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Right heart catheterisation

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
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...
September 5, 2016: Heart, Lung & Circulation
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
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
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
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
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
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(0x4af67e0) 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
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
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
Gregory M Scalia, Isabel G Scalia, Rebecca Kierle, Rebekka Beaumont, David B Cross, John Feenstra, Darryl J Burstow, Benjamin T Fitzgerald, David G Platts
BACKGROUND: Right heart catheterisation is the gold-standard for differentiating pre-capillary pulmonary hypertension (high mean pulmonary artery pressure, normal pulmonary wedge pressure) from post-capillary physiology (elevated pulmonary wedge pressure). The new non-invasive parameter, ePLAR (echocardiographic Pulmonary to Left Atrial Ratio) is calculated from the maximum tricuspid regurgitation continuous wave Doppler velocity (m/s) divided by the transmitral E-wave:septal mitral annular Doppler Tissue Imaging e'-wave ratio (TRVmax/E:e')...
June 1, 2016: International Journal of Cardiology
Debjit Chatterjee, Ambreen Sadiq, Raj Garikipati
CLINICAL INTRODUCTION: A 57-year-old woman with known moderate-to-severe mitral stenosis and atrial fibrillation (AF) presented to the emergency department with acute onset right loin pain after having a coronary angiogram and left and right heart catheterisation through the right femoral route about 28 h ago. The cardiac catheterisation was done after she presented with one episode of troponin-negative chest pain and progressive shortness of breath. She had anterior wall myocardial infarction (MI) 25 years ago, which was thought to be due to coronary artery embolism...
September 1, 2016: Heart: Official Journal of the British Cardiac Society
Anne Hilgendorff, Christian Apitz, Damien Bonnet, Georg Hansmann
Persistent pulmonary hypertension of the newborn (PPHN) is the most common neonatal form and mostly reversible after a few days with improvement of the underlying pulmonary condition. When pulmonary hypertension (PH) persists despite adequate treatment, the severity of parenchymal lung disease should be assessed by chest CT. Pulmonary vein stenosis may need to be ruled out by cardiac catheterisation and lung biopsy, and genetic workup is necessary when alveolar capillary dysplasia is suspected. In PPHN, optimisation of the cardiopulmonary situation including surfactant therapy should aim for preductal SpO2between 91% and 95% and severe cases without post-tricuspid-unrestrictive shunt may receive prostaglandin E1 to maintain ductal patency in right heart failure...
May 2016: Heart: Official Journal of the British Cardiac Society
Christian Apitz, Georg Hansmann, Dietmar Schranz
Invasive assessment of haemodynamics (ventricular, pulmonary) and testing of acute vasoreactivity in the catheterisation laboratory remain the gold standard for the diagnosis of pulmonary hypertension (PH) and pulmonary hypertensive vascular disease. However, these measurements and the interpretation thereof are challenging due to the heterogeneous aetiology of PH in childhood and potentially confounding factors in the catheterisation laboratory. Patients with pulmonary arterial hypertension (PAH) associated with congenital heart disease who have a cardiovascular shunt need to undergo a completely different catheterisation approach than those with idiopathic PAH lacking an anatomical cardiovascular defect...
May 2016: Heart: Official Journal of the British Cardiac Society
John E Cannon, Li Su, David G Kiely, Kathleen Page, Mark Toshner, Emilia Swietlik, Carmen Treacy, Anie Ponnaberanam, Robin Condliffe, Karen Sheares, Dolores Taboada, John Dunning, Steven Tsui, Choo Ng, Deepa Gopalan, Nicholas Screaton, Charlie Elliot, Simon Gibbs, Luke Howard, Paul Corris, James Lordan, Martin Johnson, Andrew Peacock, Robert MacKenzie-Ross, Benji Schreiber, Gerry Coghlan, Kostas Dimopoulos, Stephen J Wort, Sean Gaine, Shahin Moledina, David P Jenkins, Joanna Pepke-Zaba
BACKGROUND: Chronic thromboembolic pulmonary hypertension results from incomplete resolution of pulmonary emboli. Pulmonary endarterectomy (PEA) is potentially curative, but residual pulmonary hypertension following surgery is common and its impact on long-term outcome is poorly understood. We wanted to identify factors correlated with poor long-term outcome after surgery and specifically define clinically relevant residual pulmonary hypertension post-PEA. METHODS AND RESULTS: Eight hundred eighty consecutive patients (mean age, 57 years) underwent PEA for chronic thromboembolic pulmonary hypertension...
