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Pulmonary hypertension treatment

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https://www.readbyqxmd.com/read/28714608/selective-serotonin-reuptake-inhibitors-during-pregnancy-do-we-have-now-more-definite-answers-related-to-prenatal-exposure
#1
REVIEW
Asher Ornoy, Gideon Koren
Despite extensive studies, there still seems to be uncertainty as to the possible reproductive risk of selective serotonin reuptake inhibitors (SSRIs) and selective serotonin norepinephrine reuptake inhibitors (SNRIs) in pregnancy. We, therefore, assess the current data on the risk/benefit of SSRI use in pregnancy. As the neurodevelopmental effects of SSRIs are discussed in another paper in this issue, we will not address the possible neurodevelopmental effects. Special emphasis is given to the newer, large population-based studies...
July 17, 2017: Birth defects research
https://www.readbyqxmd.com/read/28711447/the-transition-from-hypertension-to%C3%A2-heart%C3%A2-failure-contemporary-update
#2
REVIEW
Franz H Messerli, Stefano F Rimoldi, Sripal Bangalore
Longstanding hypertension ultimately leads to heart failure (HF), and as a consequence most patients with HF have a history of hypertension. Conversely, absence of hypertension in middle age is associated with lower risks for incident HF across the remaining life course. Cardiac remodeling to a predominant pressure overload consists of diastolic dysfunction and concentric left ventricular (LV) hypertrophy. When pressure overload is sustained, diastolic dysfunction progresses, filling of the concentric remodeled LV decreases, and HF with preserved ejection fraction ensues...
July 6, 2017: JACC. Heart Failure
https://www.readbyqxmd.com/read/28705306/riociguat-for-patients-with-chronic-thromboembolic-pulmonary-hypertension-usefulness-of-transitioning-from-phosphodiesterase-type-5-inhibitor
#3
Keiko Yamamoto, Nobuhiro Tanabe, Rika Suda, Akane Sasaki, Akane Matsumura, Ryogo Ema, Hajime Kasai, Fumiaki Kato, Ayumi Sekine, Rintaro Nishimura, Takayuki Jujo, Toshihiko Sugiura, Ayako Shigeta, Seiichiro Sakao, Koichiro Tatsumi
BACKGROUND: Riociguat, the first approved drug for patients with chronic thromboembolic pulmonary hypertension (CTEPH), is a soluble guanylate cyclase (sGC) Stimulator. It directly stimulates sGC independently of nitric oxide (NO) and increases sGC sensitivity for NO. The safety and efficacy of transitioning from a phosphodiesterase 5 inhibitor (PDE5i) to riociguat is unknown. METHODS AND RESULTS: Twenty-three patients were prospectively enrolled: 8 symptomatic patients with inadequate clinical responses to PDE5i were changed to riociguat (transitioned group); 15 started riociguat anew (new or add-on group)...
July 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28704260/%C3%AE-solanine-reverses-pulmonary-vascular-remodeling-and-vascular-angiogenesis-in-experimental-pulmonary-artery-hypertension
#4
Xiaowei Nie, Youai Dai, Jianxin Tan, Yuan Chen, Guowei Qin, Wenjun Mao, Jian Zou, Yanhua Chang, Qian Wang, Jingyu Chen
OBJECTIVE: Similar to cancer, pulmonary arterial hypertension (PAH) is characterized by vascular remodeling, which leads to obliteration of the small pulmonary arteriole, with marked proliferation of pulmonary artery smooth muscle cells (PASMC) and/or endothelial cells dysfunction. Aberrant expression of tumor suppressor genes is closely associated with susceptibility to PAH. We hypothesized that α-solanine, a glycoalkaloid found in members of the nightshade family known to have antitumor activity in different cancers, reverses experimental PAH by activating the tumor suppressor-axis inhibition protein 2 (AXIN2)...
July 12, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28704161/cardiovascular-safety-of-low-dose-fenfluramine-in-dravet-syndrome-a-review-of-its-benefit-risk-profile-in-a-new-patient-population
#5
An-Sofie Schoonjans, Fabienne Marchau, Bernard P Paelinck, Lieven Lagae, Arnold Gammaitoni, Milka Pringsheim, Martin G Keane, Berten Ceulemans
OBJECTIVE: Dravet syndrome (DS) is a rare, treatment-resistant epilepsy syndrome for which current treatment regimens are often ineffective. Fenfluramine is currently in development for treatment of DS based on reports in the 1980s and 1990s of its antiepileptic activity in pediatric patients with intractable epilepsy. However, fenfluramine was withdrawn from global markets in 1997 following reports of its association with pulmonary hypertension and heart valve disease in adult patients treated for obesity...
