokoro, Satoru Yamazaki, Tetsuya Hashimoto, Hiroyuki Kobayashi, Toshihiko Ono
BACKGROUND: We examined the prevalence, prognosis, and effect of endothelin receptor antagonists on survival in end-stage kidney disease patients with idiopathic pre-capillary pulmonary hypertension. METHODS: We investigated 1988 end-stage kidney disease patients in Toujinkai Hospital from January 1, 2001 to December 31, 2014. Pulmonary hypertension was screened by symptoms (dyspnea, hypotension, or near syncope) and echocardiography, and diagnosed by computed tomography with enhancement, pulmonary flow scintigraphy, and right heart catheterization...
October 19, 2016: Clinical and Experimental Nephrology
Matthias Peter Hilty, Andrea Müller, Daniela Flück, Christoph Siebenmann, Peter Rasmussen, Stefanie Keiser, Katja Auinger, Carsten Lundby, Marco Maggiorini
: Matthias Peter Hilty, Andrea Mueller, Daniela Flück, Christoph Siebenmann, Peter Rasmussen, Stefanie Keiser, Katja Auinger, Carsten Lundby, and Marco Maggiorini. Effect of increased blood flow on the pulmonary circulation before and during high altitude acclimatization. High Alt Med Biol. 00:000-000, 2016.-Introduction and Methods: Acute exposure to high altitude increases pulmonary artery pressure (Ppa) and pulmonary vascular resistance (PVR). The evolution of Ppa and PVR with continuous hypoxic exposure remains, however, elusive...
October 18, 2016: High Altitude Medicine & Biology
Domenico Acanfora, Pietro Scicchitano, Gerardo Casucci, Bernardo Lanzillo, Nicola Capuano, Giuseppe Furgi, Chiara Acanfora, Marialaura Longobardi, Raffaele Antonelli Incalzi, Giuseppe Piscosquito, Marco Matteo Ciccone
BACKGROUND: The aim of this study was to evaluate the effect of exercise training on cardiac function in heart failure (HF) patients recently suffering from acute decompensation. Radionuclide ambulatory ventricular function monitoring (VEST) was used to detect variations in cardiac hemodynamics during training period. METHODS: This was a monocentric, randomized, controlled trial. We enrolled 72 HF patients [left ventricle ejection fraction (LVEF) <40%] within two weeks after acute cardiogenic pulmonary edema: 40 in the elderly group, 32 in the middle-aged group...
October 11, 2016: International Journal of Cardiology
David M Turer, Kelly L Koch, Todd M Koelling, Audrey H Wu, Francis D Pagani, Jonathan W Haft
Centrifugal and axial flow left ventricular assist devices have different hydrodynamic properties that may impact the effectiveness of left ventricular unloading. We sought to determine if patients implanted with the HeartWare HVAD (HW) and HeartMate II (HMII) had a similar degree of hemodynamic support by comparing parameters measured using echocardiography and right heart catheterization. Using our prospectively collected database, we identified 268 patients implanted with the HMII and 93 with the HW. Demographic characteristics were similar between groups...
July 26, 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Anikó Ilona Nagy, Ashwin Venkateshvaran, Béla Merkely, Lars H Lund, Aristomenis Manouras
AIMS: The diastolic pulmonary pressure gradient (DPG) has recently been introduced as a specific marker of combined pre-capillary pulmonary hypertension (Cpc-PH) in left heart disease (LHD). However, its diagnostic and prognostic superiority compared with traditional haemodynamic indices has been challenged lately. Current recommendations explicitly denote that in the normal heart, DPG values are greater than zero, with DPG ≥7 mmHg indicating Cpc-PH. However, clinicians are perplexed by the frequent observation of DPG <0 mmHg (DPGNEG ), as its physiological explanation and clinical impact are unclear to date...
