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Right heart catheterisation

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https://www.readbyqxmd.com/read/28062514/cardiopulmonary-exercise-testing-for-detecting-pulmonary-arterial-hypertension-in-systemic-sclerosis
#1
Daniel Dumitrescu, Christian Nagel, Gabor Kovacs, Tom Bollmann, Michael Halank, Jörg Winkler, Martin Hellmich, Ekkehard Grünig, Horst Olschewski, Ralf Ewert, Stephan Rosenkranz
OBJECTIVES: Pulmonary arterial hypertension (PAH) is a devastating disease with limited survival and occurs as a frequent complication in patients with systemic sclerosis (SSc). A definite diagnosis of PAH is obtained by right heart catheterisation (RHC); however, the initial suspicion is raised by non-invasive methods. We assessed the diagnostic accuracy of key parameters derived from cardiopulmonary exercise testing (CPET) for detecting and ruling out SSc-associated PAH. METHODS: In a multicentre setting, we prospectively evaluated 173 consecutive patients with SSc without known PAH, but with clinical suspicion of PAH...
January 6, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28043677/pressure-volume-loop-derived-cardiac-indices-during-dobutamine-stress-a-step-towards-understanding-limitations-in-cardiac-output-in-children-with-hypoplastic-left-heart-syndrome
#2
James Wong, Kuberan Pushparajah, Adelaide de Vecchi, Bram Ruijsink, Gerald F Greil, Tarique Hussain, Reza Razavi
BACKGROUND: Children with a single systemic right ventricle, such as in hypoplastic left heart syndrome (HLHS), frequently experience reduced exercise capacity. Elucidating the causes could help with optimising treatment strategies. METHODS: Prospective data from 10 consecutive symptomatic patients with HLHS undergoing clinical cardiac magnetic resonance with catheterisation (XMR) were analysed. Mean age 8.6years (range 3.5-11.6years), mean time since Fontan completion 5...
December 22, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28038821/prognostic-relevance-of-pulmonary-arterial-compliance-after-therapy-initiation-or-escalation-in-patients-with-pulmonary-arterial-hypertension
#3
Stefano Ghio, Michele D'Alto, Roberto Badagliacca, Patrizio Vitulo, Paola Argiento, Massimiliano Mulè, Fabio Tuzzolino, Laura Scelsi, Emanuele Romeo, Claudia Raineri, Lavinia Martino, Corrado Tamburino, Roberto Poscia, Carmine Dario Vizza
BACKGROUND: Conventional hemodynamic parameters are considered to be the gold standard indices of outcome in pulmonary arterial hypertension (PAH); on the contrary, few data support the hypothesis that the pulsatile component of right ventricular afterload provides important prognostic information. The aim of the study was to investigate the prognostic significance of pulmonary arterial compliance (PCa) after therapy initiation or escalation in PAH patients. METHODS: A cohort of 419 consecutive PAH patients (308 naive and 111 prevalent) underwent right heart catheterisation (RHC) prior to initiating or escalating PAH-targeted therapy...
December 21, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28011346/bucindolol-improves-right-ventricle-function-in-rats-with-pulmonary-arterial-hypertension-through-the-reversal-of-autonomic-imbalance
#4
Bruna Gazzi de Lima-Seolin, Rafael Colombo, Jéssica Hellen Poletto Bonetto, Rayane Brinck Teixeira, Luiza Mezzomo Donatti, Karina Rabello Casali, Alessandra Eifler Guerra Godoy, Isnard Elman Litvin, Paulo Cavalheiro Schenkel, Alex Sander da Rosa Araujo, Adriane Belló-Klein
Pulmonary arterial hypertension (PAH) is characterised by an elevation in afterload imposed on the right ventricle (RV), leading to hypertrophy and failure. The autonomic nervous system (ANS) plays a key role in the progression to heart failure, and the use of beta-blockers attenuates this process. The aim of this study was to verify the role of bucindolol, aβ1-, β2- and α1-blocker, on the ANS, and its association with RV function in rats with PAH. Male Wistar rats were divided into four groups: control, monocrotaline, control+bucindolol, and monocrotaline+bucindolol...
