Correlation of laboratory haemoconcentration measures with filling pressures obtained via pulmonary arterial pressure sensors in ambulatory heart failure patients

2020 ◽  
Vol 22 (10) ◽  
pp. 1907-1911 ◽  
Author(s):  
Aws Almufleh ◽  
Akshay S. Desai ◽  
Renaud Fay ◽  
Joao Pedro Ferreira ◽  
Leo F. Buckley ◽  
...  
Keyword(s):  
Heart Failure ◽  
Arterial Pressure ◽  
Pulmonary Arterial Pressure ◽  
Pressure Sensors ◽  
Heart Failure Patients ◽  
Pulmonary Arterial

Abstract 15903: Pulmonary Arterial Pressure During Recovery From Exercise Predicts Outcomes in Patients Undergoing Evaluation for Dyspnea

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
David S Olshan ◽  
Rohan Bhat ◽  
Robyn Farrell ◽  
Mark Schoenike ◽  
Liana Brooks ◽  
...  
Keyword(s):  
Heart Failure ◽  
Arterial Pressure ◽  
Pulmonary Arterial Pressure ◽  
Peak Exercise ◽  
Event Free Survival ◽  
Free Survival ◽  
Heart Failure Event ◽  
Failure Event ◽  
Pulmonary Arterial ◽  
Hemodynamic Measurements

Introduction: The post-exercise recovery period poses advantages over the within-exercise period for acquisition of hemodynamic measurements because of attenuated respirophasic changes, ability to time measurements precisely relative to peak exercise, and increased feasibility of multi-modality data acquisition (i.e. echocardiographic imaging). While several studies have linked rest and exercise hemodynamic measurements to outcomes, the prognostic significance of recovery hemodynamics in patients with dyspnea on exertion remains unknown. Hypothesis: Impaired recovery of mean pulmonary arterial pressure (mPAP) following exercise predicts poor clinical outcomes. Methods: Upright incremental ramp cycle ergometry cardiopulmonary exercise testing with invasive hemodynamic monitoring was performed in patients referred for evaluation of exertional dyspnea. mPAP was obtained at rest, peak exercise, and at two-minutes following peak exercise. In addition, maximum workload was recorded for each patient. mPAP elevation at recovery versus baseline, indexed to peak workload, was determined. Cox regression was performed using the primary outcome of heart failure event-free survival. Results: Among 272 patients with dyspnea on exertion and preserved LVEF [age 61 (IQR 49 – 70), 47% male, BMI 29 kg/m 2 (25 – 34), exercise duration 8.1 minutes (6.9 – 9.2), peak workload 91 watts (71 – 121)] we observed an increase in mPAP from 17 (14– 20) to 33 (28 – 41) mmHg with a fall in mPAP to 22 (18 – 29) at 2 minutes of recovery. Median mPAP elevation at recovery versus baseline mPAP, indexed to peak workload, was 0.057 (0.031 – 0.101) mmHg/W. Persistently elevated mPAP, indexed to peak workload, was associated with future risk of HF hospitalization or death both in unadjusted analysis (Cox hazard ratio 1.53 for every standard deviation increase, p=0.003), and when adjusted for age, sex, and BMI (HR 1.40, p=0.025). Conclusions: Among patients with dyspnea on exertion undergoing invasive hemodynamic evaluation during exercise, persistently elevated mPAP following exercise predicts future heart failure event-free survival and may be more feasible to estimate non-invasively than measures obtained at peak exercise.

scholarly journals Determinants and prognostic value of pulmonary arterial pressure in patients with chronic heart failure

2010 ◽  
Vol 31 (18) ◽  
pp. 2280-2290 ◽  
Author(s):  
Thibaud Damy ◽  
Kevin M. Goode ◽  
Anna Kallvikbacka-Bennett ◽  
Christian Lewinter ◽  
James Hobkirk ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Heart Failure ◽  
Arterial Pressure ◽  
Prognostic Value ◽  
Pulmonary Arterial Pressure ◽  
Pulmonary Arterial

Pulmonary Hypertension May Be a Relevant Comorbidity in Patients with Myelodysplastic Syndromes

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 5039-5039 ◽  
Author(s):  
Xhylsime Kqiku ◽  
Gabor Kovacs ◽  
Sonja Reitter ◽  
Heinz Sill ◽  
Horst Olschewski
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Arterial Pressure ◽  
Myelodysplastic Syndromes ◽  
Doppler Echocardiography ◽  
Pulmonary Arterial Pressure ◽  
Left Ventricular ◽  
Functional Class ◽  
Increased Risk ◽  
Pulmonary Arterial