July 13, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28702718/single-center-experience-using-selexipag-in-a-pediatric-population
#6
Roberto Gallotti, Diana E Drogalis-Kim, Gary Satou, Juan Alejos
Pulmonary arterial hypertension (PAH) is a rare and progressive disorder. Current treatment in the pediatric population includes phosphodiesterase 5 inhibitors (PDE-5i), endothelin receptor antagonists (ERA), and both inhaled and intravenous prostacyclin pathway agonists. As of December 22, 2015 the first oral prostacyclin pathway agonist, selexipag (Uptravi(®)), was FDA approved in the US. In this case series, we discuss our single-center experience using selexipag in a pediatric population, composed of both patients with idiopathic PAH, and patients with congenital heart disease and PAH...
July 13, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28702341/severe-dyspnea-in-a-patient-with-neurofibromatosis-type-1
#7
P B Poble, J C Dalphin, B Degano
Neurofibromatosis type 1 (NF1) is a genetic disease in which pulmonary complications are rare, but severe, especially pulmonary hypertension (PH). The mechanisms underlying the onset of PH in patients with NF1 are unclear and might be multifactorial. In particular, the frequent presence of pulmonary parenchymal lesions makes etiological diagnosis of PH difficult. We describe here the case of a patient with NF1 admitted to our clinic with dyspnea and right heart failure revealing severe pre-capillary PH. Parenchymal lesions were mild and PH was attributed to pulmonary vascular involvement...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28702316/sporotrichosis-in-a-liver-transplant-patient-a-case-report-and-literature-review
#8
Renato Ferreira da Silva, Miguel Bonfitto, Francisco Inaldo Mendes da Silva Junior, Margarete Teresa Gottardo de Ameida, Rita de Cma da Silva
The liver transplant patient was admitted to the hospital with hyperemic, granulomatous, ulcerated lesion in the anterior compartment of the right lower limb with report of local trauma. The agent Sporothrix schenckii was isolated from biopsy of the lesion and lymph nodes of the right lower limb. In this case, the treatment was difficult because the patient has severe pulmonary hypertension and took the following drugs: warfarin, sildenafil, and tacrolimus. These medicines interact with the antifungal, which made it difficult...
September 2017: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/28702260/renin-angiotensin-system-modifying-therapies-are-associated-with-improved-pulmonary-health
#9
Maira Soto, Soo I Bang, Jeff McCombs, Kathleen E Rodgers
BACKGROUND: Pulmonary diseases are often complicated and have diverse etiologies. One common factor is the lack of therapeutics available for these diseases. The goal of this study was to investigate the impact of Renin-Angiotensin System (RAS)-modifying medications on incidence and time to pulmonary complications. METHODS: A retrospective analysis was conducted using claims data from a US commercial insurance company (2007-2013). The study consisted of patients with an emerging hypertension (HTN) diagnosis...
2017: Clinical Diabetes and Endocrinology
https://www.readbyqxmd.com/read/28701355/mir-4632-mediates-pdgfbb-induced-proliferation-and-anti-apoptosis-of-human-pulmonary-artery-smooth-muscle-cells-via-targeting-cjun
#10
Zhengjiang Qian, Yanjiao Li, Jidong Chen, Xiang Li, Deming Gou
MicroRNAs (miRNAs) can regulate proliferative status of pulmonary artery smooth muscle cells (PASMCs), which is a core factor modulating pulmonary vascular remodeling diseases, such as atherosclerosis and pulmonary arterial hypertension (PAH). Our previous work has shown that miR-4632, a rarely reported miRNA, is significantly downregulated in Platelet-Derived Growth Factor (PDGF)BB-stimulated human pulmonary artery smooth muscle cells (HPASMCs), yet its cell function and the underlying molecular mechanisms remain to be elucidated...
