scholarly journals Doppler evaluation of the fetal pulmonary artery pressure

2019 ◽  
Vol 47 (2) ◽  
pp. 218-221
Author(s):  
Alberto Sosa-Olavarria ◽  
Jesús Zurita-Peralta ◽  
Claudio V. Schenone ◽  
Mauro H. Schenone ◽  
Fernando Prieto
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Main Pulmonary Artery ◽  
P Value ◽  
Review Of The Literature ◽  
Artery Pressure ◽  
Bivariate Correlation ◽  
Highly Correlated ◽  
Doppler Evaluation

Abstract Background The Doppler effect has allowed the characterization of several vessels in maternal-fetal circulation that have been used for practical purposes. Our review of the literature showed a paucity of information about fetal pulmonary artery pressure (FMPAP) and its behavior in regard to gestational age (GA). The objectives of the study were to evaluate a formula to calculate the main FMPAP and its correlation with GA. Methods A total of 337 fetuses without obvious pathology were studied prospectively using Doppler evaluation of the FMPAP. Using the fetal main pulmonary artery Doppler acceleration time (FMPAT), we obtained the FMPAP using the following formula: FMPAP=90 – (0.62×FMPAT). Regression analyses, Pearson’s bivariate correlation and paired sample t-test were used when appropriate. Results FMPAT increases while FMPAP decreases with GA. Pearson’s correlation coefficient for FMPAP and GA was −0.544 (P-value<0.001) and for FMPAT and GA was 0.556 (P-value<0.001). FMPAP and FMPAT were highly correlated (R=−0.972; P<0.001). Conclusion Pulmonary artery pressure in the fetus decreases with GA.

Effects of Acutely Induced Changes in Arterial pH on Pulmonary Vascular Resistance during Normoxia and Hypoxia in Awake Dogs

1972 ◽  
Vol 42 (3) ◽  
pp. 277-287 ◽  
Author(s):  
O. G. Thilenius ◽  
Carol Derenzo
Keyword(s):  
Cardiac Output ◽  
Pulmonary Artery ◽  
Pulmonary Vascular Resistance ◽  
Pulmonary Artery Pressure ◽  
Vascular Resistance ◽  
Main Pulmonary Artery ◽  
Compensatory Mechanisms ◽  
Artery Pressure ◽  
Arterial Ph ◽  
Small Rise

1. Awake dogs with chronically implanted catheters (pulmonary artery, left atrium, aorta) and electromagnetic flow probe (main pulmonary artery) underwent five types of experiments in succession: (1) slow infusion of 0·4 m-hydrochloric acid; (2) rapid infusion of 1·0 m-sodium bicarbonate; (3) exposure to 30 min of hypoxia (10% O2); (4) exposure to hypoxia after arterial pH had been lowered to 7·30; (5) exposure to hypoxia after pH had been increased to 7·55. Intravascular pressures, pulmonary vascular resistance, cardiac output, arterial gas tension and pH were studied. 2. Acute acidosis (pH 7·21) resulted in a small rise in pulmonary artery pressure, cardiac output and pulmonary vascular resistance, associated with a decrease in Pa,co2. Acute alkalosis (pH 7·61) was accompanied by a small rise in pulmonary artery pressure, marked increase in cardiac output, a fall in pulmonary vascular resistance and mild elevation in Pa,co2. During acidosis hypoxia resulted in a more pronounced rise in pulmonary vascular resistance than during alkalosis (P < 0·01). 3. The study provides evidence that in the intact, awake dog with its compensatory mechanisms acute alkalosis decreases pulmonary vascular resistance by decreasing vascular tone and/or recruitment of pulmonary vascular channels; it diminishes the vasoconstrictive response to hypoxia; conversely, mild acidosis increases the pulmonary vascular resistance slightly and enhances vasoconstriction during hypoxia to a small extent.

