Right and Left Ventricular Function and Pulmonary Artery Pressure in Patients With Bronchiectasis

CHEST Journal ◽  
2008 ◽  
Vol 133 (2) ◽  
pp. 468-473 ◽  
Author(s):  
Abdulaziz H. Alzeer ◽  
Abdulellah F. Al-Mobeirek ◽  
Hadil A.K. Al-Otair ◽  
Usama A.F. Elzamzamy ◽  
Ismail A. Joherjy ◽  
...  
1974 ◽  
Vol 46 (2) ◽  
pp. 253-264 ◽  
Author(s):  
Anne E. Tattersfield ◽  
M. W. McNicol ◽  
R. W. Sillett

1. Intravenous frusemide has been given to thirty-five patients with myocardial infarction and clinical signs of left ventricular failure. The haemodynamic changes following frusemide were then observed over the subsequent 6 h. 2. Frusemide produced a large diuresis, which was maximal during the first 2 h but fluid depletion was maintained at 24 h. The greatest diuresis occurred in patients with the highest stroke index. 3. All patients showed a fall in pulmonary artery pressure after frusemide. In patients with evidence of poor left ventricular function (low stroke index, high pulmonary artery pressure) this was associated with little change in stroke index. In patients with less severe impairment of left ventricular function there was an initial fall in stroke index at 1 and 2 h. 4. Six hours after frusemide there was a reduction in both pulmonary artery pressure and systemic arterial pressure; the latter correlated with the volume of the diuresis.


2007 ◽  
Vol 103 (1) ◽  
pp. 287-295 ◽  
Author(s):  
F. Akhavein ◽  
E. Jean St.-Michel ◽  
E. Seifert ◽  
C. V. Rohlicek

Decreased right as well as left ventricular function can be associated with pulmonary hypertension (PH). Numerous investigations have examined cardiac function following induction of pulmonary hypertension with monocrotaline (MCT) assuming that MCT has no direct cardiac effect. We tested this assumption by examining left ventricular function and histology of isolated and perfused hearts from MCT-treated rats. Experiments were performed on 50 male Sprague-Dawley rats [348 ± 6 g (SD)]. Thirty-seven rats received MCT (50 mg/kg sc; MCT group) while the remainder did not (Control group). Three weeks later, pulmonary artery pressure was assessed echocardiographically in 20 MCT and 8 Control rats. The hearts were then excised and perfused in the constant pressure Langendorff mode to determine peak left ventricular pressure (LVP), the peak instantaneous rate of pressure increase (+dP/d tmax) and decrease (−dP/d tmax), as well as the rate pressure product (RPP). Histological sections were subsequently examined. Pulmonary artery pressure was higher in the MCT-treated group compared with the Control group [12.9 ± 6 vs. 51 ± 35.3 mmHg ( P < 0.01)]. Left ventricular systolic function and diastolic relaxation were decreased in the MCT group compared with the Control group (+dP/d tmax4,178 ± 388 vs. 2,801 ± 503 mmHg/s, LVP 115 ± 11 vs. 83 ± 14 mmHg, RPP 33,688 ± 1,910 vs. 23,541 ± 3,858 beats·min−1·mmHg−1, −dP/d tmax−3,036 ± 247 vs. −2,091 ± 389 mmHg/s; P < 0.0001). The impairment of cardiac function was associated with myocarditis and coronary arteriolar medial thickening. Similarly depressed ventricular function and inflammatory infiltration was seen in 12 rats 7 days after MCT administration. Our findings appear unrelated to the degree of PH and indicate a direct cardiotoxic effect of MCT.


2020 ◽  
Author(s):  
Reem M. Soliman ◽  
Yasser Elsayed ◽  
Reem N. Said ◽  
Abdulaziz M. Abdulbaqi ◽  
Rania H. Hashem ◽  
...  

ABSTRACTObjectiveTo test the hypothesis that a lung ultrasound severity score (LUSsc) and assessment of left ventricular eccentricity index of the interventricular septum (LVEI) by focused heart ultrasound can predict extubation success in mechanically ventilated preterm infants with respiratory distress syndrome (RDS).DesignProspective observational study of premature infants <34 weeks’ of gestation age supported with mechanical ventilation due to RDS. LUSsc and LVEI were performed on postnatal days 3 and 7 by an investigator who was masked to infants’ ventilator parameters and clinical conditions. RDS was classified based on LUSsc into mild (score 0–9) and moderate-severe (score 10–18). A receiver operator curve was constructed to assess the ability to predict extubation success. Pearson’s correlation was performed between LVEI and pulmonary artery pressure (PAP).SettingLevel III neonatal intensive care unit, Cairo, Egypt.ResultsA total of 104 studies were performed to 66 infants; of them 39 had mild RDS (LUSsc 0–9) and 65 had moderate-severe RDS (score ≥10). LUSsc predicted extubation success with a sensitivity and a specificity of 91% and 69%; the positive and negative predictive values were 61% and 94%, respectively. Area under the curve (AUC) was 0.83 (CI: 0.75-0.91). LVEI did not differ between infants that succeeded and failed extubation. However, it correlated with pulmonary artery pressure during both systole (r=0.62) and diastole (r=0.53) and with hemodynamically significant patent ductus arteriosus (r=0.27 and r=0.46, respectively).ConclusionLUSsc predicts extubation success in preterm infants with RDS whereas LVEI correlates with high PAP.


2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Hong Li ◽  
Yi-Dan Li ◽  
Wei-Wei Zhu ◽  
Ling-Yun Kong ◽  
Xiao-Guang Ye ◽  
...  

Ultrasound lung comets (ULCs) are a nonionizing bedside approach to assess extravascular lung water. We evaluated a protocol for grading ULC score to estimate pulmonary congestion in heart failure patients and investigated clinical and echocardiographic correlates of the ULC score. Ninety-three patients with congestive heart failure, admitted to the emergency department, underwent pulmonary ultrasound and echocardiography. A ULC score was obtained by summing the ULC scores of 7 zones of anterolateral chest scans. The results of ULC score were compared with echocardiographic results, the New York Heart Association (NYHA) functional classification, radiologic score, and N-terminal pro-b-type natriuretic peptide (NT-proBNP). Positive linear correlations were found between the 7-zone ULC score and the following: E/e′, systolic pulmonary artery pressure, severity of mitral regurgitation, left ventricular global longitudinal strain, NYHA functional classification, radiologic score, and NT-proBNP. However, there was no significant correlation between ULC score and left ventricular ejection fraction, left ventricle diameter, left ventricular volume, or left atrial volume. A multivariate analysis identified the E/e′, systolic pulmonary artery pressure, and radiologic score as the only independent variables associated with ULC score increase. The simplified 7-zone ULC score is a rapid and noninvasive method to assess lung congestion. Diastolic rather than systolic performance may be the most important determinant of the degree of lung congestion in patients with heart failure.


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