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https://www.readbyqxmd.com/read/28102961/assessing-the-use-of-4dct-ventilation-in-pre-operative-surgical-lung-cancer-evaluation
#1
Yevgeniy Vinogradskiy, Matthew Jackson, Leah Schubert, Bernard Jones, Richard Castillo, Edward Castillo, Thomas Guerrero, John Mitchell, Chad Rusthoven, Moyed Miften, Brian Kavanagh
PURPOSE: A primary treatment option for lung cancer patients is surgical resection. Patients who have poor lung function prior to surgery are at increased risk of developing serious and life-threatening complications after surgical resection. Surgeons use nuclear medicine ventilation-perfusion (VQ) scans along with pulmonary function test (PFT) information to assess a patient's pre-surgical lung function. The nuclear medicine images and pre-surgery PFTs are used to calculate percent predicted postoperative (%PPO) PFT values by estimating the amount of functioning lung tissue that would be lost with surgical resection...
January 2017: Medical Physics
https://www.readbyqxmd.com/read/28095020/current-status-of-ventilation-perfusion-scintigraphy-for-suspected-pulmonary-embolism
#2
Darlene Metter, Mark Tulchinsky, Leonard M Freeman
OBJECTIVE: The purpose of this article is to outline recent progress made in ventilation-perfusion (V/Q) scintigraphy imaging techniques and the interpretation systems used for the diagnosis of pulmonary embolism (PE). Various state-of-the-art approaches that can be selected according to the needs dictated by the medical practice environment and specific patient groups are presented. CONCLUSION: Although advances in tomographic imaging have certainly improved the sensitivity of V/Q scans for the diagnosis of PE, they may lead to overdiagnosis by revealing small and clinically insignificant PEs...
January 17, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28090289/an-international-physician-survey-of-chronic-thromboembolic-pulmonary-hypertension-management
#3
Henning Gall, Ioana R Preston, Barbara Hinzmann, Sabina Heinz, David Jenkins, Nick H Kim, Irene Lang
We conducted an international study to evaluate practices in the diagnosis and management of patients with chronic thromboembolic pulmonary hypertension (CTEPH) globally across different regions. Between August and October 2012, CTEPH-treating physicians completed a 15-minute online questionnaire and provided patient record data for their 2-5 most recent patients with CTEPH. Overall, 496 physicians (Europe: 260; United States: 152; Argentina: 52; Japan: 32) completed the questionnaire and provided patient record data for 1,748 patients...
December 2016: Pulmonary Circulation
https://www.readbyqxmd.com/read/28060193/imaging-in-chronic-thromboembolic-pulmonary-hypertension
#4
Rahul D Renapurkar, Sankaran Shrikanthan, Gustavo A Heresi, Charles T Lau, Deepa Gopalan
Chronic thromboembolic pulmonary hypertension (CTEPH) is one of the potentially curable causes of pulmonary hypertension and is definitively treated with pulmonary thromboendartectomy. CTEPH can be overlooked, as its symptoms are nonspecific and can be mimicked by a wide range of diseases that can cause pulmonary hypertension. Early diagnosis of CTEPH and prompt evaluation for surgical candidacy are paramount factors in determining future outcomes. Imaging plays a central role in the diagnosis of CTEPH and patient selection for pulmonary thromboendartectomy and balloon pulmonary angioplasty...
January 2, 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28029591/cardiorespiratory-interactions-in-paediatrics-it-s-almost-always-the-circulation-stupid
#5
REVIEW
M L Rigby, M Rosenthal
The interaction of the heart and lungs is probably the most important aspect of life and survival. Fortunately, it is not difficult to understand the fundamentals. The purpose of the lungs and their ventilation is to present oxygen to the circulation via the alveoli and to receive carbon dioxide from the circulation and then expel it. The relations of the heart and lungs and the matching of blood flow to the various organs with ventilation and lung perfusion may be disrupted by a variety of congenital or acquired heart malformations...