Tissue Doppler Evaluation of Tricuspid Annulus for Estimation of Pulmonary Artery Pressure in Patients with COPD

Lung ◽  
2006 ◽  
Vol 184 (3) ◽  
pp. 121-131 ◽  
Author(s):  
Mehmet Melek ◽  
Ozlem Esen ◽  
Ali Metin Esen ◽  
Irfan Barutcu ◽  
Fatma Fidan ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Tissue Doppler ◽  
Tricuspid Annulus ◽  
Artery Pressure ◽  
Doppler Evaluation

scholarly journals P211 Short term impact of hemodialysis on right ventricular systolic function and pulmonary artery pressure in patients with end stage renal disease

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A M F Ali ◽  
A Salama ◽  
I Abd El Aziz ◽  
H Kamal
Keyword(s):  
Pulmonary Artery ◽  
Renal Disease ◽  
Right Ventricular ◽  
Pulmonary Artery Pressure ◽  
End Stage Renal Disease ◽  
Systolic Function ◽  
P Value ◽  
Artery Pressure ◽  
Stage Renal Disease ◽  
End Stage

Abstract Introduction Chronic kidney disease (CKD) is associated with increased morbidity and mortality. Cardiovascular disease (CVD) is the most common complication and a chief cause of death in patients with end stage renal disease (ESRD) accounting for 45% to 50% of causes of death in ESRD patient. Pulmonary hypertension (PH) occurs frequently in patients with CKD. The role of hemodialysis in reducing pulmonary artery pressure (PAP) and improving RV systolic function in not properly studied. Purpose To evaluate the effect of hemodialysis on Right ventricular (RV) systolic function and Pulmonary artery pressures using echocardiography in newly diagnosed end stage renal disease patients and after three months of regular hemodialysis. Patients and Methods 30 patients recently diagnosed to have ESRD were enrolled and were followed up after three months. Trans-thoracic echocardiography was done prior to the first dialysis session and after three months of regular hemodialysis to asses RV systolic function and PAP. Results There was a significant improvement of RV systolic function assessed by trans-annular plane systolic excursion (TAPSE)(mm)(pre dialysis 18.9 ± 3.76, post 21.56 ±3.51, p &lt;0.01), fractional area change (FAC)(%)(pre dialysis 41.27 ± 8.9, post 47.5 ± 6.1, p &lt; 0.01),tricuspid lateral annular systolic velocity (S’)(cm/s) (pre dialysis 12.3 ± 2.79, post 14.16 ± 2.3, p &lt; 0.01),myocardial performance index (MPI)(pre dialysis 0.2 ± 0.1, post 0.1 ± 0.1, p &lt; 0.01)and right ventricular outflow tract fractional shortening (RVOT-FS)(%)(pre dialysis 36.5 ± 9.5, post 39.3 ± 8.6, p &lt; 0.01)post dialysis (P value &lt;0.01). All parameters of assessing pulmonary artery pressures; systolic pulmonary artery pressure (PASP)(mmHg)(pre dialysis 48.03 ± 17.16, post 35.12 ± 14.73, p &lt; 0.01), pulmonary diastolic artery pressure (PADP)(mmHg)(pre dialysis 24.05 ± 9.7, post 18.12 ± 9.64, p &lt; 0.01), mean pulmonary artery pressure (MPAP)(mmHg) (pre dialysis 35.61 ± 15.07, post 25.8 ± 12.06, p &lt; 0.01), pulmonary capillary wedge pressure (PCWP)((pre dialysis 23.28 ± 8.74, post 17.39 ± 5.87, p &lt; 0.01) and pulmonary vascular resistance (PVR)(Wood unit)(pre dialysis 1.89 ± 0.57, post 1.43 ± 0.46, p &lt; 0.01) improved significantly post dialysis (P value &lt;0.01).There was a significant inverse correlation between the duration of renal impairment and the improvement in SPAP and PCWP after the initiation of dialysis (P values are 0.021 and 0.015, Correlation co-efficient -0.421, -0.441 respectively). The best cut-off value for weight reductionduring dialysis for prediction of improvement of SPAP is 2.75 Kg (AUC = 0.950, CI = 0.881-1.000, P value &lt; 0.01). Conclusions The present study shows that significant improvement occurred in all RV systolic function parameters and all parameters of assessing pulmonary artery pressures post dialysis in patients recently diagnosed to have ESRD. RVOT FS is a reliable method for assessing RV function and it is significantly correlated only with TAPSE and FAC at the baseline before dialysis.

