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https://www.readbyqxmd.com/read/29428946/determination-of-cardiac-output-in-pulmonary-hypertension-using-impedance-cardiography
#1
Marion Dupuis, Elise Noel-Savina, Gregoire Prévot, Laurent Tétu, Fabien Pillard, Daniel Rivière, Alain Didier
BACKGROUND: Cardiac output (CO) is a prognostic factor in pulmonary hypertension (PH). Right heart catheterisation using the direct Fick method or thermodilution (TD) is the reference technique for CO measurement. Impedance cardiography (IPc) is a known non-invasive method of measuring CO. OBJECTIVES: In our study, we assume that the measurement of CO by IPc using the PHYSIOFLOW® system is as accurate as TD or using the direct Fick method in patients with PH in group 1 or group 4...
February 9, 2018: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29348178/a-scoring-system-to-predict-the-elevation-of-mean-pulmonary-arterial-pressure-in-idiopathic-pulmonary-fibrosis
#2
Taiki Furukawa, Yasuhiro Kondoh, Hiroyuki Taniguchi, Mitsuaki Yagi, Toshiaki Matsuda, Tomoki Kimura, Kensuke Kataoka, Takeshi Johkoh, Masahiko Ando, Naozumi Hashimoto, Koji Sakamoto, Yoshinori Hasegawa
Elevated mean pulmonary arterial pressure (MPAP; ≥21 mmHg) is sometimes seen in patients with idiopathic pulmonary fibrosis (IPF) and has an adverse impact upon survival. Although early diagnosis is crucial, there is no established screening tool that uses a combination of noninvasive examinations.We retrospectively analysed IPF patients at initial evaluation from April 2007 to July 2015 and, using logistic regression analysis, created a screening tool to identify elevated MPAP. Internal validation was also assessed for external validity using a bootstrap method...
January 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29329993/pulmonary-arterial-hypertension-in-four-patients-treated-by-leflunomide
#3
Valentin Coirier, Alain Lescoat, Céline Chabanne, Maxime Fournet, Guillaume Coiffier, Stéphane Jouneau, Elisabeth Polard, Patrick Jégo
Pulmonary arterial hypertension (PAH) is a rare disorder that can be drug-induced, mostly following treatment by appetite-suppressant drugs. We report four cases of patients who developed PAH following a treatment by leflunomide for rheumatoid arthritis, psoriatic arthritis or undetermined connective tissue disease. All patients described a progressive dyspnea from grade II to IV of NYHA classification; clinical examination found signs of heart failure. PAH was finally diagnosed and confirmed by right heart catheterisation...
January 9, 2018: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/29326113/acute-heart-failure-with-new-onset-continuous-murmur-in-a-26-year-old-man
#4
Yi-Chen Wang, Chen-Wei Huang, Ting-Wei Lin
CLINICAL INTRODUCTION: A 26-year-old man with an unremarkable medical history sensed a momentary retrosternal 'pop' followed by overwhelming dyspnoea, without reporting any prodromal symptoms. At the emergency department, he had a significant tachycardia (170 bpm) and an extreme low diastolic blood pressure (<30 mm Hg). A loud, harsh and continuous murmur could be maximally auscultated at the right lower sternal border. ECG revealed global ST depression with ST elevation in lead aVR...
January 11, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29322712/a-cross-sectional-study-of-cardiovascular-involvement-in-systemic-lupus-erythematosus-in-an-urban-indian-tertiary-care-centre-with-emphasis-on-2-d-echocardiography
#5
Seema Kini, Chetan Vekhande, Vikram Londhey
Background: Cardiovascular manifestations are responsible for considerable morbidity and mortality in patients with SLE. A wide range of manifestations due to active lupus, like pericarditis, valvular affection, myocarditis, and less commonly pulmonary hypertension, are described. This study was undertaken to study cardiovascular manifestations in SLE, with a focus on echocardiography findings, in an urban Indian setting. Methodology: Fifty consecutive cases of SLE following up in the Rheumatology Clinic of TNMC and BYL Nair Charitable hospital, an Indian tertiary care hospital were studied...