October 17, 2016: European Journal of Heart Failure
Emmanuelle Berthelot, David Montani, Vincent Algalarrondo, Céline Dreyfus, Raed Rifai, Anouar Benmalek, Xavier Jais, Amir Bouchachi, Laurent Savale, Gerald Simonneau, Denis Chemla, Marc Humbert, Olivier Sitbon, Patrick Assayag
BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a frequent cause of pulmonary hypertension (PH) that is not easy to differentiate from precapillary PH. We aimed to determine whether the characteristic features of the patients may help differentiate between HFpEF and precapillary-PH. METHODS AND RESULTS: Clinical and echocardiographic parameters were analyzed in 156 patients referred to our PH referral center. Right heart catheterization identified 78 PH-HFpEF patients and 78 precapillary-PH...
October 11, 2016: Journal of Cardiac Failure
Yong Wang, Ting-Ting Ma, Na-Na Gao, Xiao-Ling Zhou, Jiang Hong, Rui Guo, Li-Na Jia, Hong Chang, Ying Gao, Zhi-Min Gao, Lei Pan
ETHNOPHARMACOLOGICAL RELEVANCE: Tongxinluo (TXL),which is a Chinese medicine rooted from traditional used herbs, has been used in clinic to treat cardiovascular and cerebrovascular diseases. However, it remains unknown whether TXL alleviates low pressure hypoxic pulmonary hypertension. AIM OF THE STUDY: Here, we aimed to observe the influence of TXL on pulmonary hypertension in a rat model that exposed to high altitude environment characterized by low pressure hypoxia...
October 10, 2016: Journal of Ethnopharmacology
James Wever-Pinzon, Craig H Selzman, Greg Stoddard, Omar Wever-Pinzon, Anna Catino, Abdallah G Kfoury, Nikolaos A Diakos, Bruce B Reid, Stephen McKellar, Michael Bonios, Antigone Koliopoulou, Deborah Budge, Aaron Kelkhoff, Josef Stehlik, James C Fang, Stavros G Drakos
BACKGROUND: Small-scale studies focused mainly on nonischemic cardiomyopathy (NICM) have shown that a subset of left ventricular assist device (LVAD) patients can achieve significant improvement of their native heart function, but the impact of ischemic cardiomyopathy (ICM) has not been specifically investigated. Many patients with acute myocardial infarction are discharged from their index hospitalization without heart failure (HF), only to return much later with overt HF syndrome, mainly caused by chronic remodeling of the noninfarcted region of the myocardium...
October 18, 2016: Journal of the American College of Cardiology
I E Chazova, T V Martynyuk
Chronic thromboembolic pulmonary hypertension (CTEPH) is precapillary pulmonary hypertension, in which chronic obstruction of large and middle branches of pulmonary arteries (PAs) and secondary changes in the lung microcirculatory bed result in a progressive increase in pulmonary vascular resistance and PA pressure with the development of severe right cardiac dysfunction and heart failure. CTEPH is a unique form of pulmonary hypertension since it is potentially curable by surgical treatment. The diagnostic criteria for CTEPH are a mean PA pressure of ≥25 mm Hg, as evidenced by right heart catheterization; a PA wedge pressure of ≤15 mm Hg; a pulmonary vascular resistance of >2 Wood units; the presence of chronic/organized thrombi/emboli in the elastic PAs (pulmonary trunk, lobular, segmental, subsegmental PAs); effective anticoagulant therapy at therapeutic dosages over at least 3 months...
2016: Terapevticheskiĭ Arkhiv
Mohamed Ghalayini, Pierre-Yves Brun, Pascal Augustin, Elise Guivarch, Marie Pierre Dilly, Sophie Provenchere, Pierre Mordant, Yves Castier, Philippe Montravers, Dan Longrois
Competitive flows syndrome result in severe regional hypoxemia when the deoxygenated flow from the native left ventricle (LV) competes with oxygenated flow from extracorporeal life support (ECLS) pump with potentially severe consequences for the cerebral and coronary circulations. Fast correction of hypoxemia could be obtained by decreasing native LV flow by infusion of a short-acting beta-blocker (esmolol). Our purpose was to retrospectively review the efficacy of esmolol in this situation and hypothesize on the potential mechanisms of action and the associated risks...
