scholarly journals Advances in nutritional status of patients with connective tissue-associated pulmonary hypertension

2021 ◽  
Vol 233 ◽  
pp. 02002
Author(s):  
Jiang Jinyan ◽  
Li Jin ling ◽  
Chengjie
Keyword(s):  
Pulmonary Hypertension ◽  
Connective Tissue ◽  
Pulmonary Artery ◽  
Connective Tissue Disease ◽  
Pulmonary Artery Pressure ◽  
Pathological Condition ◽  
Rare Complication ◽  
Heart Catheterization ◽  
Right Heart ◽  
Artery Pressure

Connective Tissue Disease (CTD) is an autoimmune disease involving connective tissues, including sjogren syndrome (pSS), rheumatoid arthritis (RA), systemic sclerosis (SSc), mixed connective tissue disease (MCTD), systemic lupus erythematosus (SLE), etc. [1,2]. Pulmonary Arterial Hypertension (PAH) refers to a pathological condition in which the pulmonary artery pressure rises above a certain threshold, causing right heart failure and death [3]. PAH refers to the mean Pulmonary Artery Pressure (mPAP) of greater than 25 mmHg and the pulmonary wedge pressure (PAWP) of less than 15mmhg under right heart catheterization (RHC) at rest [4,5]. The only criterion for examining pulmonary hypertension is right cardiac catheterization. Connective tissue disease-associated pulmonary hypertension (CTD-PAH) is a rare complication of PAH, characterized by high mortality, venous and cardiac involvement and poor prognosis [6-8].

scholarly journals Poor Tricuspid Regurgitation Signal on Echocardiogram: How Does It Correlate with Pulmonary Artery Pressure as Measured by Right Heart Catheterization?

2021 ◽  
Author(s):  
Mohammad Aziz ◽  
Steven Romero ◽  
Matthew Price ◽  
Rajeev Mohan
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Right Heart Catheterization ◽  
Heart Catheterization ◽  
Right Heart ◽  
Artery Pressure ◽  
Upper Limit ◽  
Lower Likelihood ◽  
Rule Out

Abstract BackgroundTricuspid Regurgitation (TR) gradient on echocardiogram is used to approximate pulmonary artery pressure (PAP) on echocardiography. A common dilemma is encountered when PAP measurement is indeterminate due to poor TR signal. We hypothesized that patients with poor TR signal would be unlikely to have pulmonary hypertension (PH) on right heart catheterization (RHC). MethodsWe performed a retrospective analysis of 141 patients who underwent RHC and had a corresponding echocardiogram showing poor TR signal within 2 months of RHC. A cutoff of 25 mm Hg was used as the upper limit of normal to define PH. ResultsFifty percent of patients had mean PAP (mPAP) greater than 25 mm Hg. 82% of values were 35 mm Hg or below. ConclusionsPoor TR signal does not rule out PH but may indicate lower likelihood of severe PH.

scholarly journals P1529 Impact of the new PH guidelines on echocardiographic definition leading to double demand of right heart catheterization

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
C Fauvel ◽  
O Raitiere ◽  
J Burdeau ◽  
N Si Belkacem ◽  
F Bauer
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Tricuspid Regurgitation ◽  
Peak Velocity ◽  
Right Heart Catheterization ◽  
Heart Catheterization ◽  
Right Heart ◽  
Artery Pressure ◽  
Mean Pulmonary Artery Pressure ◽  
Definition Of

Abstract Background Doppler echocardiography is the most widespread and well-recognized technique for the screening of patients with pulmonary hypertension (PH). When tricuspid regurgitation peak velocity (TRPV) ≥3.4 m/s, right heart catheterization is requested to confirm mean pulmonary artery pressure >25 mm Hg. In the proceedings from the 6th world symposium on pulmonary arterial hypertension recently released, the new definition of PH has been lowered to mean pulmonary artery pressure > 20 mm Hg. Purpose The purpose of our work was twofold : i) to determine a new cut-off value for TRPV to accommodate the new hemodynamic definition of PH, ii) to investigate the impact on the demand of right heart catheterization (RHC) from our echo CORE lab. Methods We extracted and analyzed both the haemodynamic and echocardiographic records of 130 patients who underwent investigations the same day. Tricuspid regurgitation peak velocity was measured in apical-4 chamber view using continuous-wave doppler modality and compared to mean pulmonary artery pressure recorded from fluid-filled catheter. Results Tricuspid regurgitation peak velocity has a weak correlation with mean pulmonary pressure (y = 9.2x-2.2, r² = 0.22, p < 0.01). Targeting a mean pulmonary pressure on right heart catheterization of 20 mm Hg for the definition of PH, receiver operating characteristic curve analysis demonstrated a good association between TRPV and PH diagnosis (area under the curve, 0.78 ; p < 0.001). The cut-off value obtained for TRPV was 3.0 m/s (Se = 0.78, Sp = 0.37). From 01/01/18 to 31/12/18, 2539 out of 6215 had TRPV recorded from which 283 had TRPV ≥ 3.0 m/s (24,1%) and 615 had TRPV ≥ 3.4 m/s (11,1%). When applied to a community population the new TRPV cutoff > 3m/s used as surrogate for mean pulmonary artery pressure > 20 mm Hg may produce a 111% increase of right heart catheterization demand. Conclusions The new definition of pulmonary hypertension (invasive mean pulmonary artery pressure > 20mm Hg) necessitates revisiting tricuspid regurgitation peak velocity > 3 m/s as a screening test leading to more than twice RHC demand.