July 12, 2017: American Journal of Physiology. Cell Physiology
https://www.readbyqxmd.com/read/28701189/stromal-derived-factor-1-mediates-the-lung-regenerative-effects-of-mesenchymal-stem-cells-in-a-rodent-model-of-bronchopulmonary-dysplasia
#11
Joel Reiter, Shelley Drummond, Ibrahim Sammour, Jian Huang, Victoria Florea, Polliana Dornas, Joshua M Hare, Claudia O Rodrigues, Karen C Young
BACKGROUND: Mesenchymal stem cells (MSCs) attenuate lung injury in experimental models of bronchopulmonary dysplasia (BPD). Stromal derived factor-1 (SDF-1), a chemokine secreted by MSCs, modulates angiogenesis and stem cell recruitment. Here we tested the hypothesis that SDF-1 mediates MSC protective effects in experimental BPD by modulating angiogenesis. METHODS: SDF-1 was knocked down in MSCs using lentiviral vectors carrying anti-SDF-1 short hairpin RNA (MSC-SDF KD)...
July 12, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28695302/argatroban-attenuates-diabetic-cardiomyopathy-in-rats-by-reducing-fibrosis-inflammation-apoptosis-and-protease-activated-receptor-expression
#12
Yogesh Bulani, Shyam Sunder Sharma
PURPOSE: Chronic diabetes is associated with cardiovascular dysfunctions. Diabetic cardiomyopathy (DCM) is one of the serious cardiovascular complications associated with diabetes. Despite significant efforts in understanding the pathophysiology of DCM, management of DCM is not adequate due to its complex pathophysiology. Recently, involvement of protease-activated receptors (PARs) has been postulated in cardiovascular diseases. These receptors are activated by thrombin, trypsin, or other serine proteases...
July 10, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28694397/-effect-of-disease-severity-on-upper-extremity-muscle-strength-exercise-capacity-and-activities-of-daily-living-in-individuals-with-pulmonary-arterial-hypertension
#13
Buse Özcan Kahraman, İsmail Özsoy, Serap Acar, Ebru Özpelit, Bahri Akdeniz, Can Sevinç, Sema Savcı
OBJECTIVE: Pulmonary arterial hypertension (PAH) is a rare disease. Although muscle strength, exercise capacity, quality of life, and activities of daily living of patients with PAH are affected, it is not known how they are affected by disease severity. The purpose of the present study was to investigate effects of disease severity on upper extremity muscle strength, exercise capacity, and performance of activities of daily living in patients with PAH. METHODS: Twenty-five patients with disease severity classified according to the New York Heart Association (NYHA) as functional class II (n=14) or class III (n=11) were included in the study...
July 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28693641/arterial-switch-operation-in-patients-with-transposition-and-a-left-sided-aorta
#14
Sachin Talwar, Robert H Anderson, Pradeep Ramakrishnan, Amolkumar Bhoje, Saurabh Gupta, Shiv Kumar Choudhary, Balram Airan
OBJECTIVES: Arterial switch operation is the treatment of choice in infants with transposed arterial trunks. It is technically challenging to perform in patients having usual atrial arrangement and concordant atrioventricular connections but having a left-sided aorta. Correction in this setting requires surgical expertise and precision. Here we review our experience with such patients. METHODS: Between January, 2002 and October, 2013, the arterial switch operation was performed in 20 patients in the combination emphasised above...
July 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28690295/high-frequency-of-acute-adverse-cardiovascular-events-after-lung-transplantation-in-patients-with-pulmonary-arterial-hypertension-receiving-preoperative-long-term-intravenous-prostacyclin
#15
Satoshi Akagi, Takahiro Oto, Motomu Kobayashi, Kentaroh Miyoshi, Seiichiro Sugimoto, Masaomi Yamane, Kazufumi Nakamura, Toshihiro Sarashina, Shinichiro Miyoshi, Hiroshi Ito
Adverse cardiovascular events after lung transplantation (LT) increase the mortality in patients with pulmonary arterial hypertension (PAH). Long-term intravenous prostacyclin is the usual treatment in severe patients with PAH, but it may increase the risk of hemorrhage due to its antiplatelet aggregation effect or thrombocytopenia. We investigated the impact of length of intravenous prostacyclin therapy on acute adverse cardiovascular events including hemorrhagic complication after LT. We retrospectively compared the incidence of adverse events (death, intrathoracic hematoma and bleeding, cardiac congestion or shock, cerebral infarction and pulmonary embolism) within 30 days after LT between no/short-term (median 0...