September 2016: Journal of Extra-corporeal Technology
Senad Pesto, Zijo Begic, Sabina Prevljak, Ehlimana Pecar, Nihad Kukavica, Edin Begic
Pulmonary hypertension is a pathophysiological state hemodynamically defined as the increase of the mean pulmonary arterial pressure above 25, or 30 mmHg at rest, measured by catheterization of the right heart. Laboratory findings usually reveals polycythemia, the ECG right ventricle hypertrophy, and x-ray characteristic of diseased branches (echocardiography and biomarkers such as B-type natriuretic peptide (BNP) and N-terminal pro-BNP hormones are potentially helpful tools in identifying PH). Echocardiography can be found the increase of the right atrium and ventricle, right ventricular hypertrophy, abnormal contraction of the interventricular septum, left ventricular diastolic dysfunction and decreased left ventricular size, with reduced volumes of systole and end diastole...
July 27, 2016: Medical Archives
Kavita Sharma, Poonam Thankavel
Congenital stenosis/atresia of a coronary artery is an exquisitely rare anomaly (Congenit Heart Dis, 2, 2007, 347) with increased risk of sudden death. Bilateral coronary obstruction is even more unusual but has been reported in conjunction with aortic valve disease, syphilis, and Takayasu's arteritis. To the best of our knowledge, obstruction of both coronaries in a pediatric patient has only been reported once (Ann Thorac Surg, 55, 1993, 1564). We present a patient with an intramural, anomalous aortic origin of the right coronary artery from the contralateral sinus (AAORCA) with near atresia of the left main coronary ostium...
October 4, 2016: Echocardiography
Mengxi Li, Shouyang Wang, Weiquan Lin, Jinhui Li, Chunyang Wang, Huai Chen, Wenju Lu, Kai Yang, Jian Wang, Qingsi Zeng
OBJECTIVE: To develop a formula to compute mean pulmonary arterial pressure (MPAP) by chest computerized tomography (CT), and to verify its accuracy and reliability. METHODS: 85 patients who had taken chest CT and right heart catheterization (RHC) were recruited. The pulmonary arterial systolic pressure (PASP), pulmonary arterial diastolic pressure (PADP) and MPAP of each subject were measured and recorded by right heart catheterization (RHC). The diameters of the ascending aorta (dAA), descending aorta (dDA) and main pulmonary artery (dMPA), Cobb angle, diameters of right ventricle (dRV), diameters of left ventricle (dLV) were measured by means of chest CT scans...
October 3, 2016: Clinical Respiratory Journal
Li Liang, Guofeng Ma, Kai Chen, Yangxiang Liu, Xiaohong Wu, Kejing Ying, Ruifeng Zhang
BACKGROUND: Pulmonary veno-occlusive disease (PVOD) is a rare and devastating cause of pulmonary arterial hypertension with a non-specific clinical presentation and a relatively specific presentation in high-resolution thoracic CT scan images. Definitive diagnosis is made by histological examination in previous. According to the 2015 ESC/ERS Guidelines, detection of a mutation in the eukaryotic translation initiation factor 2 alpha kinase 4 (EIF2AK4) without histological confirmation is recommended to validate the diagnosis of PVOD...
September 2016: Medicine (Baltimore)
Lorenzo Cavagna, Veronica Codullo, Stefano Ghio, Carlo Alberto Scirè, Eleonora Guzzafame, Laura Scelsi, Silvia Rossi, Carlomaurizio Montecucco, Roberto Caporali
Among different subgroups of pulmonary arterial hypertension (PAH), those associated with connective tissue diseases (CTDs) have distinct hemodynamic and prognostic features; a correct etiologic diagnosis is thus mandatory.To estimate frequency and prognosis of previously undiagnosed CTDs in a suspect idiopathic (i) PAH cohort.Consecutive patients with PAH confirmed by right heart catheterization referred at the Cardiology Division of our Hospital without a previous rheumatological assessment or the occurrence of other conditions explaining PAH were checked for CTD by a clinical, laboratory, and instrumental evaluation...