Abstract Abstract 5039 Background: Pulmonary hypertension (PH) is characterized by elevated pulmonary arterial pressure and increased pulmonary vascular resistance, leading to right-sided heart failure and death. PH is defined as an increase in mean pulmonary arterial pressure (mPAP) ≥25 mmHg at rest. PAP values can be non-invasively estimated by Doppler echocardiography while right heart catheterization is needed for definite diagnosis. Hematologic disorders are associated with PH but it is unknown if myelodysplastic syndromes (MDS) bear an increased risk for PH. The objective of this study was to investigate the prevalence of PH in patients with MDS. Patients and Methods: From March 2009 to July 2011 consecutive MDS patients were recruited from the Hematology Division of the Medical University of Graz and enrolled in this PH screening program. All patients underwent Doppler echocardiography. PH was suspected if resting systolic pulmonary arterial pressure (SPAP) exceeded 40 mmHg. Additionally six minute walk distance (6MWD), pulmonary function test (PFT), laboratory tests including N-terminal pro brain natriuretic peptide (NT-proBNP), IPSS Score and WHO functional class were determined. Results: Fourty four MDS patients (female:male=18:26, age 70±12 years, disease onset 5±8 years, NYHA functional class I:II:III:IV=21:16:7:0, IPSS low/intermediate-I/intermediate- II/high/unknown=16:14:8:3:3; hemoglobin: 11±2 g/dl, white blood cell count 4±3 g/l; platelet count 159±125 g/l; regular transfusions n=19; WHO Classification: RCUD/RARS/RCMD/MDS del(5q)/RAEBI/RAEB II/MDSU=2:3:21:2:6:6:4 ) were included. Six patients had elevated SPAP (PH group, SPAP: 56±9mmHg) vs. 38 patients with normal values (SPAP 29±5mmHg). PH group were slightly older (79±9 vs. 69±11 years, p=0.53), had a decreased right ventricular function (TAPSE: 18±5mm vs. 22±4mm, p=0.05), a larger left atrium (46±5mm vs. 36±9mm measured in the parasternal long axis, p=0.005), a slightly decreased left ventricular systolic function (fractional shortening: 30±11% vs. 38±9 %, p=0.1) a significantly lower 6MWD (275±117m vs. 438±105m, p=0.01) and higher NT proBNP (4515±4732 pg/ml vs. 313±252 pg/ml, p=0.001) than patients with normal SPAP. In 4/6 PH group patients a relevant diastolic dysfunction of the left ventricle was suggested by echocardiography. Conclusion: According to our data, PH is present in about 15% of MDS patients and is associated with decreased physical capacity and heart failure. This suggests that PH may be considered as a relevant comorbidity in this cohort of patients. The reason of PAP increase may be multifactorial, postcapillary factors probably playing a relevant role. Disclosures: No relevant conflicts of interest to declare.

Gene Variant of the Bradykinin B2 Receptor Influences Pulmonary Arterial Pressures in Heart Failure Patients

2009 ◽  
Vol 3 ◽  
pp. CCRPM.S2147
Author(s):  
Thomas P. Olson ◽  
Robert P. Frantz ◽  
Stephen T. Turner ◽  
Kent R. Bailey ◽  
Christina M. Wood ◽  
...  
Keyword(s):  
Heart Failure ◽  
Vascular Tone ◽  
Pulmonary Arterial Pressure ◽  
Nyha Class ◽  
Left Ventricular ◽  
Gene Variant ◽  
Blood Draw ◽  
Heart Failure Patients ◽  
Lv Dysfunction ◽  
Pulmonary Arterial

