scholarly journals Perioperative Changes of Plasma Endothelin-1 Concentrations in Patients Undergoing Cardiac Valve Surgery

1996 ◽  
Vol 24 (3) ◽  
pp. 342-347 ◽  
Author(s):  
C. H. Huang ◽  
H. H. Huang ◽  
T. L. Chen ◽  
M. J. Wang
Keyword(s):  
Cardiopulmonary Bypass ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Right Atrium ◽  
Valve Surgery ◽  
Cardiac Valve ◽  
Protective Mechanism ◽  
Artery Pressure ◽  
Endothelin 1 ◽  
Valvular Replacement

Twenty-one patients who underwent cardiac valvular replacement procedures were studied to determine the peri-operative changes of plasma endothelin-1 (ET-1) concentration and disposition of ET-1 in the pulmonary and systemic vasculature between patients with elevated (over 20 mmHg) mean pulmonary artery pressure and patients with normal pulmonary artery pressure. The overall profile alterations of plasma ET- 1 concentration did not differ between the two groups of patients. The plasma ET- 1 levels in the pulmonary artery and right atrium were significantly higher in patients with high pulmonary artery pressure than in patients with normal pulmonary artery pressure. Before cardiopulmonary bypass, significant pulmonary extraction of the plasma ET- 1 existed in patients with high pulmonary artery pressure but the pulmonary extraction was not seen after bypass. There was no transpulmonary difference of the plasma ET- 1 concentration in patients with normal pulmonary artery pressure either before or after bypass. The high levels of ET- 1 in the pulmonary circuit and the pulmonary extraction of the ET- 1 in patients with high pulmonary artery pressure might be a protective mechanism for rheumatic valvular patients with elevated pulmonary artery pressure.

scholarly journals CHANGES IN PULMONARY ARTERY PRESSURE DURING CARDIOPULMONARY BYPASS

1958 ◽  
Vol 36 (4) ◽  
pp. 604-620
Author(s):  
James B. Littlefield ◽  
J. Francis Dammann ◽  
Phyllis R. Ingram ◽  
William H. Muller
Keyword(s):  
Cardiopulmonary Bypass ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Artery Pressure

Endothelin-A receptor antagonist prevents acute hypoxia-induced pulmonary hypertension in the rat

1995 ◽  
Vol 268 (1) ◽  
pp. L95-L100 ◽  
Author(s):  
S. Oparil ◽  
S. J. Chen ◽  
Q. C. Meng ◽  
T. S. Elton ◽  
M. Yano ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Receptor Antagonist ◽  
Pulmonary Artery Pressure ◽  
Saline Control ◽  
Mrna Levels ◽  
Artery Pressure ◽  
Endothelin 1 ◽  
Eta Receptor ◽  
Endothelin A

Exposure to hypoxia is associated with increased pulmonary artery pressure and plasma endothelin-1(ET-1) levels and with selective enhancement in ET-1 peptide and mRNA and endothelin-A (ETA) receptor mRNA levels in rat lung. The current study tested the hypothesis that endogenous ET-1 can account for hypoxia-induced pulmonary hypertension via a paracrine effect on ETA receptors in lung. Intravenous infusion of the ETA receptor antagonist BQ-123 (D-Trp-D-Asp-Pro-D-Val-Leu) (0.4 mg/microliters at 1 microliter/h) into Sprague-Dawley rats beginning 4 h before and for 90 min during normobaric hypoxia (10% O2) markedly attenuated the hypoxic response: mean pulmonary artery pressure increased from 17.2 +/- 0.7 to 29.0 +/- 1.2 mmHg in saline control rats but did not increase from baseline in BQ-123-treated rats. BQ-123 did not alter systemic arterial pressure, heart rate, or plasma endothelin-1 levels. These findings suggest that ET-1 synthesized in lung in response to hypoxia acts locally on ETA receptors to cause pulmonary hypertension.