August 12, 2016: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/28013417/left-atrial-mechanics-strongly-predict-functional-capacity-assessed-by-cardiopulmonary-exercise-testing-in-subjects-without-structural-heart-disease
#6
Luís Leite, Sofia Lázaro Mendes, Rui Baptista, Rogério Teixeira, Manuel Oliveira-Santos, Nelson Ribeiro, Rosa Coutinho, Victor Monteiro, Rui Martins, Graça Castro, Maria João Ferreira, Mariano Pego
Left atrium function is essential for cardiovascular performance and is evaluable by two-dimensional speckle-tracking echocardiography (2D-STE). Our aim was to determine how echocardiographic parameters interrelate with exercise capacity and ventilatory efficiency in subjects with no structural heart disease. Asymptomatic volunteers, in sinus rhythm and with normal biventricular size and function, were recruited from a community-based population. Individuals with moderate-to-severe valvular disease, pulmonary hypertension, and history of cardiac disease were excluded...
December 24, 2016: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28012013/ventilation-perfusion-ratio-and-right-to-left-shunt-in-healthy-newborn-infants
#7
Theodore Dassios, Kamal Ali, Thomas Rossor, Anne Greenough
Oxygenation impairment can be assessed non-invasively by determining the degree of right-to-left shunt and ventilation/perfusion (VA/Q) inequality. These indices have been used in sick newborn infants, but normative values have not been reported which are essential to determine the magnitude of the abnormality. We, therefore, aimed to measure the shunt and VA/Q in infants with no history of respiratory conditions and determine if there was any effect of supine or prone position and the reproducibility of the data...
December 23, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27995008/desflurane-inhalation-before-ischemia-increases-ischemia-reperfusion-induced-vascular-leakage-in-isolated-rabbit-lungs
#8
Yoshiaki Oshima, Seiji Sakamoto, Kazumasa Yamasaki, Shinsuke Mochida, Kazumi Funaki, Naoki Moriyama, Akihiro Otsuki, Ryo Endo, Masato Nakasone, Shunsaku Takahashi, Tomomi Harada, Yukari Minami, Yoshimi Inagaki
BACKGROUND: Isoflurane and sevoflurane protect lungs with ischemia-reperfusion (IR) injury. We examined the influence of desflurane on IR lung injury using isolated rabbit lungs perfused with a physiological salt solution. METHODS: The isolated lungs were divided into three groups: IR, desflurane-treated ischemia-reperfusion (DES-IR), and ventilation/perfusion-continued control (Cont) groups (n = 6 per group). In the DES-IR group, inhalation of desflurane at 1 minimum alveolar concentration (MAC) was conducted in a stable 30-min phase...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27977536/incidence-of-a-single-subsegmental-mismatched-perfusion-defect-in-single-photon-emission-computed-tomography-and-planar-ventilation-perfusion-scans
#9
Matthew Stubbs, Kenneth Chan, Helena McMeekin, Shaunak Navalkissoor, Thomas Wagner
OBJECTIVE: This study aims to compare the incidence of ventilation/perfusion (V/Q) scans interpreted as indeterminate for the diagnosis of pulmonary embolism (PE) using single-photon emission computed tomography (SPECT) versus planar scintigraphy and to consider the effect of variable interpretation of single subsegmental V/Q mismatch (SSM). METHODS: A total of 1300 consecutive V/Q scans were retrospectively reviewed. After exclusion and matching for age and sex, 542 SPECT and 589 planar scans were included in the analysis...
December 13, 2016: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/27913507/diagnosis-of-suspected-venous-thromboembolism
#10
Clive Kearon
The primary goal of diagnostic testing for venous thromboembolism (VTE) is to identify all patients who could benefit from anticoagulant therapy. Test results that identify patients as having a ≤2% risk of VTE in the next 3 months are judged to exclude deep vein thrombosis (DVT) or pulmonary embolism (PE). Clinical evaluation, with assessment of: (1) clinical pretest probability (CPTP) for VTE; (2) likelihood of important alternative diagnoses; and (3) the probable yield of D-dimer and various imaging tests, guide which tests should be performed...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27886421/pathophysiology-of-dyspnoea-in-acute-pulmonary-embolism-a-cross-sectional-evaluation
#11
Olivier Sanchez, Aurore Caumont-Prim, Elisabeth Riant, Laurent Plantier, Martin Dres, Bruno Louis, Marie-Anne Collignon, Benoit Diebold, Guy Meyer, Claudine Peiffer, Christophe Delclaux
BACKGROUND AND OBJECTIVE: Dyspnoea in pulmonary embolism (PE) remains poorly characterized. Little is known about how to measure intensity or about the underlying mechanisms that may be related to ventilatory abnormalities, alveolar dead space ventilation or modulating factors such as psychological modulate. We hypothesized that dyspnoea would mainly be associated with pulmonary vascular obstruction and its pathophysiological consequences, while the sensory-affective domain of dyspnoea would be influenced by other factors...
