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https://www.readbyqxmd.com/read/29898910/fulminant-pulmonary-embolism-with-fatal-outcome-in-a-patient-with-low-clinical-prediction-scores
#1
Christian Degen, Severin Poechtrager, Gregor Leibundgut
We present a case of a 72-year-old man with submassive acute pulmonary thromboembolism. Pulmonary embolism severity index Score and common clinical risk stratification recommended systemic anticoagulation and a clinical course without complications was expected. A primary reperfusion strategy was not indicated by the current guidelines. Under established anticoagulation, the patient was found in cardiac arrest immediately after mobilisation from the bed the next morning. Right heart catheterisation under ongoing resuscitation revealed a complete obstruction of the right pulmonary artery by a big thrombus...
June 13, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29869175/evaluation-of-right-ventricular-function-by-coronary-computed-tomography-angiography-using-a-novel-automated-3d-right-ventricle-volume-segmentation-approach-a-validation-study
#2
Philipp Burghard, Fabian Plank, Christoph Beyer, Silvana Müller, Jakob Dörler, Marc-Michael Zaruba, Leo Pölzl, Gerhard Pölzl, Andrea Klauser, Stefan Rauch, Fabian Barbieri, Christian-Ekkehardt Langer, Wilfried Schgoer, Eric E Williamson, Gudrun Feuchtner
OBJECTIVES: To evaluate right ventricle (RV) function by coronary computed tomography angiography (CTA) using a novel automated three-dimensional (3D) RV volume segmentation tool in comparison with clinical reference modalities. METHODS: Twenty-six patients with severe end-stage heart failure [left ventricle (LV) ejection fraction (EF) <35%] referred to CTA were enrolled. A specific individually tailored biphasic contrast agent injection protocol was designed (80%/20% high/low flow) was designed...
June 4, 2018: European Radiology
https://www.readbyqxmd.com/read/29804068/systemic-scleroderma-related-interstitial-pneumonia-associated-with-borderline-pulmonary-arterial-hypertension
#3
Keishi Sugino, Takayuki Kabuki, Kazutoshi Shibuya, Sakae Homma
A 65-year-old woman with a 35-year history of limited cutaneous systemic scleroderma was admitted to our hospital complaining of a 3-month history of progressive dyspnoea on exertion. High-resolution CT images of the chest revealed diffuse reticular opacities and traction bronchiectasis predominantly in the bilateral lower lobes of the lung. Specimens obtained during video-assisted thoracic surgery were consistent with fibrocellular non-specific interstitial pneumonia and accompanied by accumulation of lymph follicles within areas of fibrosis...
May 26, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29750141/a-stepwise-composite-echocardiographic-score-predicts-severe-pulmonary-hypertension-in-patients-with-interstitial-lung-disease
#4
Simon Bax, Charlene Bredy, Aleksander Kempny, Konstantinos Dimopoulos, Anand Devaraj, Simon Walsh, Joseph Jacob, Arjun Nair, Maria Kokosi, Gregory Keir, Vasileios Kouranos, Peter M George, Colm McCabe, Michael Wilde, Athol Wells, Wei Li, Stephen John Wort, Laura C Price
European Respiratory Society (ERS) guidelines recommend the assessment of patients with interstitial lung disease (ILD) and severe pulmonary hypertension (PH), as defined by a mean pulmonary artery pressure (mPAP) ≥35 mmHg at right heart catheterisation (RHC). We developed and validated a stepwise echocardiographic score to detect severe PH using the tricuspid regurgitant velocity and right atrial pressure (right ventricular systolic pressure (RVSP)) and additional echocardiographic signs. Consecutive ILD patients with suspected PH underwent RHC between 2005 and 2015...
April 2018: ERJ Open Research
https://www.readbyqxmd.com/read/29724385/sildenafil-added-to-pirfenidone-in-patients-with-advanced-idiopathic-pulmonary-fibrosis-and-risk-of-pulmonary-hypertension-a-phase-iib-randomised-double-blind-placebo-controlled-study-rationale-and-study-design
#5
Jürgen Behr, Steven D Nathan, Sergio Harari, Wim Wuyts, Klaus-Uwe Kirchgaessler, Monica Bengus, Frank Gilberg, Athol U Wells
BACKGROUND: Pulmonary hypertension (PH) is commonly observed in patients with advanced idiopathic pulmonary fibrosis (IPF). Despite the availability of therapies for both IPF and PH, none are approved for PH treatment in the context of significant pulmonary disease. This study will investigate the use of sildenafil added to pirfenidone in patients with advanced IPF and risk of PH, who represent a group with a high unmet medical need. METHODS: This Phase IIb, randomised, double-blind, placebo-controlled trial is actively enrolling patients and will study the efficacy, safety and tolerability of sildenafil or placebo in patients with advanced IPF and intermediate or high probability of Group 3 PH who are receiving a stable dose of pirfenidone...
May 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29676489/improving-the-echocardiographic-assessment-of-pulmonary-pressure-using-the-tricuspid-regurgitant-signal-the-chin-vs-the-beard
#6
Stephen J Kyranis, Jilani Latona, David Platts, Natalie Kelly, Michael Savage, Martin Brown, Christian Hamilton-Craig, Gregory M Scalia, Darryl Burstow
AIM: Transthoracic echocardiography (TTE) is a fundamental investigation for the noninvasive assessment of pulmonary hemodynamics and right heart function. The aim of this study was to assess the correlation and agreement of Doppler calculation of right ventricular systolic pressure (RVSP) and pulmonary vascular resistance (PVR) using "chin" and "beard" measurements of tricuspid regurgitant velocity (TRVmax ), with invasive pulmonary artery systolic pressure (PASP) and PVR...