Outcomes of Repeat Mitral Valve Surgery in Patients with Pulmonary Hypertension

2015 ◽  
Vol 10 (2) ◽  
pp. 120-124 ◽  
Author(s):  
Mario Castillo-Sang ◽  
Tracey J. Guthrie ◽  
Marc R. Moon ◽  
Jennifer S. Lawton ◽  
Hersh S. Maniar ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Mitral Valve ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Systolic Pulmonary Artery Pressure ◽  
Peripheral Vascular ◽  
Artery Pressure ◽  
The Mean

Objective We sought to study the outcomes of redo-mitral valve surgery in patients with pulmonary hypertension. Methods We reviewed data on redo mitral valve surgery in patients with pulmonary hypertension measured by Swan-Ganz catheter (mean pulmonary artery pressure ≥ 25 mm Hg or systolic pulmonary artery pressure ≥ 40 mm Hg). Results Between 1996 and 2010, 637 patients underwent 658 redo mitral valve operations; 138 of them had pulmonary hypertension. The mean patient age was 61.3 (13.9) years, with mean left ventricular ejection fraction of 47.6% (13.2%). The mean systolic pulmonary artery pressure was 61.5 (16.8) mm Hg, and mean pulmonary artery pressure was 40.8 (11.6) mm Hg. Patients had one (71%, 98/138), two (23.9%, 33/138), and three (5.1%, 7/138) previous mitral valve operations. Thirty-day mortality was 10.1% (14/138). Multivariate predictors of 30-day mortality were chronic renal failure [odds ratio (OR), 8.041; P = 0.022], peripheral vascular disease (OR, 5.976; P = 0.025), previous mitral valve replacement (OR, 9.034; P = 0.014), and increasing age (OR, 1.077; P = 0.013). The severity of pulmonary hypertension did not impact 30-day ( P = 0.314) or late mortality ( P = 0.860). Kaplan-Meier survival rates at 1, 3, and 5 years were 76.6% (n = 99), 65.7% (n = 62), and 55.9% (n = 41), respectively. Conclusions Patients with pulmonary hypertension that undergo redo mitral valve surgery have a 55.9% 5-year survival rate. Increasing age, chronic renal insufficiency, peripheral vascular disease, and preexisting mitral valve prosthesis are associated with early mortality. The severity of pulmonary hypertension does not affect operative mortality rates, but it may decrease 1-, 3-, and 5-year survival.

Hemodynamic effects of endothelin-1 on ovine fetal pulmonary circulation

1991 ◽  
Vol 261 (1) ◽  
pp. R182-R187 ◽  
Author(s):  
B. A. Chatfield ◽  
I. F. McMurtry ◽  
S. L. Hall ◽  
S. H. Abman
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Pulmonary Circulation ◽  
Ductus Arteriosus ◽  
Left Lung ◽  
Hemodynamic Effects ◽  
Fetal Sheep ◽  
Flow Transducer ◽  
Artery Pressure ◽  
Endothelin 1

To determine the hemodynamic effects of endothelin-1 (ET-1) in the fetal pulmonary circulation, we studied pulmonary vascular responses to brief and prolonged intrapulmonary infusions of the peptide in nine chronically prepared late-gestation fetal sheep. Left pulmonary artery (LPA) blood flow was measured with an electromagnetic flow transducer, and a catheter placed in the LPA allowed ET-1 infusion directly into the left lung. Brief (10-min) infusions of ET-1 (12.5-100 ng/min) increased flow up to 212% of baseline without changing pulmonary artery pressure. With prolonged (120-min) infusion of ET-1 (50 ng/min), flow increased from 69 +/- 8 to 164 +/- 23 ml/min at 10 min (P less than 0.05) but then declined and was not different from baseline at 120 min. The gradient between mean pulmonary artery and aortic pressures did not change, suggesting no constriction of the ductus arteriosus. Systemic (vena caval) infusion of ET-1 (100 ng/min for 30 min) caused systemic and pulmonary hypertension, as mean pulmonary artery pressure increased from 43 +/- 1 to 51 +/- 2 mmHg (P less than 0.05) and remained elevated for 30 min after cessation of the ET-1 infusion. We conclude that intrapulmonary ET-1 is a potent fetal pulmonary vasodilator, but its dilator effect is transient during prolonged infusion. In contrast, systemic infusion causes sustained hypertension, suggesting differential effects of ET-1 on the pulmonary and systemic circulations. These findings demonstrate marked vasoactivity of ET-1 in the fetus, suggesting a potential role in the normal or abnormal transitional circulation.