December 20, 2016: European Journal of Pharmacology
https://www.readbyqxmd.com/read/27940630/positive-predictive-value-of-cardiac-examination-procedure-and-surgery-codes-in-the-danish-national-patient-registry-a-population-based-validation-study
#5
Kasper Adelborg, Jens Sundbøll, Troels Munch, Trine Frøslev, Henrik Toft Sørensen, Hans Erik Bøtker, Morten Schmidt
OBJECTIVE: Danish medical registries are widely used for cardiovascular research, but little is known about the data quality of cardiac interventions. We computed positive predictive values (PPVs) of codes for cardiac examinations, procedures and surgeries registered in the Danish National Patient Registry during 2010-2012. DESIGN: Population-based validation study. SETTING: We randomly sampled patients from 1 university hospital and 2 regional hospitals in the Central Denmark Region...
December 9, 2016: BMJ Open
https://www.readbyqxmd.com/read/27939746/non-invasive-assessment-of-pulmonary-vascular-resistance-in-pulmonary-hypertension-current-knowledge-and-future-direction
#6
REVIEW
Pyi Naing, Harveen Kuppusamy, Gregory Scalia, Graham S Hillis, David Playford
Pulmonary Hypertension (PHT) is relatively common, dangerous and under-recognised. Pulmonary hypertension is not a diagnosis in itself; it is caused by a number of differing diseases each with different treatments and prognoses. Therefore, timely and accurate recognition of the underlying cause for PHT is essential for appropriate management. This is especially true for patients with Pulmonary Arterial Hypertension (PAH) in the current era of disease-specific drug therapy. Measurement of Pulmonary Vascular Resistance (PVR) helps separate pre-capillary from post-capillary PHT, and is measured with right heart catheterisation (RHC)...
November 20, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27873763/pericardiectomy-as-a-diagnostic-and-therapeutic-procedure
#7
Ewa Konik, Jeffrey Geske, William Edwards, Bernard Gersh
A 70-year-old man presented with recent onset, predominantly right-sided heart failure. Echocardiogram demonstrated features of hypertensive heart disease and was suggestive of, but non-diagnostic for, constrictive pericarditis (CP). CT demonstrated mild pericardial thickening. Right heart catheterisation showed elevation and equalisation of diastolic pressures in all cardiac chambers with early rapid filling, minimal ventricular interdependence, and no dissociation of intrathoracic and intracardiac pressures...
November 14, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27824602/exercise-pulmonary-haemodynamics-predict-outcome-in-patients-with-systemic-sclerosis
#8
Adriana Stamm, Stéphanie Saxer, Mona Lichtblau, Elisabeth D Hasler, Suzana Jordan, Lars C Huber, Konrad E Bloch, Oliver Distler, Silvia Ulrich
The aim of the present study was to investigate the prognostic value of exercise haemodynamics measured during right heart catheterisation (RHC) in patients with systemic sclerosis (SSc) referred for evaluation of pulmonary hypertension.SSc patients undergoing RHC at rest and during maximal supine incremental cycle exercise were grouped into resting precapillary pulmonary hypertension (PHrest) (mean pulmonary artery pressure (mPAP) ≥25 mmHg, pulmonary artery wedge pressure <15 mmHg), exercise-induced pulmonary hypertension (PHex) (mPAP ≥30 mmHg and mPAP/cardiac output >3 mmHg·L(-1)·min(-1) at maximal exercise), and without pulmonary hypertension (PHnone)...
December 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/27816421/pilot-study-of-endothelin-receptor-blockade-in-heart-failure-with-diastolic-dysfunction-and-pulmonary-hypertension-baddhy-trial
#9
B Koller, R Steringer-Mascherbauer, C H Ebner, Th Weber, M Ammer, J Eichinger, I Pretsch, M Herold, J Schwaiger, H Ulmer, W Grander
BACKGROUND: In this multi-centre, randomised, placebo-controlled pilot trial, we investigated the clinical and haemodynamic effects of the endothelin-receptor blocker Bosentan in patients with heart failure, preserved ejection fraction and pulmonary hypertension (PH-HFpEF). MATERIALS AND METHODS: Eligible patients received either 12 weeks of Bosentan therapy, or a placebo drug. Patients were thereafter followed for a further period of 12 weeks without the study medication...
September 28, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27809840/eif2ak4-mutation-as-second-hit-in-hereditary-pulmonary-arterial-hypertension
#10
Christina A Eichstaedt, Jie Song, Nicola Benjamin, Satenik Harutyunova, Christine Fischer, Ekkehard Grünig, Katrin Hinderhofer
BACKGROUND: Mutations in the eukaryotic translation initiation factor 2α kinase 4 (EIF2AK4) gene have recently been identified in recessively inherited veno-occlusive disease. In this study we assessed if EIF2AK4 mutations occur also in a family with autosomal dominantly inherited pulmonary arterial hypertension (HPAH) and incomplete penetrance of bone morphogenic protein receptor 2 (BMPR2) mutations. METHODS: Clinical examinations in a family with 10 members included physical examination, electrocardiogram, (stress)-echocardiography and lung function...