A gray zone in the literature: indications, options, and outcomes for surgical repair of pulmonary artery aneurysms

2021 ◽  
pp. 1-6
Author(s):  
Ergin Arslanoglu ◽  
Kenan Abdurrahman Kara ◽  
Fatih Yigit ◽  
Cüneyt Arkan ◽  
Esra Ozcan ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricular ◽  
Pulmonary Artery Pressure ◽  
Main Pulmonary Artery ◽  
Artery Aneurysm ◽  
Pulmonary Artery Aneurysm ◽  
Artery Pressure ◽  
Risk Of Rupture ◽  
Significant Difference ◽  
Pulmonary Artery Aneurysms

Abstract Pulmonary artery aneurysms are rare. They are characterised by an aneurysmatic dilatation of the pulmonary vascular bed, including the main pulmonary artery or the accompanying pulmonary artery branches. Increases in pulmonary flow and pulmonary artery pressure increase the risk of rupture: when these conditions are detected, surgical intervention is necessary. This study is a retrospective analysis of 33 patients treated in our paediatric cardiac surgery clinic from 2012 to 2020. Aneurysms and pseudoaneurysms in patients who were patched for right ventricular outflow tract reconstruction and corrected with a conduit were excluded from the study. Seventeen (51.5%) of the patients included in the study were female and 16 (48.5%) were male. The patients were aged between 23 and 61 years (mean 30.66 ± 12.72 years). Graft interpositions were performed in 10 patients (30.3%) and pulmonary artery plications were performed in 23 patients (69.7%) to repair aneurysms. There was no significant difference in mortality between the two groups (p > 0.05). Pulmonary artery aneurysm interventions are safe, life-saving treatments that prevent fatal complications such as ruptures, but at present there is no clear guidance regarding surgical timing or treatment strategies. Pulmonary artery interventions should be performed in symptomatic patients with dilations ≥5 cm or asymptomatic patients with dilations ≥8 cm; pulmonary artery pressure, right ventricular systolic pressure, and pulmonary artery aneurysm diameter must be considered when planning surgeries, their timing, and making decisions regarding indications. Experienced surgical teams can achieve satisfactory results using one of the following surgical techniques: reduction pulmonary arterioplasty, plication, or graft replacement.

scholarly journals Evaluation of the Results of Balloon Pulmonary Angioplasty in Patients with Chronic Distal Pulmonary Thromboembolic Disease and Pulmonary Hypertension

2021 ◽  
Vol 06 (03) ◽  
pp. 157-164
Author(s):  
M. Hanumantha Reddy ◽  
George Cherian ◽  
Bagirath Raghuraman
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Right Ventricular ◽  
Pulmonary Artery Pressure ◽  
Thromboembolic Disease ◽  
Right Atrial ◽  
P Value ◽  
Artery Pressure ◽  
Balloon Pulmonary Angioplasty ◽  
Minute Walk

Introduction The gold standard curative treatment for chronic pulmonary thromboembolic disease and pulmonary hypertension (CTEPH) is pulmonary thromboendarterectomy (PTE). Balloon pulmonary angioplasty (BPA) is emerging for distal CTEPH patients, where lesion is inaccessible for surgery. This is the first study conducted in Indian patients for evaluating the impact of BPA in patients with distal CTEPH. Aims and Objectives To evaluate the effect of BPA in patients with distal CTEPH with the help of New York Heart Association (NYHA) functional class and 6-minute walk distance (6MWD). To study decrease in pulmonary artery pressure and improvement in right atrial and right ventricular function with the help of echocardiography. Material and Methods Study population—CTEPH patients presenting to the hospital during the study interval of 16 months from January 2017 to April 2018. A. Method: This was an observational retrospective and prospective follow-up study. All distal CTEPH patients after meeting inclusion and exclusion criteria were taken for study. B. Detailed case records containing information on demographics, clinical features and necessary blood and imaging investigations, ventilation/perfusion (V/Q) scan, computed tomography pulmonary angiography (CTPA), right heart catheterization (RHC) study, pulmonary angiogram, and BPA procedure details were obtained for all participants. C. After 8 weeks of last BPA session, patients were assessed clinically and then 6-minute walk test, blood investigations and echocardiography were done. Data Analysis Statistical analysis was performed by using the software SPSS 22.0 version. We used paired t-test to test the significant difference in the mean pre- and post-BPA. p-value < 0.05 will be considered as statistically significant. Results In our study, mean age of presentation was 39.81 ± 12 years. Out of 11 patients, 5 were females and 6 were males. Mean duration of symptoms was 40.5 months. The total number of BPA sessions performed were 30. The minimum number of BPA sessions undergone was 1 and maximum number of BPA sessions undergone by one patient was 5, with 45% of patients undergoing 2 BPA sessions. The total number of segmental arteries dilated was 104. Segmental vessels dilated per each session was 3.46. There was statistically significant improvement in NYHA class and 6MWD after BPA. 6MWD increased from 299 m to 421 m (p-value < 0.001). This improvement in functional capacity is strongly associated with the improvement in right ventricular (RV) function (tricuspid annular plane systolic excursion [TAPSE] from 15.3 mm to 18.9 mm) and with the reduction in pulmonary artery systemic pressure (PASP) (from 92 mm Hg to 60 mm Hg). Conclusion In patients with distal CTEPH who undergo BPA, there was statistically significant improvement in 6MWD. These changes correspond to a treatment-induced reduction in pulmonary artery pressure and lend support to use of BPA in patients with distal CTEPH. ECHO and 6MWD can be used for evaluating BPA efficacy and monitoring disease progression.