865 Increased Mean Pulmonary Artery Pressure on Right Heart Catheterization Affects Post-OLT Complications

2013 ◽  
Vol 144 (5) ◽  
pp. S-964
Author(s):  
Hye Yeon Jhun ◽  
Catherine T. Frenette ◽  
Maha Boktour ◽  
Arvind Bhimaraj ◽  
Jerry Estep ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Right Heart Catheterization ◽  
Heart Catheterization ◽  
Right Heart ◽  
Artery Pressure ◽  
Mean Pulmonary Artery Pressure

scholarly journals Sensitivity and Specificity of pulmonary artery pressure measurement in echocardiography and correlation with right heart catheterization

2021 ◽  
Vol 33 (3) ◽  
pp. 228-336
Author(s):  
Muhammad Adil Soofi ◽  
Muhammad Azam Shah ◽  
Ammar Mohammed AlQadhi ◽  
Abdulla Mofareh AlAnazi ◽  
Waleed M Alshehri ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Sensitivity And Specificity ◽  
Pressure Measurement ◽  
Right Heart Catheterization ◽  
Heart Catheterization ◽  
Right Heart ◽  
Artery Pressure

scholarly journals Effect of Ketamine in Pulmonary Hypertensive Children

2017 ◽  
Vol 6 (1) ◽  
pp. 23-26
Author(s):  
Jeju N Pokharel ◽  
M R Upreti ◽  
D R Shakya ◽  
Shyam Raj Regmi ◽  
Urmila Shakya ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Right Heart Catheterization ◽  
Heart Catheterization ◽  
Catheterization Laboratory ◽  
Cardiac Catheterization Laboratory ◽  
Artery Pressure ◽  
Before And After ◽  
Uncommon Condition

Pulmonary hypertension is not an uncommon condition in clinical setting. Pulmonary artery (PA) pressure may increase during anesthesia because of the hypoxia, hypoventilation and acidosis. Keeping these factors constant there are also other possibilities which can increase the PA pressure, for example drugs. Among them ketamine is known to increase PA pressure in adults especially when they have baseline increased PA pressure. In few literatures it is claimed that in children ketamine may be safe even in those with pulmonary hypertension. We are using ketamine as a component of intravenous anesthesia in catheterization lab during right heart catheterization, pressure measurement and saturation evaluation. We thought it was necessary to evaluate the effect to ketamine on pulmonary artery pressure in pediatric patients in our setting. Altogether fifteen children diagnosed with pulmonary hypertension wer anesthetized with ketamine based anesthesia and the pulmonary artery pressure was evaluated in cardiac catheterization laboratory before and after 5, 10 and 15 min of injection of the ketamine (2mg/kg body weight) intravenously. We found in our study only about 6.2% increment in pulmonary artery pressure after 5 minutes of the injection of the ketamine and the pressure came to the pre-injection level at 10 to 15 minutes of the injection In conclusion of this preliminary study with limited number of the cases, ketamine can be used safely without much problems in pulmonary hypertensive children secondary to the increased blood flow to the lungs.

scholarly journals Prediction of pulmonary hypertension in older adults based on vital capacity and systolic pulmonary artery pressure

2020 ◽  
Vol 9 ◽  
pp. 204800402097383
Author(s):  
Simon Wernhart ◽  
Jürgen Hedderich
Keyword(s):  
Older Adults ◽  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Vital Capacity ◽  
Heart Catheterization ◽  
Systolic Pulmonary Artery Pressure ◽  
Operating Characteristics ◽  
Artery Pressure ◽  
Non Invasive

Objective Right heart catheterization (RHC) is associated with a higher procedural risk in older adults, but non-invasive estimation of pulmonary hypertension (PH) is a challenge. We aimed to elaborate a non-invasive prediction model to estimate PH. Methods and design We retrospectively analysed 134 older adults (70.0 years ±12.3; 44.9% males) who reported to our clinic with unclear dyspnea between 01/2015 and 01/2020 and had received RHC as a part of their diagnostic workup. Lung function testing, analysis of blood gas samples, 6 min walk distance and echocardiography were performed within 24 hours of RHC. Main outcome measures In a stepwise statistical approach by using an in/exclusion algorithm (using the AIC criterion) we analysed non-invasive parameters to test their value in predicting PH (defined as mean pulmonary artery pressure, PAmean, >25mmHg). Discrimination capability of the final model was measured by the AUC (area under curve) from an ROC (receiver operating characteristics) analysis. Results We yielded a sensitivity of 87.2% and a specificity of 62.5% in a combinatorial logistical model with systolic pulmonary artery pressure (sPAP) and forced vital capacity (VCmax), the discrimination index was 86.7%. The odds ratios for an increase of 10 mmHg of sPAP were 2.99 (2.08–4.65) and 1.86 (1.11–3.21) for a 1 l decrease in VCmax. On their own, VCmax proved to be specific (83.3%), while sPAP was a sensitive (79.1%) predictor for PH. Conclusions We provide a combinatorial model to predict PH from sPAP and VCmax in older adults, which may help to avoid invasive procedures.

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