November 4, 2016: Respiratory Research
https://www.readbyqxmd.com/read/27677579/risk-factors-for-development-of-pulmonary-arterial-hypertension-in-australian-systemic-sclerosis-patients-results-from-a-large-multicenter-cohort-study
#11
Kathleen Morrisroe, Molla Huq, Wendy Stevens, Candice Rabusa, Susanna M Proudman, Mandana Nikpour
BACKGROUND: Pulmonary arterial hypertension (PAH) is the leading cause of mortality in patients with systemic sclerosis (SSc). We sought to determine the incidence, prevalence and risk factors for PAH development in a large Australian SSc cohort. METHODS: PAH was diagnosed on right heart catheterisation (mPAP >25 and PAWP <15 mmHg at rest). Patients with PH secondary to interstitial lung disease (ILD; defined as abnormal HRCT scan and FVC < 60 %) were excluded...
September 27, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27670585/cardiac-perforation-by-migrated-fractured-strut-of-inferior-vena-cava-filter-mimicking-acute-coronary-syndrome
#12
Chris W Piercecchi, Julio C Vasquez, Stephen J Kaplan, Jordan Hoffman, John D Puskas, Jacob DeLaRosa
We present a rare late complication after inferior vena cava filter (IVC) placement. A 52-year-old woman with an IVC presented with sudden onset of chest pain. Cardiac catheterisation and echocardiography revealed an embolised IVC filter strut penetrating the right ventricle. Endovascular retrieval was considered but deemed unsafe due to proximity to the right coronary artery and concern for migration to pulmonary circulation. Urgent removal of the strut was performed via sternotomy. The postoperative course was uneventful...
February 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27572898/pulmonary-haemodynamics-in-fontan-physiology-after-lobectomy-in-a-patient-with-a-single-ventricle-associated-with-pulmonary-sequestration
#13
Sayaka Mii, Kazushi Yasuda, Hiroomi Murayama
A 2-year-old girl with a functionally univentricular heart associated with a pulmonary sequestration underwent right lower lobectomy after which increased lung volume with low mean pulmonary artery pressure and pulmonary vascular resistance was documented. A cardiac catheterisation performed after a subsequent total cavopulmonary connection demonstrated favourable Fontan haemodynamics. Lobectomy may have induced compensatory lung growth, contributing to the maintenance of haemodynamics favourable for the long-term success of the Fontan procedure...
August 30, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27566296/reduced-haemodynamic-coupling-and-exercise-are-associated-with-vascular-stiffening-in-pulmonary-arterial-hypertension
#14
Alessandro Bellofiore, Eric Dinges, Robert Naeije, Hamorabi Mkrdichian, Lauren Beussink-Nelson, Melissa Bailey, Michael J Cuttica, Ranya Sweis, James R Runo, Jon G Keevil, Christopher J Francois, Sanjiv J Shah, Naomi C Chesler
OBJECTIVE: Inadequate right ventricular (RV) and pulmonary arterial (PA) functional responses to exercise are important yet poorly understood features of pulmonary arterial hypertension (PAH). This study combined invasive catheterisation with echocardiography to assess RV afterload, RV function and ventricular-vascular coupling in subjects with PAH. METHODS: Twenty-six subjects with PAH were prospectively recruited to undergo right heart catheterisation and Doppler echocardiography at rest and during incremental exercise, and cardiac MRI at rest...
August 26, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27554104/prevalence-and-incidence-of-pulmonary-hypertension-among-hiv-infected-people-in-africa-a-systematic-review-and-meta-analysis
#15
Jean Joel R Bigna, Jobert Richie N Nansseu, Lewis N Um, Steve Raoul N Noumegni, Paule Sandra D Simé, Leopold Ndemngue Aminde, Sinata Koulla-Shiro, Jean Jacques N Noubiap
OBJECTIVE: Patients infected with HIV have a direly increased risk of developing pulmonary hypertension (PH), and of dying from the condition. While Africa carries the greatest burden of HIV infection worldwide, there is unclear data summarising the epidemiology of PH among HIV-infected people in this region. Our objective was to determine the prevalence and incidence of PH among HIV-infected people living across Africa. DESIGN: A systematic review and meta-analysis...
