Computed Tomography Measurement Of Small Pulmonary Vessel Cross-Sectional Area In A Non-Human Primate Model Of HIV-Associated Pulmonary Arterial Hypertension

Pulmonary arterial hypertension (PAH) impairs exercise tolerance and daily physical activity (PA). Aside from the hemodynamic limitations, physical, cognitive and emotional factors may play a relevant and as yet unexplored role. We investigated whether there is an association between the PA level and psychological disorders, health-related quality of life, and daily activities. We also searched for an association of the PA level with clinical factors and functional capacity. This was an analytical, cross-sectional, observational study conducted in a Brazilian University Hospital. Twenty stable PAH subjects wore an accelerometer for a week and completed an activity diary. They answered the quality of life questionnaire (SF-36), as well as the anxiety and depression scale (HADS), and the Manchester Respiratory Activities of Daily Living questionnaire (MRADL). Transthoracic echocardiography, the 6-Minute walk test (6MWT), the 1-minute sit-to-stand test (STST), and spirometry were performed. For statistical analysis we used Chi-square tests or Fisher's test as appropriate and the Mann-Whitney test to compare numerical values between two groups. The relationship between the parameters was assessed using the Spearman correlation test. The mean age was 44.3 years, 80% were women, 80% had idiopathic PAH, and 20% had connective tissue disease . The mean daily step count was 4,280 Â± 2,351, and the mean activity time was 41.6 Â± 19.3 minutes. The distance covered (6MWT) was 451.5 m, and the number of movements (1-STST) was 23.8. Thirty percent scored positive for anxiety, and 15% for depression (HADS). There was a significant correlation between accelerometer data and walking distance (6MWT), number of movements (1-STST), level of daily physical activity (MRADL), and depression symptoms. Our findings support the hypothesis that other aspects beyond physical and hemodynamic ones might impact the daily physical activity of patients with PAH.

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Quantification of Arterial and Venous Morphological Markers in Pulmonary Arterial Hypertension Using Computed Tomography

CHEST Journal ◽

10.1016/j.chest.2021.06.069 ◽

2021 ◽

Author(s):

Farbod.N. Rahaghi ◽

Pietro Nardelli ◽

Eileen Harder ◽

Inderjit Singh ◽

Gonzalo Vegas Sanchez-Ferrero ◽

...

Keyword(s):

Computed Tomography ◽

Pulmonary Arterial Hypertension ◽

Arterial Hypertension ◽

Morphological Markers ◽

Pulmonary Arterial

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Reliability and responsiveness of incremental shuttle walk test to estimate exercise capacity in patients with pulmonary arterial hypertension

Comparative Exercise Physiology ◽

10.3920/cep190056 ◽

2020 ◽

Vol 16 (3) ◽

pp. 179-185

Author(s):

R. Ishrat ◽

A. Mujaddadi ◽

M.S. Ali ◽

D. Talwar ◽

M.E. Hussain

Keyword(s):