November 25, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27820928/pulmonary-perfusion-changes-as-assessed-by-contrast-enhanced-dual-energy-computed-tomography-after-endoscopic-lung-volume-reduction-by-coils
#12
Frédéric Lador, Anne-Lise Hachulla, Olivia Hohn, Jérôme Plojoux, Maxime Ronot, Xavier Montet, Paola M Soccal
BACKGROUND: Endoscopic lung volume reduction by coils (LVRC) is a recent treatment approach for severe emphysema. Furthermore, dual-energy computed tomography (DECT) now offers a combined assessment of lung morphology and pulmonary perfusion. OBJECTIVES: The aim of our study was to assess the impact of LVRC on pulmonary perfusion with DECT. METHODS: Seventeen patients (64.8 ± 6.7 years) underwent LVRC. DECT was performed prior to and after LVRC...
2016: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27816974/troponin-i-and-d-dimer-for-discriminating-acute-pulmonary-thromboembolism-from-myocardial-infarction
#13
Soo Jin Kim, Moo Hyun Kim, Kwang Min Lee, Tae Hyung Kim, Sun Yong Choi, Min Kook Son, Ji Woen Park, Victor L Serebruany
BACKGROUND: Acute pulmonary thromboembolism (APTE) is a life-threatening condition, often manifesting with chest pain, dyspnea, and increased cardiac biomarkers including cardiac troponin I (CTI) and D-dimer. Therefore, APTE is often misdiagnosed with classical non-ST elevation myocardial infarction (NSTEMI), resulting in unnecessary coronary interventions and a delay of therapy. OBJECTIVES: Our aim was to distinguish APTE from NSTEMI based on CTI and D-dimer levels...
November 5, 2016: Cardiology
https://www.readbyqxmd.com/read/27815969/residual-pulmonary-vascular-obstruction-and-recurrence-after-acute-pulmonary-embolism-a-single-center-cohort-study
#14
Benjamin Planquette, Alexis Ferré, Julien Peron, Amandine Vial-Dupuy, Jean Pastre, Gisèle Mourin, Joseph Emmerich, Marie-Anne Collignon, Guy Meyer, Olivier Sanchez
INTRODUCTION: Up to 50% of patients with pulmonary embolism (PE) present lung perfusion defects after six months of anticoagulant treatment, suggesting residual pulmonary vascular obstruction (RPVO). The risk of recurrence in patients with RPVO remains unknown. The present study aims to assess the risk of recurrent venous thromboembolism (VTE) in patients with RPVO after a first symptomatic episode of PE. METHODS: Consecutive patients who survived a first objectively proven acute PE, treated for at least three months with anticoagulants, were included and followed prospectively...
December 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27815261/soluble-epoxide-hydrolase-deficiency-or-inhibition-enhances-murine-hypoxic-pulmonary-vasoconstriction-after-lipopolysaccharide-challenge
#15
Martin Wepler, Arkadi Beloiartsev, Mary D Buswell, Dipak Panigrahy, Rajeev Malhotra, Emmanuel S Buys, Peter Radermacher, Fumito Ichinose, Donald B Bloch, Warren M Zapol
Hypoxic pulmonary vasoconstriction (HPV) is the response of the pulmonary vasculature to low levels of alveolar oxygen. HPV improves systemic arterial oxygenation by matching pulmonary perfusion to ventilation during alveolar hypoxia and is impaired in lung diseases such as the acute respiratory distress syndrome (ARDS) and in experimental models of endotoxemia. Epoxyeicosatrienoic acids (EETs) are pulmonary vasoconstrictors, which are metabolized to less vasoactive dihydroxyeicosatrienoic acids (DHETs) by soluble epoxide hydrolase (sEH)...
