Inhaled nitric oxide versus aerosolized iloprost for the treatment of pulmonary hypertension with left heart disease*

2009 ◽  
Vol 37 (3) ◽  
pp. 980-986 ◽  
Author(s):  
Ning Yin ◽  
Stephanie Kaestle ◽  
Jun Yin ◽  
Thomas Hentschel ◽  
Axel R. Pries ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Inhaled Nitric Oxide ◽  
Left Heart ◽  
Left Heart Disease

Abstract 17912: Importance of Acute Hemodynamic Effects of Inhaled Nitric Oxide in Optimization of Heart Failure Treatment in Patients with Pulmonary Hypertension due to Left Heart Disease

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Shunsuke Tatebe ◽  
Koichiro Sugimura ◽  
Kotaro Nochioka ◽  
Tatsuo Aoki ◽  
Masanobu Miura ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Arterial Pressure ◽  
Vascular Resistance ◽  
Inhaled Nitric Oxide ◽  
Left Heart ◽  
Hemodynamic Effects ◽  
Left Heart Disease

Background: Pulmonary hypertension (PH) due to left heart disease (LHD) is a major category of the disorder. We have recently reported that elevated pulmonary vascular resistance (PVR) in patients with post-capillary PH (pc-PH: defined as mean pulmonary arterial pressure (mPAP)≥25mmHg and pulmonary capillary wedge pressure (PCWP)>15mmHg) is associated with poor prognosis compared with those with no PH or pc-PH without elevated PVR. Although new treatment is required for targeting pulmonary vascular disease (PVD), thereis a concern about raising PCWP. In this study, we thus examined acute hemodynamic effects of inhaled nitric oxide (iNO) in patients with PH due to LHD and whether optimal heart failure (HF) treatment ameliorates pc-PH. Methods: We examined 60 consecutive pc-PH patients with chronic heart failure (63±14[SD] years, M/F 38/22, NYHA≥2) who underwent acute vasoreactivity test by iNO (40 ppm for 10 min) under right heart catheterization at our hospital from June 2011 to May 2014. Among them, 25 had valvular heart disease (VHD) and 35 had non-VHD. PVD (defined as PVR> 240dynes/s/cm -5 ) was noted in 18. We also evaluated right ventricular systolic pressure (RVSP) by echocardiography after optimization of HF treatment such as medications and valvular surgery. Results: iNO significantly decreased mPAP (-1.7±0.5 mmHg; P<0.01) and PVR (-66 ±14dyne/s/cm -5 , P<0.01) without altering cardiac output. iNO significantly increased PCWP (1.3±0.5 mmHg, P=0.01) only in non-VHD patients, while it significantly increased mean arterial pressure and systemic vascular resistance in VHD patients than in non-VHD patients (both P<0.05). Pc-PH patients with PVD were re-classified as having pc-PH without PVD in 9 and no PH in 1. Eight patients remained pc-PH with PVD. After the optimal medical treatment for 7.6 months, RVSP was significantly decreased in both non-VHD and VHD patient (-8±3mmHg, P=0.04, -19±8mmHg, P=0.01, respectively). However, in non-VHD group, significant reduction in RVSP was noted only in pc-PH patients without PVD (-8±3mmHg, P=0.03). Conclusions: These results indicate that elevated PVR in patients with pc-PH and non-VHD could be a novel therapeutic indication for NO-related pulmonary vasodilators in the current practice of HF.

Characterization of a Pulmonary Hypertension Model Caused by Left Heart Disease in Mouse

2020 ◽  
Author(s):  
L. K. Pallos ◽  
J. M. Dietrich ◽  
A. Simon ◽  
E. Carls ◽  
M. Matthey ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Left Heart ◽  
Left Heart Disease

Roundtable: Pulmonary Hypertension Due to Left Heart Disease

2015 ◽  
Vol 14 (2) ◽  
pp. 105-110
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Guest Editor ◽  
Mayo Clinic ◽  
Diagnosis And Treatment ◽  
Left Heart ◽  
Health Network ◽  
University Of Utah ◽  
School Of Medicine ◽  
Left Heart Disease

Guest editor Teresa De Marco, MD, along with Brian Shapiro, MD, Mayo Clinic, Jacksonville, FL, convened a panel of experts to discuss the challenges in diagnosis and treatment and the emerging science regarding pulmonary hypertension due to left heart disease. Contributing to the engaging discussion were James Fang, MD, University of Utah School of Medicine; Barry Borlaug, MD, Mayo Clinic, Rochester, MN; and Srinivas Murali, MD, Allegheny Health Network, Pittsburgh, PA.

Pulmonary Hypertension secondary to Left Heart Disease

2018 ◽  
Vol 16 (6) ◽  
pp. 555-560 ◽  
Author(s):  
Ghazal Kabbach ◽  
Debabrata Mukherjee
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Left Heart ◽  
Left Heart Disease

scholarly journals Under pressure: pulmonary hypertension associated with left heart disease

2015 ◽  
Vol 24 (138) ◽  
pp. 665-673 ◽  
Author(s):  
Harrison W. Farber ◽  
Simon Gibbs
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Survival Rates ◽  
Left Ventricular ◽  
Left Heart ◽  
Mean Pulmonary Arterial Pressure ◽  
Left Heart Disease ◽  
Right Heart Catheterisation ◽  
Pulmonary Capillary ◽  
Pulmonary Arterial

Pulmonary hypertension (PH) associated with left heart disease (PH-LHD) is the most common type of PH, but its natural history is not well understood. PH-LHD is diagnosed by right heart catheterisation with a mean pulmonary arterial pressure ≥25 mmHg and a pulmonary capillary wedge pressure >15 mmHg. The primary causes of PH-LHD are left ventricular dysfunction of systolic and diastolic origin, and valvular disease. Prognosis is poor and survival rates are low. Limited progress has been made towards specific therapies for PH-LHD, and management focuses on addressing the underlying cause of the disease with supportive therapies, surgery and pharmacological treatments. Clinical trials of therapies for pulmonary arterial hypertension in patients with PH-LHD have thus far been limited and have provided disappointing or conflicting results. Robust, long-term clinical studies in appropriate target populations have the potential to improve the outlook for patients with PH-LHD. Herein, we discuss the knowledge gaps in our understanding of PH-LHD, and describe the current unmet needs and challenges that are faced by clinicians when identifying and managing patients with this disease.

Sign in / Sign up

Export Citation Format

Share Document