Background Pulmonary arterial pressure (PAP) varies considerably in heart failure (HF) despite similar degrees of left ventricular (LV) dysfunction. Bradykinin alters vascular tone and common variations in the kinin B2 receptor (BDKRB2) gene exists. We hypothesized that genetic variation in this receptor would influence PAP in HF. Methods 131 HF patients (>1yr history systolic HF), without COPD, not currently smoking, BMI < 40, without atrial fibrillation completed the study which included a blood draw for genotyping and neurohormones (ACE, A-II, Bradykinin, ANP, BNP, and catecholamines), an echocardiogram for cardiac function and systolic PAP (PAPsys). Results Mean LVEF was 29% ∓ 12%, NYHA class 2 ∓ 1, age 56 ∓ 12 yr, BMI 28 ∓ 5 kg/m2. Forty-six patients (35%) were homozygous for the +9 allele, 58 (44%) were heterozygous (+9/-9) and 27 (21%) were homozygous for the -9 allele of the BDKRB2. PAPsys averaged 42 ∓ 13, 38 ∓ 12, and 35 ∓ 11 mmHg for +9/+9, +9/-9 and -9/-9, respectively (p = 0.03). There was a trend towards gene effect for plasma ACE with the highest values in +9/+9 and lowest in -9/-9 patients (9.5 ∓ 10.7, 7.1 ∓ 8.7, and 5.4 ∓ 6.4 U/L, respectively, p = 0.06). There were no differences in plasma bradykinin or A-II, LVEF, or NYHA across genotypes. Conclusion These data suggest the +9/+9 polymorphism of the BDKRB2 receptor influences pulmonary vascular tone in stable HF.

Treatment of Severe Hypertension with Minoxidil and its Effects on Systemic and Pulmonary Haemodynamics

1976 ◽  
Vol 51 (s3) ◽  
pp. 587s-589s ◽  
Author(s):  
D. Hall ◽  
K. L. Froer ◽  
C. Loracher
Keyword(s):  
Heart Failure ◽  
Arterial Pressure ◽  
Pulmonary Arterial Pressure ◽  
Severe Hypertension ◽  
Chronic Administration ◽  
Direct Result ◽  
Small Decrease ◽  
Mean Pulmonary Arterial Pressure ◽  
Pulmonary Haemodynamics ◽  
Pulmonary Arterial

1. The chronic administration of minoxidil, 0024–0·212 mmol (5–40 mg) daily, to fifty-two severely hypertensive patients resulted in an average reduction of mean arterial pressure from 170 to 111 mmHg. 2. Haemodynamic studies in twelve of these patients indicated that the rise in pulmonary arterial pressure in patients without heart failure appears to be a direct result of a disproportionately large increase in cardiac output with respect to a relatively small decrease in pulmonary vascular resistance. Anti-hypertensive treatment of patients with congestive heart failure resulted in a decrease in mean pulmonary arterial pressure.

scholarly journals Prognostic value of the right ventricle diameter, pulmonary arterial pressure and biomarkers in patients with acute heart failure

2021 ◽  
Vol 38 (2) ◽  
pp. 116-124
Author(s):  
Dejan Petrović ◽  
Marina Deljanin-Ilić ◽  
Sanja Stojanović ◽  
Dejan Simonović ◽  
Dijana Stojanović ◽  
...  
Keyword(s):  
Heart Failure ◽  
Arterial Pressure ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Acute Heart Failure ◽  
Pulmonary Arterial Pressure ◽  
Prognostic Significance ◽  
Pulmonary Arterial ◽  
One Year ◽  
The Right

The aim of the paper was to examine the echocardiographic parameters of the right ventricle (RV), its diameter and pulmonary arterial pressure (PAP); to determine their relationship to B-type natriuretic peptide (BNP), troponin and (TnI) and high-sensititity C-raective protein (hsCRP), and to evaluate their prognostic significance to one-year mortality in patients with acute heart failure (AHF). The study included a total of 225 patients (pts) (70.29 ± 9.74 years) who were admitted to Intensive care unit due to the signs and symptoms of AHF. The values of standard biochemical parameters, BNP, TnI and hsCRP were determined during the first 24 hours after admission. All patients underwent echocardiographic examination. During a one-year follow-up, 78 (34.70%) patients died. As compared with the group of survivors (n = 147), the group of non-survivors had higher values of BNP (853.10 ± 384.92 vs. 1399.68 ± 464.44 pg/mL, p < 0.001), TnI (0.59 ± 2.04 vs. 2.00 ± 8.29 ng/ml, p < 0.05), right ventricular diameter and PAP (p < 0.001). BNP was positively correlated with TnI (r = 0.311), PAP (r = 0.255) and right ventricular diameter (r = 0.304, p < 0.001 for all correlations). The cut-off value of BNP ≥ 1062.04 pg/ml, PAP ≥ 44.5 mmHg and TnI ≥ 0.04 ng/ml were associated with a higher risk of mortality. Our results have shown that BNP, PAP and TnI are strong and independent predictors of one-year mortality in hospitalized patients with acute heart failure.

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