scholarly journals Pulmonary Hypertension and Hypocholesterolemia Secondary to Thyrotoxicosis

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Narangoda Liyanage Ajantha Shyamali ◽  
Chandrike Ponnamperuma
Keyword(s):  
Pulmonary Hypertension ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Lipid Levels ◽  
Case Presentation ◽  
Cholesterol Levels ◽  
Thyrotropin Receptor Antibodies ◽  
Sternal Border ◽  
Receptor Antibodies ◽  
Low Cholesterol

Background. Thyroid disorders commonly affect the cardiovascular system. Thyrotoxicosis leading to pulmonary hypertension has been increasingly reported during recent years. Thyroid dysfunction affects the lipid metabolism, and thyrotoxicosis can be associated with low lipid levels. Thyrotoxicosis presenting with right ventricular dysfunction is rare, and only few cases had been reported. Case Presentation. A 53-year-old woman presented with progressive shortness of breath and swelling of body for four months. Examination showed generalized oedema and a systolic murmur over the left sternal border. Transthoracic echocardiography confirmed pulmonary hypertension with tricuspid regurgitation. Investigations revealed thyrotoxicosis and very low cholesterol levels. Diagnosis of Graves’ disease was confirmed with detection of thyrotropin receptor antibodies. Pulmonary pressure was normalized six months after antithyroid therapy. Conclusion. Thyrotoxicosis is a recognized cause of reversible pulmonary hypertension and acquired hypocholesterolemia. However, most clinicians are not aware of these associations. This case illustrates the importance of assessing thyroid function in patients presenting with pulmonary hypertension.

The strain-encoded (SENC) MR imaging for detection of global right ventricular dysfunction in pulmonary hypertension

2012 ◽  
Vol 29 (2) ◽  
pp. 371-378 ◽  
Author(s):  
Noriko Oyama-Manabe ◽  
Takahiro Sato ◽  
Ichizo Tsujino ◽  
Kohsuke Kudo ◽  
Osamu Manabe ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Mr Imaging ◽  
Right Ventricular ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction

scholarly journals PULMONARY ARTERY STIFFNESS IS INDEPENDENTLY ASSOCIATED WITH THE DEGREE OF RIGHT VENTRICULAR DYSFUNCTION IN PULMONARY HYPERTENSION

2010 ◽  
Vol 55 (10) ◽  
pp. A154.E1446
Author(s):  
Gerin Rachel Stevens ◽  
Ana Garcia-Alvarez ◽  
Sean Pinney ◽  
Mario J. Garcia ◽  
Valentin Fuster ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Right Ventricular ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Artery Stiffness

scholarly journals The Clinical Impact of Flow Titration on Epoprostenol Delivery via High Flow Nasal Cannula for ICU Patients with Pulmonary Hypertension or Right Ventricular Dysfunction: A Retrospective Cohort Comparison Study

2020 ◽  
Vol 9 (2) ◽  
pp. 464 ◽  
Author(s):  
Jie Li ◽  
Payal K. Gurnani ◽  
Keith M. Roberts ◽  
James B. Fink ◽  
David Vines
Keyword(s):  
Pulmonary Hypertension ◽  
Right Ventricular ◽  
Gas Flow ◽  
Ventricular Dysfunction ◽  
Right Ventricular Dysfunction ◽  
Constant Flow ◽  
High Flow Nasal Cannula ◽  
Refractory Hypoxemia ◽  
Pulmonary Arterial ◽  
Flow Titration

(1) Background: inhaled epoprostenol (iEPO) delivered via high-flow nasal cannula (HFNC) has been reported to be effective for pulmonary hypertension and right ventricular dysfunction. In vitro studies have identified HFNC gas flow as a key factor in trans-nasal aerosol delivery efficiency; however, little evidence is available on the clinical impact of flow titration on trans-nasal aerosol delivery. At our institution, iEPO via HFNC was initiated in 2015 and the concept of flow titration during iEPO via HFNC has been gradually accepted and carried out by clinicians in the recent years. (2) Methods: a retrospective review of the electronic medical records for all adult patients who received iEPO via HFNC in a tertiary teaching hospital. Pre- and post- iEPO responses were reported for patients whose HFNC flow was titrated or maintained constant during iEPO delivery. Positive response to iEPO was defined as the reduction of mean pulmonary arterial pressure (mPAP) > 10% for pulmonary hypertension patients or the improvement of oxygenation [pulse oximetry (SpO2)/fraction of inhaled oxygen (FIO2)] > 20%. The number of responders to iEPO was compared between groups with titrated vs constant flow. (3) Results: 51 patients who used iEPO to treat pulmonary hypertension and/or right ventricular dysfunction were reviewed. Following iEPO administration via HFNC, mPAP decreased (43.6 ± 11.7 vs. 36.3 ± 9.7 mmHg, p < 0.001). Among the 51 patients, 24 had concomitant refractory hypoxemia, their oxygenation (SpO2/FIO2) improved after iEPO delivery (127.8 ± 45.7 vs. 157.6 ± 62.2, p < 0.001). During iEPO initiation, gas flow was titrated in 25 patients and the remaining 26 patients used constant flow. The percentage of patients in the flow titration group who met the criteria for a positive response was higher compared to the group with constant flow (85.7% vs. 50%, p = 0.035). Pre- vs post-iEPO responses were significant in the flow titration group included improvement in cardiac output (p = 0.050), cardiac index (p = 0.021) and FIO2 reduction (p = 0.016). These improvements in hemodynamics and FIO2 were not observed in the constant flow group. (4) Conclusion: in patients with pulmonary hypertension and/or right ventricular dysfunction, trans-nasal iEPO decreased pulmonary arterial pressure. It also improved oxygenation in patients with combined refractory hypoxemia. These improvements were more evident in patients whose gas flow was titrated during iEPO initiation than those patients using constant flow.

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