Pulmonary Arterial Hypertension ◽

Arterial Hypertension ◽

Exercise Capacity ◽

Intraclass Correlation ◽

World Health ◽

Minimal Detectable Change ◽

Walk Test ◽

Cross Sectional ◽

Suitable Alternative ◽

Pulmonary Arterial

The purpose of the present study was to evaluate the reliability and responsiveness of the incremental shuttle walk test (ISWT) to estimate exercise capacity in patients with pulmonary arterial hypertension (PAH). This was a cross-sectional longitudinal study performed on stable PAH patients (n=30, mean age ± standard deviation, 60±13.6 years) with World Health Organization functional class II & III. Reliability was assessed by comparing the distance covered between ISWT-1 (initial) and ISWT-2 (retest). Responsiveness was determined by comparing the distance covered in the ISWT-3 post pulmonary rehabilitation (PR) to the ISWT-1. The distance covered between ISWT-1 (177±87.85 m) and ISWT-2 (191.67±96.39 m) was not statistically significant. The result of the relative reliability has shown to be excellent with an intraclass correlation coefficient (ICC2,1 = 0.98, 95%CI = 0.95-0.99). Absolute reliability was evaluated through the standard error of the measurement and minimal detectable change at a 95% confidence interval (MDC95) were 12.29 and 33.9 m, respectively. Bland Altman plot showed good agreement between the two ISWTs. Following PR, the effect size (ES=0.78) and standardised response mean (SRM=1.50) were moderate and large respectively. ISWT is considered to be a reliable and responsive measure to estimate exercise capacity in patients with PAH. The ISWT may be considered a suitable alternative tool over a 6-min walk test and in the absence of equipment availability or expertise for conducting cardiopulmonary exercise test for the assessment of exercise capacity in these patients.

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A computed method for noninvasive MRI assessment of pulmonary arterial hypertension

Journal of Applied Physiology ◽

10.1152/japplphysiol.00292.2003 ◽

2004 ◽

Vol 96 (2) ◽

pp. 463-468 ◽

Cited By ~ 49

Author(s):

Eric Laffon ◽

Christophe Vallet ◽

Virginie Bernard ◽

Michel Montaudon ◽

Dominique Ducassou ◽

...

Keyword(s):

Arterial Pressure ◽

Pulmonary Arterial Pressure ◽

Cross Sectional Area ◽

Physical Parameters ◽

Sectional Area ◽

Biophysical Parameters ◽

Cross Sectional ◽

Mean Pulmonary Arterial Pressure ◽

Pulmonary Arterial ◽

The Mean

The present method enables the noninvasive assessment of mean pulmonary arterial pressure from magnetic resonance phase mapping by computing both physical and biophysical parameters. The physical parameters include the mean blood flow velocity over the cross-sectional area of the main pulmonary artery (MPA) at the systolic peak and the maximal systolic MPA cross-sectional area value, whereas the biophysical parameters are related to each patient, such as height, weight, and heart rate. These parameters have been measured in a series of 31 patients undergoing right-side heart catheterization, and the computed mean pulmonary arterial pressure value (PpaComp) has been compared with the mean pressure value obtained from catheterization (PpaCat) in each patient. A significant correlation was found that did not differ from the identity line PpaComp = PpaCat ( r = 0.92). The mean and maximal absolute differences between PpaComp and PpaCat were 5.4 and 11.9 mmHg, respectively. The method was also applied to compute the MPA systolic and diastolic pressures in the same patient series. We conclude that this computed method, which combines physical (whoever the patient) and biophysical parameters (related to each patient), improves the accuracy of MRI to noninvasively estimate pulmonary arterial pressures.

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Peripheral blood B lymphocytes derived from patients with idiopathic pulmonary arterial hypertension express a different RNA pattern compared with healthy controls: a cross sectional study

Respiratory Research ◽

10.1186/1465-9921-9-20 ◽

2008 ◽

Vol 9 (1) ◽

Cited By ~ 33

Author(s):

Silvia Ulrich ◽

Laima Taraseviciene-Stewart ◽

Lars C Huber ◽

Rudolf Speich ◽

Norbert Voelkel

Keyword(s):

Pulmonary Arterial Hypertension ◽

Arterial Hypertension ◽

B Lymphocytes ◽

Peripheral Blood ◽

Cross Sectional Study ◽

Idiopathic Pulmonary Arterial Hypertension ◽

Healthy Controls ◽

Sectional Study ◽

Cross Sectional ◽

Pulmonary Arterial

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Abstract 16667: Computed Tomography-Based Pulmonary Vascular Tortuosity as a Marker in Resting and Exercise Pulmonary Arterial Hypertension

Circulation ◽

10.1161/circ.142.suppl_3.16667 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Eileen M Harder ◽

Pietro Nardelli ◽

Gonzalo Sanchez-Ferrero ◽

James Ross ◽

Sam Y Ash ◽

...

