Impact of right ventricular dysfunction and end-diastolic pulmonary artery pressure estimated from analysis of tricuspid regurgitant velocity spectrum in patients with preserved ejection fraction

2018 ◽  
Vol 20 (4) ◽  
pp. 446-454 ◽  
Author(s):  
Guy Baruch ◽  
Ehud Rothschild ◽  
Livia Kapusta ◽  
Lorin Arie Schwartz ◽  
Simon Biner ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Pulmonary Artery ◽  
Right Ventricular ◽  
Pulmonary Artery Pressure ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Velocity Spectrum ◽  
Preserved Ejection Fraction ◽  
Artery Pressure

CHANGES IN THE LEVEL OF NT-proBNP AND MEAN PULMONARY ARTERY PRESSURE FOLLOWING BRONCHOPLASTIC LOBECTOMY OR PNEUMONECTOMY AS MARKERS OF RIGHT VENTRICULAR DYSFUNCTION

2021 ◽  
pp. 6-13
Author(s):  
V. F. Larin ◽  
V. A. Zhikharev ◽  
A. S. Bushuev ◽  
V. A. Porhanov ◽  
V. A. Koriachkin ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Pulmonary Artery ◽  
Right Ventricular ◽  
Pulmonary Artery Pressure ◽  
Pulmonary Resection ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Control Group ◽  
Artery Pressure ◽  
The Mean

Background There are scanty data of right ventricular dysfunction markers after major pulmonary resection.Objective To study the changes of plasma level of N-terminal pro-brain natriuretic peptide (NT-proBNP) and its association with pulmonary artery pressure (PAP) as markers of right ventricular dysfunction in patients who underwent bronchoplastic lobectomy or pneumonectomy.Material and Methods The study population consisted of 36 patients aged 40–65 who underwent major  pulmonary resection for lung cancer in 2016–2018. Patients were stratified into two groups according to the type of surgical procedure: bronchoplastic lobectomy, the main group (n = 19), and pneumonectomy, control group (n = 17). They were then analyzed for plasma NT-proBNP concentration, operative time, blood loss, intraoperative fluid administration, intraoperative urine output, and mean PAP level before and after an operation.Results The mean PAP level correlated positively with the plasma NT-proBNP concentration in the pneumonectomy group (Pearson r = 0.916754; p < 0.001). This correlation was no evident in the subset of patients undergoing bronchoplastic lobectomy at the same determination point (Pearson r = 0.234741; p = 0.330).Conclusion The mean PAP increased significantly after pneumonectomy and is closely correlated with plasma  NTproBNP concentration. These findings support the conclusion that bronchoplasty is preferable over pneumonectomy for lung cancer patients.

scholarly journals Management of Pulmonary Embolism with Rheolytic Thrombectomy

2011 ◽  
Vol 18 (4) ◽  
pp. e52-e58 ◽  
Author(s):  
Lisa Ferrigno ◽  
Robert Bloch ◽  
Judson Threlkeld ◽  
Thomas Demlow ◽  
Raman Kansal ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Right Ventricular ◽  
Pulmonary Artery Pressure ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Shock Index ◽  
Pulmonary Embolectomy ◽  
Artery Pressure ◽  
Rheolytic Thrombectomy

BACKGROUND: Catheter thrombectomy combining thrombus destruction with local thrombolysis has been used in patients with pulmonary embolism (PE) who are unstable or have significant right heart dysfunction, but have contraindications to systemic thrombolytic therapy.OBJECTIVES: To assess the outcomes of patients who underwent pulmonary embolectomy using a commercially available thrombectomy device.METHODS: A retrospective chart review of patients who underwent pulmonary embolectomy between March 2007 and August 2009 was performed. Patients were classified as having clinical massive or submassive PE, and moderate or severe right ventricular dysfunction. Data collected included pre- and postprocedure shock index (heart rate divided by systolic blood pressure) and mean pulmonary artery pressure.RESULTS: Sixteen patients with a mean (± SD) age of 54.4±15.8 years underwent embolectomy. Five had clinical massive PE (two in cardiogenic shock) and three of 11 submassive cases had severe right ventricular dysfunction. All were deemed to have contraindications to systemic lysis. Both shock index (1.02±33 preintervention versus 0.71±0.2 postintervention [P=0.001]) and mean pulmonary artery pressure (34.5±9.9 mmHg preintervention versus 27.1±7.1 postintervention [P=0.01]) improved. In the massive PE group, one patient died and two survivors experienced retroperitoneal bleeding and transient renal failure. At follow-up (17.3±7.8 months), two patients in the massive PE group demonstrated evidence of mild cor pulmonale.CONCLUSION: Rheolytic thrombectomy is an effective strategy in managing massive PE, particularly in patients who have well-defined contraindications to systemic lytic therapy. The effectiveness of rheolytic thrombectomy for submassive PE is not as well defined, but warrants a comparison with systemic lytic therapy.

scholarly journals Functional Status, Pulmonary Artery Pressure, and Clinical Outcomes in Heart Failure With Preserved Ejection Fraction

2016 ◽  
Vol 68 (2) ◽  
pp. 189-199 ◽  
Author(s):  
Daniel Dalos ◽  
Julia Mascherbauer ◽  
Caroline Zotter-Tufaro ◽  
Franz Duca ◽  
Andreas A. Kammerlander ◽  
...  
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Pulmonary Artery ◽  
Functional Status ◽  
Clinical Outcomes ◽  
Pulmonary Artery Pressure ◽  
Preserved Ejection Fraction ◽  
Artery Pressure

Right Heart Phenotype in Heart Failure With Preserved Ejection Fraction

2021 ◽  
Author(s):  
Marco Guazzi ◽  
Robert Naeije
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Ventricular Dysfunction ◽  
Imaging Techniques ◽  
Treatment Options ◽  
Right Ventricular Dysfunction ◽  
Preserved Ejection Fraction ◽  
Right Heart ◽  
The Right

The health burden of heart failure with preserved ejection fraction is increasingly recognized. Despite improvements in diagnostic algorithms and established knowledge on the clinical trajectory, effective treatment options for heart failure with preserved ejection fraction remain limited, mainly because of the high mechanistic heterogeneity. Diagnostic scores, big data, and phenomapping categorization are proposed as key steps needed for progress. In the meantime, advancements in imaging techniques combined to high-fidelity pressure signaling analysis have uncovered right ventricular dysfunction as a mediator of heart failure with preserved ejection fraction progression and as major independent determinant of poor outcome. This review summarizes the current understanding of the pathophysiology of right ventricular dysfunction in heart failure with preserved ejection fraction covering the different right heart phenotypes and offering perspectives on new treatments targeting the right ventricle in its function and geometry.

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