September 2016: Medicine (Baltimore)
Ioana R Preston, Barbara Hinzmann, Sabina Heinz, Henning Gall, David Jenkins, Nick H Kim, Irene Lang
We conducted an international study to evaluate practices in the diagnosis and management of pulmonary arterial hypertension (PAH) globally across different geographic regions. Between July and October 2012, PAH-treating physicians completed a 15-minute online questionnaire and provided patient record data for their 3 or 5 most recent patients with PAH. Overall, 560 physicians (Europe: 278; United States: 160; Argentina: 53; Japan: 69) completed the questionnaire and provided data for 2,618 patients. The proportion of physicians who described themselves as working in or affiliated with a specialized pulmonary hypertension center ranged from 13% in Argentina to 74% in the United States...
September 2016: Pulmonary Circulation
Tufik R Assad, Evan L Brittain, Quinn S Wells, Eric H Farber-Eger, Stephen J Halliday, Laura N Doss, Meng Xu, Li Wang, Frank E Harrell, Chang Yu, Ivan M Robbins, John H Newman, Anna R Hemnes
Although commonly encountered, patients with combined postcapillary and precapillary pulmonary hypertension (Cpc-PH) have poorly understood pulmonary vascular properties. The product of pulmonary vascular resistance and compliance, resistance-compliance (RC) time, is a measure of pulmonary vascular physiology. While RC time is lower in postcapillary PH than in precapillary PH, the RC time in Cpc-PH and the effect of pulmonary wedge pressure (PWP) on RC time are unknown. We tested the hypothesis that Cpc-PH has an RC time that resembles that in pulmonary arterial hypertension (PAH) more than that in isolated postcapillary PH (Ipc-PH)...
September 2016: Pulmonary Circulation
Giuseppe Murdaca, Francesca Lantieri, Francesco Puppo, Gian Paolo Bezante, Manrico Balbi
OBJECTIVE: To investigate the effects of long-term treatment with bosentan on pulmonary arterial hypertension (PAH) in patients with systemic sclerosis. METHODS: Patients with systemic sclerosis were followed between 2003 and 2014; those who developed digital ulcers were treated with standard regimens of bosentan. Patients were assessed at baseline and every 12 months using transthoracic Doppler echocardiography, 6-min walking distance test, Borg dyspnoea index and monitoring of plasma levels of 76-amino-acid N-terminal probrain natriuretic peptide...
September 2016: Journal of International Medical Research
Miki Imazu, Hiroyuki Takahama, Makoto Amaki, Yasuo Sugano, Takahiro Ohara, Takuya Hasegawa, Hideaki Kanzaki, Toshihisa Anzai, Naoki Mochizuki, Hiroshi Asanuma, Masanori Asakura, Masafumi Kitakaze
Recently, fibroblast growth factor 23 (FGF23), a phosphate-regulating hormone, has been linked to the pathophysiology of heart failure (HF), thus encouraging us to examine which hemodynamic abnormalities of HF are linked to either serum FGF23 or plasma B-type natriuretic peptide (BNP) levels. We measured both the serum FGF23 and plasma BNP levels in 154 consecutive prospectively enrolled hospitalized HF patients, with an estimated glomerular filtration rate >40 ml min(-1) 1.73 m(-2), who underwent heart catheterizations and an echocardiogram...
September 29, 2016: Hypertension Research: Official Journal of the Japanese Society of Hypertension
Yuzo Yamasaki, Michinobu Nagao, Kohtaro Abe, Kazuya Hosokawa, Satoshi Kawanami, Takeshi Kamitani, Torahiko Yamanouchi, Koshin Horimoto, Hidetake Yabuuchi, Hiroshi Honda
To use cardiac magnetic resonance imaging (MRI) to investigate the effect of balloon pulmonary angioplasty (BPA) on interventricular dyssynchrony and its associations with ventricular interaction, which impairs LV function in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). This prospective observational study was approved by our institutional review board. Cardiac MRI and right heart catheterization were conducted before BPA sessions and at the follow up after BPA in 20 patients with CTEPH...
September 26, 2016: International Journal of Cardiovascular Imaging
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