November 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29193758/haemodynamic-impact-of-pulmonary-vasodilators-on-single-ventricle-physiology
#6
Biagio Castaldi, Giulia Bordin, Massimo Padalino, Elena Cuppini, Vladimiro Vida, Ornella Milanesi
INTRODUCTION: The Fontan procedure is the palliative procedure for single ventricle physiology. Pulmonary resistance plays a key role in the success of this operation. There are conflicting data concerning the impact of pulmonary vasodilators on survival and functional capacity among Fontan patients. AIM: The aim of this retrospective, single-centre, non-randomised study was to investigate the potential effect of pulmonary vasodilators on pulmonary vasculature in Fontan patients...
November 28, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/29167297/an-official-european-respiratory-society-statement-pulmonary-haemodynamics-during-exercise
#7
Gabor Kovacs, Philippe Herve, Joan Albert Barbera, Ari Chaouat, Denis Chemla, Robin Condliffe, Gilles Garcia, Ekkehard Grünig, Luke Howard, Marc Humbert, Edmund Lau, Pierantonio Laveneziana, Gregory D Lewis, Robert Naeije, Andrew Peacock, Stephan Rosenkranz, Rajeev Saggar, Silvia Ulrich, Dario Vizza, Anton Vonk Noordegraaf, Horst Olschewski
There is growing recognition of the clinical importance of pulmonary haemodynamics during exercise, but several questions remain to be elucidated. The goal of this statement is to assess the scientific evidence in this field in order to provide a basis for future recommendations.Right heart catheterisation is the gold standard method to assess pulmonary haemodynamics at rest and during exercise. Exercise echocardiography and cardiopulmonary exercise testing represent non-invasive tools with evolving clinical applications...
November 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29150159/diagnostic-performance-of-pulmonary-capacitance-at-rest-and-during-exercise-in-idiopathic-pulmonary-arterial-hypertension
#8
Pankaj Jain, Sriram Rao, Peter Macdonald, Eugene Kotlyar, Andrew Jabbour, Christopher Hayward, Anne Keogh
BACKGROUND: Reliable markers of early disease are needed in pulmonary arterial hypertension (PAH). As measures of the contribution of abnormal vascular compliance to overall vascular resistance, resting and exercise pulmonary capacitance-defined as the stroke volume divided by the change in pulmonary pulse pressure-may be sensitive markers of early disease. METHODS: We examined all patients in our pulmonary hypertension database with idiopathic PAH, who had undergone rest and exercise right heart catheterisation in one sitting...
November 8, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29051271/combined-measurement-of-carbon-monoxide-and-nitric-oxide-lung-transfer-does-not-improve-the-identification-of-pulmonary-hypertension-in-systemic-sclerosis
#9
Bruno Degano, Thibaud Soumagne, Thomas Delaye, Patrick Berger, Thierry Perez, Alicia Guillien, Jean-Luc Pellegrin, David Launay, Nadine Magy-Bertrand, Christian Agard, Kiet Phong Tiev, Thông Hua-Huy, Catherine Tardiff, Véronique Diaz, Arnaud Chambellan, Anh Tuan Dinh-Xuan
Screening is important to determine whether patients with systemic sclerosis (SSc) have pulmonary hypertension because earlier pulmonary hypertension treatment can improve survival in these patients. Although decreased transfer factor of the lung for carbon monoxide (TLCO) is currently considered the best pulmonary function test for screening for pulmonary hypertension in SSc, small series have suggested that partitioning TLCO into membrane conductance (diffusing capacity) for carbon monoxide (DMCO) and alveolar capillary blood volume (VC) through combined measurement of TLCO and transfer factor of the lung for nitric oxide (TLNO) is more effective to identify pulmonary hypertension in SSc patients compared with TLCO alone...