May 3, 2016: Circulation
Lalit Mehra, Shashi Raheja, Sneh Agarwal, Yashoda Rani, Kulwinder Kaur, Anita Tuli
INTRODUCTION: Coronary venous catheterisation has been used for performing various cardiologic interventions. The procedure might become complicated due to obstruction offered by the valve of coronary sinus (Thebesian valve) the acute bend of the Great Cardiac Vein (GCV). The present study sought to expound the anatomical considerations of coronary venous catheterization and to elucidate the potential causes of obstruction and the complications of this procedure. MATERIALS AND METHODS: In this cross-sectional observational study, coronary sinus and GCV were dissected in 40, formalin fixed, adult cadaveric human hearts...
February 2016: Journal of Clinical and Diagnostic Research: JCDR
María José Orellana, Angelo Fulle, Diego Carrillo, Lucía Escobar, Alicia Ebensperger, Raúl Martínez, Hana Rumié Carmi
INTRODUCTION: Papillary thyroid carcinoma (PTC) is a rare childhood disease. The development of PTC in dyshormonogenetic congenital hypothyroidism (CH) is infrequent, with very few case reports in literature. OBJECTIVE: To report a case of PTC in a boy with dyshormonogenetic CH without goitre and exposed to ionising radiation. To evaluate relationships between these factors and development of PTC. CASE REPORT: We present a boy with dyshormonogenetic CH since birth...
March 26, 2016: Revista Chilena de Pediatría
Maria Del Trigo, Sebastien Bergeron, Mathieu Bernier, Ignacio J Amat-Santos, Rishi Puri, Francisco Campelo-Parada, Omar Abdul-Jawad Altisent, Ander Regueiro, Neal Eigler, Erez Rozenfeld, Philippe Pibarot, William T Abraham, Josep Rodés-Cabau
BACKGROUND: In patients with heart failure, interventions to reduce elevated left atrial pressure improve symptoms and reduce the risk of hospital admission. We aimed to assess the safety and potential efficacy of therapeutic left-to-right interatrial shunting in patients with heart failure with reduced ejection fraction. METHODS: We did this proof-of-principle cohort study at one centre in Canada. Patients (aged ≥18 years) with New York Heart Association (NYHA) class III chronic heart failure with reduced ejection fraction were enrolled under the Canadian special access programme...
March 26, 2016: Lancet
Michele D'Alto, Konstantinos Dimopoulos, Werner Budts, Gerhard-Paul Diller, Giovanni Di Salvo, Santo Dellegrottaglie, Pierluigi Festa, Giancarlo Scognamiglio, Gaetano Rea, Lamia Ait Ali, Wei Li, Michael A Gatzoulis
Pulmonary arterial hypertension (PAH) in adult patients with congenital heart disease (CHD) is associated with increased morbidity and mortality. The present review aims to discuss the clinical applications of invasive and non-invasive diagnostic modalities and to describe the strengths and weaknesses of each technique. Chest radiograph is an inexpensive investigation providing information on pulmonary arterial and hilar dilatation, pruning of peripheral pulmonary arteries and cardiomegaly. Transthoracic two-dimensional and Doppler echocardiography is the most widely used imaging tool...
June 15, 2016: Heart: Official Journal of the British Cardiac Society
Simon Lee, Irene D Lytrivi, Zhanna Roytman, Hyun-Sook Helen Ko, Cheryl Vinograd, Shubhika Srivastava
UNLABELLED: Introduction Agreement between echocardiography and right heart catheterisation-derived right ventricular systolic pressure is modest in the adult heart failure population, but is unknown in the paediatric cardiomyopathy population. METHODS: All patients at a single centre from 2001 to 2012 with a diagnosis of cardiomyopathy who underwent echocardiography and catheterisation within 30 days were included in this study. The correlation between tricuspid regurgitation gradient and catheterisation-derived right ventricular systolic pressure and mean pulmonary artery pressure was determined...
October 2016: Cardiology in the Young
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