scholarly journals Pulmonary arterial hypertension in rheumatic mitral stenosis: does it affect right ventricular function and outcome after mitral valve replacement?☆

2009 ◽  
Vol 9 (3) ◽  
pp. 421-425 ◽  
Author(s):  
Shantanu Pande ◽  
Surendra K. Agarwal ◽  
Udgeath Dhir ◽  
Amit Chaudhary ◽  
Sudeep Kumar ◽  
...  
2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Seyeon Oh ◽  
Albert Y. Jang ◽  
Sehyun Chae ◽  
Seungbum Choi ◽  
Jeongsik Moon ◽  
...  

AbstractDespite the advancement of targeted therapy for pulmonary arterial hypertension (PAH), poor prognosis remains a reality. Mesenchymal stem cells (MSCs) are one of the most clinically feasible alternative treatment options. We compared the treatment effects of adipose tissue (AD)-, bone marrow (BD)-, and umbilical cord blood (UCB)-derived MSCs in the rat monocrotaline-induced pulmonary hypertension (PH) model. The greatest improvement in the right ventricular function was observed in the UCB-MSCs treated group. The UCB-MSCs treated group also exhibited the greatest improvement in terms of the largest decrease in the medial wall thickness, perivascular fibrosis, and vascular cell proliferation, as well as the lowest levels of recruitment of innate and adaptive immune cells and associated inflammatory cytokines. Gene expression profiling of lung tissue confirmed that the UCB-MSCs treated group had the most notably attenuated immune and inflammatory profiles. Network analysis further revealed that the UCB-MSCs group had the greatest therapeutic effect in terms of the normalization of all three classical PAH pathways. The intravenous injection of the UCB-MSCs, compared with those of other MSCs, showed superior therapeutic effects in the PH model for the (1) right ventricular function, (2) vascular remodeling, (3) immune/inflammatory profiles, and (4) classical PAH pathways.


2020 ◽  
pp. 43-46
Author(s):  
Debashis Karmokar ◽  
Pinaki Majumdar ◽  
Manjushree Ray ◽  
Asim Kumar Kundu

Objective:Right ventricular dysfunction constitutes a major risk factor for patients suffering from degenerative mitral valve disease. The objective of this study was to assess right ventricular function by echocardiography and to detect role of right ventricular functions in prediction of outcome following mitral valve replacement operation in patients with rheumatic heart disease involving mitral valve. Methods:Transthoracic 3D echocardiography was done in 52 patients posted for mitral valve replacement surgery. Right ventricular function was analyzed by measuring fractional area change (FAC) of right ventricle, tethering distance and, tricuspid annular plane systolic excursion (TAPSE). Tricuspid regurgitation was graded 0 to 4. Based on echocardiographic ndings of right ventricle, patients were allocated in two groups; Group A (normal right ventricular function) and Group B (poor right ventricular function). After surgery, incidence of complications such as; low cardiac output syndrome, refractory arrhythmia and, sepsis were compared in two group. Results: Incidence of postoperative complication such as low cardiac output syndrome and sepsis was signicantly more in patients with poor right ventricular function. Right ventricular variables, FAC <35%, TAPSE <17 mm and tethering distance > 8 mm are independent predictors of postoperative complications. Tricuspid valve was repaired in patients with grade 3 and 4 regurgitation. Therefore cardiopulmonary bypass time was signicantly more in patients with grade 3 and 4 TR (84.42±69.77 min) (p<0.01). Duration of intensive care support was also signicantly more in patients with poor right ventricular function (p<0.001) Conclusion: To predict possible complications and outcome following mitral valve replacement surgery, right ventricular functions should be thoroughly assessed by 3D echocardiography


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