October 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29027516/-chronic-thromboembolic-pulmonary-hypertension-recognition-diagnosis-and-treatment
#10
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/28970276/outcomes-of-persistent-pulmonary-hypertension-following-transcatheter-aortic-valve-replacement
#11
Ahmad Masri, Islam Abdelkarim, Michael S Sharbaugh, Andrew D Althouse, Jeffrey Xu, Wei Han, Stephen Y Chan, William E Katz, Frederick W Crock, Matthew E Harinstein, Dustin E Kliner, Forozan Navid, Joon S Lee, Thomas G Gleason, John T Schindler, João L Cavalcante
OBJECTIVES: To determine the prevalence and factors associated with persistent pulmonary hypertension (PH) following transcatheter aortic valve replacement (TAVR) and its relationship with long-term mortality. METHODS: Consecutive patients who underwent TAVR from July 2011 through January 2016 were studied. The prevalence of baseline PH (mean pulmonary artery pressure ≥25 mm Hg on right heart catheterisation) and the prevalence and the predictors of persistent≥moderate PH (pulmonary artery systolic pressure (PASP)>45 mm Hg on 1 month post-TAVR transthoracic Doppler echocardiography) were collected...
September 29, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28969979/inverse-association-between-myocardial-b-type-natriuretic-peptide-release-and-functional-capacity-in-healthy-humans
#12
Micha T Maeder, Bruce R Thompson, David M Kaye
BACKGROUND: B-type natriuretic peptide (BNP) has been found to be inversely related to peak oxygen consumption (peak VO2) in various patient populations. However, in these studies, circulating plasma BNP, i.e. the net effect of release and elimination, rather than cardiac BNP release has been measured. We assessed the relationship between the transcardiac BNP gradient [ΔBNPCS-A, i.e. the difference between BNP in coronary sinus (BNPCS) and arterial (BNPA) plasma] and peak VO2 in healthy subjects with a view to better understanding the regulation of cardiac BNP release in humans...
September 12, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28954831/exertional-dyspnoea-in-a-28-year-old-woman
#13
Selma D Carlson, Zachary L Steinberg, Eric V Krieger
CLINICAL INTRODUCTION: A 28-year-old woman with a history of critical pulmonic stenosis, status postsurgical valvotomy and subsequent pulmonary valve replacement, presented to the cardiology clinic with 1 year of progressive exertional dyspnoea. She has a heart rate of 75 bpm and blood pressure of 110/55 mm Hg. Cardiac auscultation reveals a 1/6 systolic ejection murmur along the left sternum and an early 3/6 diastolic decrescendo murmur. A transthoracic echocardiogram is obtained (figure 1)...
November 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28879041/pulmonary-arterial-hypertension-a-novelty-in-idiopathic-inflammatory-myopathies-insights-and-first-experiences-with-vasoactive-therapy
#14
Kavish J Bhansing, Anton Vonk-Noordegraaf, Frank Pt Oosterveer, Piet Lcm van Riel, Madelon C Vonk
To characterise the different types of pulmonary hypertension (PH) among idiopathic inflammatory myopathy (IIM). A retrospective case series with assessment of PH by right heart catheterisation, extent of interstitial lung disease (ILD) and outcome of vasoactive therapy.The group of patients with IIM with PH (n=9) showed a median age at PH diagnosis of 62 years (IQR 48-71 years; eight women), seven diagnosed with polymyositis and two with dermatomyositis; median disease duration of 5.7 years and five patients with a positive anti-Jo1 antibody...
2017: RMD Open
https://www.readbyqxmd.com/read/28877978/how-i-manage-pulmonary-langerhans-cell-histiocytosis
#15
Gwenaël Lorillon, Abdellatif Tazi
Pulmonary Langerhans cell histiocytosis (PLCH) is a rare sporadic cystic lung disease of unknown aetiology that is characterised by the infiltration and destruction of the wall of distal bronchioles by CD1a + Langerhans-like cells. In adults, PLCH is frequently isolated and affects young smokers of both sexes. Recent multicentre studies have led to the more standardised management of patients in clinical practice. Smoking cessation is essential and is occasionally the only suitable intervention. Serial lung function testing is important because a significant proportion of patients may experience an early decline in forced expiratory volume in 1 s and develop airflow obstruction...
September 30, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28816352/pulmonary-artery-wave-propagation-and-reservoir-function-in-conscious-man-impact-of-pulmonary-vascular-disease-respiration-and-dynamic-stress-tests
#16
Junjing Su, Charlotte Manisty, Ulf Simonsen, Luke S Howard, Kim H Parker, Alun D Hughes
KEY POINTS: Wave travel plays an important role in cardiovascular physiology. However, many aspects of pulmonary arterial wave behaviour remain unclear. Wave intensity and reservoir-excess pressure analyses were applied in the pulmonary artery in subjects with and without pulmonary hypertension during spontaneous respiration and dynamic stress tests. Arterial wave energy decreased during expiration and Valsalva manoeuvre due to decreased ventricular preload. Wave energy also decreased during handgrip exercise due to increased heart rate...
