scholarly journals RIGHT VENTRICULAR CARDIAC POWER OUTPUT IS INVERSELY RELATED TO PULMONARY VASCULAR RESISTANCE IN CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION

2012 ◽  
Vol 59 (13) ◽  
pp. E1610
Author(s):  
Yu Xie ◽  
William Auger ◽  
Michael Madani ◽  
Lori Daniels ◽  
Thomas Waltman ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Right Ventricular ◽  
Pulmonary Vascular Resistance ◽  
Vascular Resistance ◽  
Power Output ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Cardiac Power ◽  
Thromboembolic Pulmonary Hypertension

scholarly journals Regional Right Ventricular Abnormalities Implicate Distinct Pathophysiological Conditions in Patients With Chronic Thromboembolic Pulmonary Hypertension

2020 ◽  
Vol 9 (21) ◽  
Author(s):  
Hidenori Moriyama ◽  
Takashi Kawakami ◽  
Masaharu Kataoka ◽  
Takahiro Hiraide ◽  
Mai Kimura ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Right Ventricular ◽  
Pulmonary Vascular Resistance ◽  
Pulmonary Artery Pressure ◽  
Vascular Resistance ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Area Change ◽  
Thromboembolic Pulmonary Hypertension ◽  
Rv Function

Background Right ventricular (RV) dysfunction is a prognostic factor for cardiovascular disease. However, its mechanism and pathophysiology remain unknown. We investigated RV function using RV‐specific 3‐dimensional (3D)‐speckle‐tracking echocardiography (STE) in patients with chronic thromboembolic pulmonary hypertension. We also assessed regional wall motion abnormalities in the RV and chronological changes during balloon pulmonary angioplasty (BPA). Methods and Results Twenty‐nine patients with chronic thromboembolic pulmonary hypertension who underwent BPA were enrolled and underwent right heart catheterization and echocardiography before, immediately after, and 6 months after BPA. Echocardiographic assessment of RV function included both 2‐dimensional‐STE and RV‐specific 3D‐STE. Before BPA, global area change ratio measured by 3D‐STE was significantly associated with invasively measured mean pulmonary artery pressure and pulmonary vascular resistance ( r =0.671 and r =0.700, respectively). Dividing the RV into the inlet, apex, and outlet, inlet area change ratio showed strong correlation with mean pulmonary artery pressure and pulmonary vascular resistance before BPA ( r =0.573 and r =0.666, respectively). Only outlet area change ratio was significantly correlated with troponin T values at 6 months after BPA ( r =0.470), and its improvement after BPA was delayed compared with the inlet and apex regions. Patients with poor outlet area change ratio were associated with a delay in RV reverse remodeling after treatment. Conclusions RV‐specific 3D‐STE analysis revealed that 3D RV parameters were novel useful indicators for assessing RV function and hemodynamics in pulmonary hypertension and that each regional RV portion presents a unique response to hemodynamic changes during treatment, implicating that evaluation of RV regional functions might lead to a new guide for treatment strategies.

scholarly journals Physical activity and its clinical correlates in chronic thromboembolic pulmonary hypertension

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
C Schmidt ◽  
M Monteiro ◽  
A Reis ◽  
M Santos
Keyword(s):  
Physical Activity ◽  
Pulmonary Hypertension ◽  
Pulmonary Vascular Resistance ◽  
Vascular Resistance ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Functional Domain ◽  
Poor Agreement ◽  
Clinical Correlates ◽  
Thromboembolic Pulmonary Hypertension ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Fundação para a Ciência (FCT) Coordenação de Aperfeiçoamento de Pessoal de Nível (CAPES) Background  Limited data is available on physical activity (PA) levels in chronic thromboembolic pulmonary hypertension (CTEPH) patients, as well as on the impact of using different tools to assess PA such as questionnaires and accelerometers.  Purpose  We aimed to quantify PA levels of CTEPH patients and study its clinical correlates, as well as to compare PA levels measured by the International Physical Activity Questionnaire (IPAQ) with measures from accelerometers. Methods  This is a cross-sectional study (n = 50). Physical activity levels were measured using accelerometers and questionnaire (IPAQ). Clinical parameters evaluated were walked distance on the 6-minute-walking test (6MWT), pulmonary vascular resistance, N-terminal brain natriuretic peptide and quality of life (HRQoL) using the Cambridge Pulmonary Hypertension Outcome Review questionnaire. Results  Accelerometer-derived data showed that CTEPH patients spent 60% of the recorded time in sedentary behaviours and only 2% in moderate-to-vigorous PA (MVPA). MVPA was mildly correlated with 6MWT (r = 0.359; p= 0.023) and symptom domain of HRQoL (r=-0.371; p = 0.044) but not with NT-proBNP, pulmonary vascular resistance or functional domain of HRQoL. Time spent in sedentary behaviour was lower in self-reported measurement (279 ± 165min/day) compared to accelerometry (446 ± 117min/day, p < 0.001). Self-reported MVPA was significantly higher than the one registered by the accelerometer (411 ± 569 vs. 131 ± 108 min/week, p = 0.027). Bland-Altman analysis indicated poor agreement between the two methods.  Conclusions  Our results showed that CTEPH patients spend most of their days in sedentary behaviors and only a small amount of time in MVPA. MVPA was associated with symptoms domain of HRQoL and submaximal functional capacity. In addition, we showed a poor agreement between self-reported and accelerometer-derived PA in CTEPH patients, with the former overestimating the overall PA activity.