July 10, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28688765/ctrp9-regulates-hypoxia-mediated-human-pulmonary-artery-smooth-muscle-cell-proliferation-apoptosis-and-migration-via-tgf-%C3%AE-1-erk1-2-signaling-pathway
#16
Yong Xin Li, Lin Run, Tao Shi, Yong Jian Zhang
Hypoxia is an important risk factor for pulmonary arterial remodeling in pulmonary arterial hypertension (PAH). Vascular remodeling in hypoxia-induced PAH is driven by excessive proliferation and migration of pulmonary arterial smooth muscle cells (PASMCs). The purpose of the present study was to explore the expression of CTRP9 in rats model of hypoxia-induced PAH and investigate the effects of CTRP9 on HPASMCs function in vitro and determine the underlying mechanisms. We established a rat model of hypoxic PAH, which showed an downregulation of CTRP9 expression...
July 5, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28687503/surgical-management-of-congenital-arteriovenous-fistula-near-lateral-cranial-base
#17
Rongxu Du, Bao Liu, Jiang Shao, Yu Chen, Fangda Li, Yuehong Zheng
BACKGROUND: An arteriovenous fistula is an aberrant communication between an artery and a vein, here is a case where risk factors including multiple fistulae, dangerous location and high flow blood occurred simultaneously. METHODS: The patient is a 13-year-old boy diagnosed with bilateral arteriovenous fistulae between the jugular vein and carotid artery separately, with cardiac dilatation and pulmonary artery hypertension. We performed right arteriovenous fistulae resection, ligated the involved small vessels and tightened the internal jugular vein...
July 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28686445/discovery-and-optimization-of-chromeno-2-3-c-pyrrol-9-2h-ones-as-novel-selective-and-orally-bioavailable-phosphodiesterase-5-inhibitors-for-the-treatment-of-pulmonary-arterial-hypertension
#18
Deyan Wu, Tianhua Zhang, Yiping Chen, Yadan Huang, Haiju Geng, Yanfa Yu, Chen Zhang, Zengwei Lai, Yinuo Wu, Xiaolei Guo, Jianwen Chen, Hai-Bin Luo
Phosphodiesterase 5 (PDE5) inhibitors have been used as clinical agents to treat erectile dysfunction and pulmonary arterial hypertension (PAH). Herein, we detail the discovery of a novel series of chromeno[2,3-c]pyrrol-9(2H)-one derivatives as selective and orally bioavailable inhibitors against phosphodiesterase 5. Medicinal chemistry optimization resulted in 2, which exhibits a desirable inhibitory potency of 5.6 nM with remarkable selectivity as well as excellent pharmacokinetic properties and an oral bioavailability of 63...
July 7, 2017: Journal of Medicinal Chemistry
https://www.readbyqxmd.com/read/28681363/physiological-insights-of-recent-clinical-diagnostic-and-therapeutic-technologies-for-cardiovascular-diseases
#19
REVIEW
Kenji Shigemi, Soichiro Fuke, Dai Une, Keita Saku, Shuji Shimizu, Toru Kawada, Toshiaki Shishido, Kenji Sunagawa, Masaru Sugimachi
Diagnostic and therapeutic methods for cardiovascular diseases continue to be developed in the 21st century. Clinicians should consider the physiological characteristics of the cardiovascular system to ensure successful diagnosis and treatment. In this review, we focus on the roles of cardiovascular physiology in recent diagnostic and therapeutic technologies for cardiovascular diseases. In the first section, we discuss how to evaluate and utilize left ventricular arterial coupling in the clinical settings...
July 5, 2017: Journal of Physiological Sciences: JPS
https://www.readbyqxmd.com/read/28680634/thyrotoxicosis-presenting-as-exertional-dyspnea-and-pulmonary-hypertension-case-report-and-review-of-literature
#20
Farid Rashidi, Hossein Sate, Esmaeil Faraji, Sepideh Tahsini Tekantapeh
OBJECTIVES: In this case study, we describe a 35-year-old woman with pulmonary hypertension that was secondary to thyrotoxicosis who presented with exertional dyspnea. In the approach to exertional dyspnea, detailed physical examination and laboratory findings helped to get the diagnosis. METHODS: Echocardiography showed right ventricular systolic pressure = 60 mmHg. A suppressed thyroid-stimulating hormone was seen in lab tests. The patient was treated with radioactive iodine...
2017: SAGE open medical case reports
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