April 20, 2018: Echocardiography
https://www.readbyqxmd.com/read/29674399/liver-chemistry-abnormalities-and-leg-oedema-in-rheumatoid-arthritis
#7
Eva Marianne van Soest, Anho Liem, Jende van Zeben
A 66-year-old man with seronegative, erosive rheumatoid arthritis for 12 years presented with malaise, elevated alkaline phosphatase and gamma-glutamyl transferase, and leg oedema. He subsequently developed ascites. No liver pathology was found, but cardiac analysis including right heart catheterisation revealed constrictive pericarditis. Rheumatoid constrictive pericarditis is a rare condition, but, despite current effective treatment for rheumatoid arthritis, still occurs. Diagnostic delay is frequent. Although mortality of the intervention is high, pericardiectomy is needed for most patients...
April 19, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29674186/pulmonary-hypertension-real-world-data-from-a-portuguese-expert-referral-centre
#8
A Gomes, C Cruz, J Rocha, M Ricardo, M Vicente, A Melo, M Santos, L Carvalho, F Gonçalves, A Reis
BACKGROUND: Pulmonary hypertension (PH) is a heterogeneous, debilitating condition with highly relevant impact on functional capacity, quality of life, and life-expectancy. OBJECTIVES: This study aims to provide long-term data on the Portuguese PH population, by characterising the clinical presentation, evolution, and outcomes of PH patients in a specialised referral centre. METHODS: Retrospective analysis of a cohort of 101 patients with pre-capillary PH (pcPH) referenced to an expert tertiary care referral centre in northern Portugal from 2002 to 2013...
April 16, 2018: Pulmonology
https://www.readbyqxmd.com/read/29604064/altered-autonomic-control-of-heart-rate-variability-in-the-chronically-hypoxic-fetus
#9
C J Shaw, B J Allison, N Itani, K J Botting, Y Niu, C C Lees, D A Giussani
KEY POINTS: Fetal heart rate variability (FHRV) has long been recognised as a powerful predictor of fetal wellbeing, and a decrease in FHRV is associated with fetal compromise. However, the mechanisms by which FHRV is reduced in the chronically hypoxic fetus have yet to be established. The sympathetic and parasympathetic influences on heart rate mature at different rates throughout fetal life, and can be assessed by time domain and power spectral analysis of FHRV. In this study of chronically instrumented fetal sheep in late gestation, we analysed FHRV daily over a 16 day period towards term, and compared changes between fetuses of control and chronically hypoxic pregnancy...
March 31, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29563171/multicentre-observational-screening-survey-for-the-detection-of-cteph-following-pulmonary-embolism
#10
Nicolas Coquoz, Daniel Weilenmann, Daiana Stolz, Vladimir Popov, Andrea Azzola, Jean-Marc Fellrath, Hans Stricker, Alberto Pagnamenta, Sebastian Ott, Silvia Ulrich, Sandor Györik, Jérôme Pasquier, John-David Aubert
Chronic thromboembolic pulmonary hypertension (CTEPH) is a severe complication of pulmonary embolism. Its incidence following pulmonary embolism is debated. Active screening for CTEPH in patients with acute pulmonary embolism is yet to be recommended.This prospective, multicentre, observational study (Multicentre Observational Screening Survey for the Detection of Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Following Pulmonary Embolism (INPUT on PE); ISRCTN61417303) included patients with acute pulmonary embolism from 11 centres in Switzerland from March 2009 to November 2016...
April 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29531959/rationale-and-design-of-the-screening-of-pulmonary-hypertension-in-systemic-lupus-erythematosus-sophie-study
#11
Duo Huang, Yang-Yang Cheng, Pak-Hei Chan, Jojo Hai, Kai-Hang Yiu, Hung-Fat Tse, Ka-Lam Wong, Katherine Fan, Ying Wah Li, Woon-Leung Ng, Cheuk-Wan Yim, Cheuk-Hon John Wong, Lai-Shan Tam, Priscilla C H Wong, Chi-Yuen Wong, Chup-Hei Ho, Alexander M H Leung, Chi-Chiu Mok, Ho Lam, Chak-Sing Lau, Tommy Cheung, Carmen Ho, Sharon W Y Law, Esther W Chan, Li-Xue Yin, Wen-Sheng Yue, Toi Meng Mok, Mario Alberto Evora, Chung-Wah Siu
Current guideline-recommended screening for pulmonary hypertension in patients with systemic sclerosis has not been evaluated in systemic lupus erythematosus (SLE), which is disproportionately prevalent in Asians. This multicentre, cross-sectional screening study aims to study the prevalence of pulmonary hypertension among SLE patients using these guidelines, and identify independent predictors and develop a prediction model for pulmonary hypertension in SLE patients. SLE patients from participating centres will undergo an echocardiography- and biomarker-based pulmonary hypertension screening procedure as in the DETECT study...
January 2018: ERJ Open Research
https://www.readbyqxmd.com/read/29428946/determination-of-cardiac-output-in-pulmonary-hypertension-using-impedance-cardiography
#12
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
#13
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
#14
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
#15
Yi-Chen Wang, Chen-Wei Huang, Ting-Wei Lin
No abstract text is available yet for this article.
April 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
#16
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/hemodynamic-impact-of-pulmonary-vasodilators-on-single-ventricle-physiology
#17
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-center, nonrandomized study was to investigate the potential effect of pulmonary vasodilators on pulmonary vasculature in Fontan patients...
February 2018: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/29167297/an-official-european-respiratory-society-statement-pulmonary-haemodynamics-during-exercise
#18
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
#19
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
#20
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
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