Keyword(s):

Computed Tomography ◽

Pulmonary Arterial Hypertension ◽

Arterial Hypertension ◽

Right Heart Catheterization ◽

Heart Catheterization ◽

Early Form ◽

Arterial Tortuosity ◽

Vascular Tortuosity ◽

Measure Analysis ◽

Pulmonary Arterial

Introduction: Increased vascular tortuosity has been proposed as a marker of pulmonary arterial hypertension (PAH). In this analysis, we compared arterial and venous vascular tortuosity between controls and subjects with resting PAH. Furthermore, we examined if abnormalities could be detected in exercise PAH (EPAH), thought to be an early form of PAH. Methods: From an institutional registry, 388 patients with both right heart catheterization and computed tomography angiography (CTA) data were selected. Within this cohort, three distinct groups were identified: 1) controls, who had no cardiopulmonary disease and normal resting and exercise hemodynamics; 2) EPAH, with normal resting hemodynamics but age-adjusted pre-capillary pulmonary hypertension on exertion, and 3) PAH, defined as resting mPAP >20mmHg, pulmonary vascular resistance >3 Wood Units, and pulmonary capillary wedge pressure <15mmHg. Tortuosity was defined as the actual path length of a vessel divided by the linear distance between the two farthest endpoints of the vessel segment on CTA. AV>10% was defined as the number of arterial segments with tortuosity >10% divided by the same venous measure. Analysis was performed with Wilcoxon rank sum tests in R 3.5. Results: There were 99 patients in the final cohort, including 47 (47.4%) with PAH, 12 (12.1%) with EPAH, and 40 (40.4%) without disease. Compared to controls, median arterial tortuosity was increased in PAH (3.3 ± 0.1% vs. 3.4 ± 0.1%, p=0.0009; Figure 1) but not in EPAH (3.3 ± 0.1%, p=0.82). Median venous tortuosity did not differ between groups. AV>10% was increased in EPAH (vs. controls, 1.86 ± 0.38 vs. 1.56 ± 0.44, p=0.03) and resting PAH (2.0 ± 1.2 p=2e-6). Conclusions: Increased arterial tortuosity on CTA is a biomarker of resting PAH. When corrected for venous tortuosity, arterial tortuosity also appears to be abnormal in EPAH. Figure 1 . Arterial vessels in PAH, EPAH, and control subjects. Red segments have tortuosity > 10%.

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Pulmonary arterial hypertension and acute and chronic thromboembolism

ESC CardioMed ◽

10.1093/med/9780198784906.003.0079 ◽

2018 ◽

pp. 406-409

Author(s):

Thomas Henzler

Keyword(s):

Computed Tomography ◽

Pulmonary Embolism ◽

Pulmonary Hypertension ◽

Pulmonary Arterial Hypertension ◽

Arterial Hypertension ◽

Imaging Modality ◽

Chronic Thromboembolic Pulmonary Hypertension ◽

Right Ventricular Dysfunction ◽

Chronic Pulmonary Embolism ◽

Pulmonary Arterial

Pulmonary arterial hypertension (PAH) and acute and chronic pulmonary embolism represent severe cardiovascular diseases with a high mortality if left undiagnosed and untreated. Computed tomography of the chest plays a pivotal role in the diagnosis of all three disorders. In acute pulmonary embolism, computed tomography pulmonary angiography has become the gold-standard imaging modality due to its high diagnostic accuracy, cost-effectiveness, 24-hour availability at most institutions, as well as the ability to diagnose alternative chest pathologies and right ventricular dysfunction within a single examination. In PAH, computed tomography of the chest is also deeply embedded within the diagnostic algorithm in order to exclude other causes of pulmonary hypertension, such as structural lung disease and chronic thromboembolic pulmonary hypertension of left heart disease. This article intends to provide a short overview on imaging techniques and characteristic findings in PAH, as well as acute and chronic pulmonary embolism.

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