P6515Balloon pulmonary angioplasty in patients with chronic thromboembolic pulmonary hypertension: a systematic review and meta-analysis

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G Denas ◽  
G Zoppellaro ◽  
M R Badawy ◽  
A Squizzato ◽  
G Tarantini ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pulmonary Hypertension ◽  
Publication Bias ◽  
Pulmonary Vascular Resistance ◽  
Vascular Resistance ◽  
Treatment Option ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Walking Distance ◽  
Balloon Pulmonary Angioplasty ◽  
Thromboembolic Pulmonary Hypertension

Abstract Introduction Balloon pulmonary angioplasty (BPA) is a percutaneous treatment option for patients with chronic thromboembolic pulmonary hypertension (CTEPH) judged inoperable or with persistent symptoms after surgery. Purpose We performed a systematic review of the literature to better understand the effectiveness and safety of balloon pulmonary angioplasty. Methods PubMed and EMBASE were searched for studies reporting BPA results in patients with CTEPH. Differences in clinical and hemodynamic parameters including 6-minute walking distance, NYHA class, mean PAP, pulmonary vascular resistance, and cardiac output, before and after the procedure were analyzed. Weighted mean proportion and 95% confidence intervals (CIs) of adverse events were calculated. Results Of the 1084 potentially eligible studies, 13 were included in the final analysis, yielding on overall cohort of 676 patients. BPA was associated with a reduction in mean pulmonary artery pressure (median: from 43 to 30 mmHg), reduction in pulmonary vascular resistance (median: from 10.22 to 5.00 Woods Units), increase in cardiac index (median: from 2.45 to 2.72 l/min/m2), and improvement of 6-minute walking distance (median: from 328 to 442 meters). Estimated peri-procedural mortality was 2.2% of patients (95% CI 0.7–4.4) with a low risk of publication bias. Mortality rate tends to be higher in older studies and this is consistent with the progressive experience gathered by operators. Reperfusion and pulmonary vessel injuries occurred in 9.5% (95% CI 2.7–19.6) and 2.5% (95% CI 0.8–5.0) of the total BPA sessions, respectively, with on overall high risk of publication bias. Haemodynamic parameters and 6-minute wal Conclusions Our findings suggest that BPA in CTEPH patients is an effective and safe treatment option in inoperable patients or patients with persistent-recurrent symptoms after surgery. Balloon pulmonary angioplasty might be considered as a second line-treatment in patients with chronic thromboembolic pulmonary hypertension not amenable for surgery.

scholarly journals Surgical Treatment of Chronic Thromboembolic Pulmonary Hypertension

2000 ◽  
Vol 7 (1) ◽  
pp. 49-57 ◽  
Author(s):  
Fraser Rubens ◽  
Phil Wells ◽  
Steven Bencze ◽  
Michael Bourke
Keyword(s):  
Pulmonary Hypertension ◽  
Cardiac Index ◽  
Pulmonary Vascular Resistance ◽  
Vascular Resistance ◽  
Case Series ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Chronic Obstructive ◽  
Pulmonary Thromboendarterectomy ◽  
Case Series Study ◽  
Thromboembolic Pulmonary Hypertension

BACKGROUND:There are only limited treatment options for patients with chronic thromboembolic pulmonary hypertension in Canada.OBJECTIVE:To conduct a case-series study to assess the effectiveness of surgical endarterectomy of the pulmonary artery.DESIGN AND SETTING:Twenty-one patients with chronic thromboembolic pulmonary hypertension were admittedfor surgerybetween July 1995 and October 1999. Clinical, laboratory and radiological data were collected for all patients who then underwent pulmonary thromboendarterectomy.MAIN RESULTS:Thirteen men and eight women between 22 and 71 years of age underwent surgery. The main presenting complaint was dyspnea on exertion. Pulmonary vascular resistance ranged from 382 to 1694 dynes·s·cm-5with a mean of 765±372 dynes·s·cm-5(normal is less than 180 dynes·s·cm-5) with a mean cardiac index of 2.2±0.9 L/min/m2. Two patients had concomitant tricuspid valve replacement and one patient had coronary bypass grafting. In three cases, the surgery involved a repeat sternotomy. After surgery, there was a significant drop in the pulmonary vascular resistance (208±92 dynes·s·cm-5, P<0.05) and a concomitant rise in the cardiac index to a mean of 3.1±0.6 L/min/m2(P<0.05). There was one death in a patient who also had severe chronic obstructive pulmonary disease. Of the remaining patients, all but two showed significant clinical improvement. Spiral computed tomography postsurgery demonstrated improvement in pulmonary perfusion with either complete clearing or significant improvement in the mosaic perfusion pattern. Right ventricular function and pressure on echocardiogram improved in all but two patients.CONCLUSIONS:Pulmonary thromboendarterectomy provides effective treatment for chronic thromboembolic pulmonary hypertension.

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