December 1, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/27797317/prevalence-of-pulmonary-embolism-among-patients-hospitalized-for-syncope
#16
Paolo Prandoni, Anthonie W A Lensing, Martin H Prins, Maurizio Ciammaichella, Marica Perlati, Nicola Mumoli, Eugenio Bucherini, Adriana Visonà, Carlo Bova, Davide Imberti, Stefano Campostrini, Sofia Barbar
Background The prevalence of pulmonary embolism among patients hospitalized for syncope is not well documented, and current guidelines pay little attention to a diagnostic workup for pulmonary embolism in these patients. Methods We performed a systematic workup for pulmonary embolism in patients admitted to 11 hospitals in Italy for a first episode of syncope, regardless of whether there were alternative explanations for the syncope. The diagnosis of pulmonary embolism was ruled out in patients who had a low pretest clinical probability, which was defined according to the Wells score, in combination with a negative d-dimer assay...
October 20, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27793158/clinical-and-echocardiographic-predictors-of-mortality-in-acute-pulmonary-embolism
#17
Talal Dahhan, Irfan Siddiqui, Victor F Tapson, Eric J Velazquez, Stephanie Sun, Clemontina A Davenport, Zainab Samad, Sudarshan Rajagopal
PURPOSE: The aim of this study was to evaluate the utility of adding quantitative assessments of cardiac function from echocardiography to clinical factors in predicting the outcome of patients with acute pulmonary embolism (PE). METHODS: Patients with a diagnosis of acute PE, based on a positive ventilation perfusion scan or computed tomography (CT) chest angiogram, were identified using the Duke University Hospital Database. Of these, 69 had echocardiograms within 24-48 h of the diagnosis that were suitable for offline analysis...
October 28, 2016: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/27784118/c-arm-computed-tomography-adds-diagnostic-information-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-and-a-positive-v-q-spect
#18
Jan B Hinrichs, Thomas Werncke, Till Kaireit, Marius M Hoeper, Karen M Olsson, Jan-Christopher Kamp, Frank K Wacker, Frank Bengel, Christian von Falck, Imke Schatka, Bernhard C Meyer
Purpose To determine if C-Arm computed tomography (CACT) has added diagnostic value in patients suffering from chronic thromboembolic pulmonary hypertension (CTEPH) with a positive mismatch pattern in ventilation/perfusion single photon emission computed tomography (V/Q SPECT). Materials and Methods 28 patients (23 men, 5 women, 62 ± 18 years) with CTEPH who had undergone SPECT, followed by CACT and right heart catheterization (RHC) were included. Two independent readers reviewed SPECT and CACT. Findings indicating CTEPH and their location (segmental or sub-segmental) were identified (V/Q mismatch in SPECT and vascular pathologies in CACT)...
January 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/27764879/state-of-the-art-imaging-in-pulmonary-embolism-ventilation-perfusion-single-photon-emission-computed-tomography-versus-computed-tomography-angiography-controversies-results-and-recommendations-from-a-systematic-review
#19
Søren Hess, Evan C Frary, Oke Gerke, Poul Henning Madsen
Pulmonary embolism (PE) is a common, ubiquitous, and potentially lethal disease. As symptoms and clinical findings are notoriously nonspecific, diagnostic imaging is essential to avoid undertreatment as well as overtreatment. Controversies remain regarding first-line imaging in suspected PE. The two main contemporary contenders are ventilation/perfusion scintigraphy with single-photon emission computed tomography (V/Q SPECT) with or without additional low-dose CT (SPECT/CT) and CT angiography (CTA). We present our results from a systematic review and meta-analysis of the diagnostic performances of these modalities: V/Q SPECT, V/Q SPECT/CT, and CTA are all viable options, but we consider V/Q SPECT/CT to be superior in most clinical settings with better overall diagnostic performance, that is, pooled sensitivities (97...
November 2016: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/27758995/pulmonary-stenting-for-the-treatment-of-sarcoid-induced-pulmonary-vascular-stenosis
#20
Jose F Condado, Vasilis Babaliaros, Travis S Henry, Brian Kaebnick, Dennis Kim, Gerald W Staton
BACKGROUND: The best treatment of patients with external pulmonary vascular compression due to advanced sarcoidosis is unknown. OBJECTIVES: To report a single-center experience of percutaneous treatment for pulmonary vascular stenosis caused by external compression due to advanced sarcoidosis. METHODS: We report a case series of 5 patients with biopsy confirmed advanced sarcoidosis, seen at our academic institution with worsening dyspnea despite increase of immunosuppressive therapy...
October 7, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
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