2016: BMJ Open
https://www.readbyqxmd.com/read/27478030/nt-probnp-95-ng-l-can-exclude-pulmonary-hypertension-on-echocardiography-at-diagnostic-workup-in-patients-with-interstitial-lung-disease
#16
Charlotte Andersen, Søren Mellemkjær, Ole Hilberg, Elisabeth Bendstrup
BACKGROUND: Pulmonary hypertension (PH) is a serious complication to interstitial lung disease (ILD) and has a poor prognosis. PH is often diagnosed by screening with echocardiography followed by right heart catheterisation. A previous study has shown that a value of NT-pro-brain natriuretic peptide (NT-proBNP) <95 ng/l could be used to rule out PH in patients with ILD. AIM: To evaluate this rule-out test for PH in a new cohort of incident patients with ILD. METHODS: An established database with data from 148 consecutive patients referred from January 2012 to October 2014 was used to identify patients and obtain data from echocardiography, NT-proBNP, diagnosis and lung function...
2016: European Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27220694/efficacy-of-cardiac-rehabilitation-after-balloon-pulmonary-angioplasty-for-chronic-thromboembolic-pulmonary-hypertension
#17
Shigefumi Fukui, Takeshi Ogo, Hiroshi Takaki, Jin Ueda, Akihiro Tsuji, Yoshiaki Morita, Reon Kumasaka, Tetsuo Arakawa, Michio Nakanishi, Tetsuya Fukuda, Satoshi Yasuda, Hisao Ogawa, Norifumi Nakanishi, Yoichi Goto
OBJECTIVE: To determine safety and efficacy of cardiac rehabilitation (CR) initiated immediately following balloon pulmonary angioplasty (BPA) in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) who presented with continuing exercise intolerance and symptoms on effort even after a course of BPA; 2-8 sessions/patient. METHODS: Forty-one consecutive patients with inoperable CTEPH who underwent their final BPA with improved resting mean pulmonary arterial pressure of 24...
September 1, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27175288/prognostic-value-of-tapse-after-therapy-optimisation-in-patients-with-pulmonary-arterial-hypertension-is-independent-of-the-haemodynamic-effects-of-therapy
#18
Stefano Ghio, Silvia Pica, Catherine Klersy, Eleonora Guzzafame, Laura Scelsi, Claudia Raineri, Annalisa Turco, Sandra Schirinzi, Luigi Oltrona Visconti
OBJECTIVE: To evaluate the prognostic significance of right ventricular function assessed by echocardiography after start or escalation of targeted therapy in patients with pulmonary arterial hypertension. METHODS: HASH(0x374a068) STUDY DESIGN: longitudinal study. SETTING: tertiary referral centre for pulmonary hypertension. PATIENTS: 81 consecutive patients with pulmonary arterial hypertension (33 naive and 48 prevalent)...
2016: Open Heart
https://www.readbyqxmd.com/read/27084957/ct-evaluation-of-small-pulmonary-vessels-area-in-patients-with-copd-with-severe-pulmonary-hypertension
#19
Florence Coste, Gaël Dournes, Claire Dromer, Elodie Blanchard, Véronique Freund-Michel, Pierre-Olivier Girodet, Michel Montaudon, Fabien Baldacci, François Picard, Roger Marthan, Patrick Berger, François Laurent
RATIONALE: Severe pulmonary hypertension (PH) is very uncommon in COPD, and a distinct phenotype has been hypothesised. We aimed to evaluate whether CT can help to recognise this condition non-invasively by measuring small pulmonary vessels. MATERIAL AND METHODS: Patients with COPD who underwent pulmonary function tests, unenhanced CT of the chest and right heart catheterisation (RHC) during a period of stability were included in the study. From 105 included patients, 20 patients with COPD with severe PH (mean pulmonary arterial pressure, mPAP>35 mm Hg) were compared with 20 FEV1-matched and age-matched patients with COPD with mild or without PH (mPAP<35 mm Hg)...
September 2016: Thorax
https://www.readbyqxmd.com/read/27074812/right-heart-catheterisation-may-be-cautiously-performed-through-a-mechanical-valve-prosthesis-in-the-tricuspid-position
#20
Stephen Pettit, Steven Tsui, Jayan Parameshwar
Right heart catheterisation (RHC) may be performed through a mechanical valve prosthesis in the tricuspid position using a partially inflated pulmonary artery flotation catheter. Preprocedural preparation should include an ex vivo trial with an identical valve prosthesis and the type of catheter to be used for the procedure. The operator should expect immediate unloading of the right ventricle due to catheter-associated tricuspid regurgitation, but it is possible to estimate pulmonary vascular resistance using the Fick principle...
2016: BMJ Case Reports
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