October 15, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28751413/long-term-outcomes-of-dasatinib-induced-pulmonary-arterial-hypertension-a-population-based-study
#17
Jason Weatherald, Marie-Camille Chaumais, Laurent Savale, Xavier Jaïs, Andrei Seferian, Matthieu Canuet, Hélène Bouvaist, Pascal Magro, Anne Bergeron, Christophe Guignabert, Olivier Sitbon, Gérald Simonneau, Marc Humbert, David Montani
This study aimed to describe the long-term outcomes of pulmonary arterial hypertension (PAH) induced by dasatinib.21 incident, right heart catheterisation-confirmed cases of dasatinib-induced PAH were identified from the French Pulmonary Hypertension Registry. Clinical and haemodynamic variables were compared from baseline to last follow-up (median (range) 24 (1-81) months).Median age was 52 years and 15 patients were female (71%). 19 patients received dasatinib for chronic myelogenous leukaemia for a median (range) duration of 42 (8-74) months before PAH diagnosis...
July 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28722077/invasive-haemodynamic-evaluation-of-the-pulmonary-circulation-in-pulmonary-hypertension
#18
Alberto Pagnamenta, Andrea Azzola, Maurice Beghetti, Frédéric Lador, On Behalf Of The Swiss Society Of Pulmonary Hypertension
The term pulmonary hypertension refers to a serious condition characterised by high pulmonary vascular pressure, mainly as a consequence of various cardiac and respiratory diseases. Current clinical classification of pulmonary hypertension considers five distinct groups. Transthoracic echocardiography represents the first and most important noninvasive screening tool for estimating the probability of pulmonary hypertension. The diagnostic approach to pulmonary hypertension is supported by a proposed algorithm, which identifies the underlying cause...
July 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28664832/clinical-determinants-of-elevated-systolic-pulmonary-artery-pressure-measured-by-transthoracic-doppler-echocardiography-in-early-systemic-sclerosis
#19
Patricia E Carreira, Loreto Carmona, Beatriz E Joven, Estibaliz Loza, Jose Luis Andreu, Gabriela Riemekasten, Serena Vettori, Yannick Allanore, Alexandra Balbir-Gurman, Paolo Airò, Ulrich A Walker, Nemanja Damjanov, Lidia P Ananieva, Simona Rednic, László Czirják, Oliver Distler, Dominique Farge, Roger Hesselstrand, Ada Corrado, Paola Caramaschi, Mohammed Tikly, Marco Matucci-Cerinic
OBJECTIVES: To explore the prevalence and clinical associations of elevated systolic pulmonary artery pressure (sPAP), measured by Transthoracic Doppler-echocardiography (TTE) in patients with early systemic sclerosis (SSc). METHODS: A cross-sectional analysis of the prospective EULAR Scleroderma Trial and Research (EUSTAR) database was performed. SSc patients with <3 years from the first non-Raynaud's phenomenon (RP) symptom at baseline EUSTAR visit, were selected...
June 20, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28663315/upfront-combination-therapy-reduces-right-ventricular-volumes-in-pulmonary-arterial-hypertension
#20
Mariëlle C van de Veerdonk, Anna E Huis In T Veld, J Tim Marcus, Nico Westerhof, Martijn W Heymans, Harm-Jan Bogaard, Anton Vonk-Noordegraaf
In pulmonary arterial hypertension (PAH), upfront combination therapy is associated with better clinical outcomes and a greater reduction in N-terminal pro-brain natriuretic peptide (NT-proBNP) than monotherapy. NT-proBNP levels reflect right ventricular (RV) wall stress, which increases when the right ventricle dilates. This study explored the impact of upfront combination therapy on RV volumes compared with monotherapy in PAH patients.This retrospective study involved 80 incident PAH patients (New York Heart Association class II and III) who were treated with upfront combination therapy (n=35) (i...
June 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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