scholarly journals Inverse correlation between systemic endothelin-1 level and pulmonary artery pressure in adult patients with uncorrected atrial septal defect

Life Sciences ◽  
2013 ◽  
Vol 93 (25-26) ◽  
pp. e64
Author(s):  
Dyah Wulan Anggrahini ◽  
Lucia Krisdinarti ◽  
Anggoro Budi Hartopo ◽  
Arina Nugraheni ◽  
Hariadi Hariawan ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Atrial Septal Defect ◽  
Pulmonary Artery Pressure ◽  
Septal Defect ◽  
Inverse Correlation ◽  
Adult Patients ◽  
Artery Pressure ◽  
Endothelin 1

Inflammation and Congenital Heart Disease Associated Pulmonary Hypertension

2015 ◽  
Vol 18 (1) ◽  
pp. 038 ◽  
Author(s):  
Mete Gursoy ◽  
Ece Salihoglu ◽  
Ali Can Hatemi ◽  
A. Faruk Hokenek ◽  
Suleyman Ozkan ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Neutrophil To Lymphocyte Ratio ◽  
Cell Distribution ◽  
Inflammation Markers ◽  
Distribution Width ◽  
Artery Pressure ◽  
Lymphocyte Ratio ◽  
Mean Pulmonary Artery Pressure ◽  
Pulmonary Arterial

<strong>Background:</strong> Increased blood flow may trigger pulmonary arterial wall inflammation, which may influence progression of pulmonary artery hypertension in patients with congenital heart disease. In this study, we aimed to investigate the correlation between preoperative inflammation markers and pulmonary arterial hypertension. <br /><strong>Methods:</strong> A total of 201 patients with pulmonary hypertension were enrolled in this study retrospectively; they had undergone open heart surgery between January 2012 and December 2013. Patients’ preoperative C-reactive protein (CRP), neutrophil to lymphocyte ratio, red blood cell distribution width, pulmonary pressures, and postoperative outcomes were evaluated.<br /><strong>Results:</strong> Patient age, neutrophil to lymphocyte ratio, red blood cell distribution width, and CRP were found to be significantly correlated with both preoperative peak and mean pulmonary artery pressures. These data were entered into a linear logistic regression analysis. Patient age, neutrophil to lymphocyte ratio, and CRP were found to be independently correlated with peak pulmonary pressure (P &lt; .001, P &lt; .001, and P = .004) and mean pulmonary artery pressure (P &lt; .001, P &lt; .001, and P = .001), whereas preoperative mean pulmonary artery pressure was found to be independently correlated with intensive care unit stay (P &lt; .001). No parameter was found to be significantly correlated with extubation time and mortality. Eighteen patients had experienced pulmonary hypertensive crisis; in this subgroup, patients’ mean pulmonary artery pressure and neutrophil to lymphocyte ratio were found to be significant (P = .047, P = .003). <br /><strong>Conclusion:</strong> Preoperative inflammation markers may be correlated with the progression of pulmonary hypertensive disease, but further studies with larger sample size are needed to determine the predictive role of these markers for postoperative outcomes.<br /><br />

scholarly journals Association of Admission Glucose Level and Improvement in Pulmonary Artery Pressure in Patients with Submassive-type Acute Pulmonary Embolism

2018 ◽  
Vol 57 (5) ◽  
pp. 647-654
Author(s):  
Masaomi Gohbara ◽  
Keigo Hayakawa ◽  
Azusa Hayakawa ◽  
Yusuke Akazawa ◽  
Yukihiro Yamaguchi ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Glucose Level ◽  
Acute Pulmonary Embolism ◽  
Artery Pressure ◽  
Admission Glucose
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