scholarly journals P834 Pulmonary arterial hypertension in patients with direct-acting antiviral medications for hepatitis C virus infection - a prospective observational cohort study

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
D Schild ◽  
G J Hellige ◽  
R J Piso ◽  
N Arenja
Keyword(s):  
Hepatitis C ◽  
Pulmonary Artery ◽  
Right Ventricular ◽  
Pulmonary Artery Pressure ◽  
Left Ventricular ◽  
Hcv Infection ◽  
P Value ◽  
Systolic Pulmonary Artery Pressure ◽  
Artery Pressure ◽  
Direct Acting Antiviral

Abstract Funding Acknowledgements Kantonsspital Olten, Switzerland Background In patients with chronic hepatitis C virus (HCV) infection, a higher risk for pulmonary artery hypertension (PAH) has been described after interferon (IFN) therapy. With the development of direct-acting antiviral (DAA) agents, vast improvements have been made in tolerance and less complications of HCV treatment. However, except of a few case reports, to date no clinical study about the evidence of PAH in patients with DAA medication for HCV infection has been published. We hypothesized that in patients, who receive DAA medication for HCV-infection, the systolic pulmonary artery pressure (sPAP) will not change significantly during and after competition of the therapy and there may be a lower post treatment risk for PAH within the population. Methods We prospectively enrolled patients who underwent treatment with DAA for chronic HCV infection. The patients received a transthoracic echocardiography (TTE) for the measurement of the pulmonary artery pressure before, during (8 weeks after starting the medication) and 8 weeks after completion of the HCV medication for evaluation of sPAP (figure 1). The whole treatment period took 8-12 weeks. Results Between June 2016 and October 2018, 33 patients completed the study protocol. In mean, the patient’s age was 50.1 ± 1.4 years and 30% of the population were female. Three patients (9 %) were HCV and human immunodeficiency virus (HIV) coinfected. The patients received different treatment regimens, according to hepatitis C genotype and co-medication. The left ventricular systolic and diastolic function were normal in all patients before treatment was started (left ventricular ejection fraction 60.7% [59.7 – 61.7%], E/A 1.18 [1.0 – 1.37]). The following table depicts the right ventricular parameter before the DAA therapy was started, 8 weeks after therapy start, and 8 weeks after therapy was completed. The analysis showed no significant difference between the sPAP in all three groups (25.9 ± 1.2 mmHg vs. 26.0 ± 1.3 mmHg vs.26.9 ± 1.1 mmHg, p-value 0.37, see figure). Conclusion DAA-therapy in chronic HCV infected patients is not associated with PAH in a follow-up of 2 months after the treatment was completed. Echocardiography Data Echocardiography data Before DAA medication was started 8 weeks after DAA-therapy 8 weeks after completion of DAA-therapy p-Value Right ventricular fractional area change (FAC), % 49.1 ± 1.4 51.7 ± 1.0 51.8 ± 1.1 0.09 Tricuspid Annular Plane Systolic Excursion (TAPSE), mm 25.2 ± 1.1 25.8 ± 0.7 24.3 ± 0.5 0.4 Right ventricular/right atrial gradient, mmHg 19.9 ± 1.0 20.5 ± 0.9 21.0 ± 0.8 0.24 Systolic pulmonary artery pressure (sPAP), mmHg 25.9 ± 1.2 26.0 ± 1.3 26.9 ± 1.1 0.37 Abstract P834 Figure. Multiple variable graph of sPAP

scholarly journals The changes in main pulmonary artery pressure after bilateral lung autotransplantation in dogs

1998 ◽  
Vol 39 (4) ◽  
pp. 296
Author(s):  
Doo Yun Lee ◽  
Hyo Chae Paik ◽  
Hae Kyoon Kim ◽  
Yoon Joo Hong ◽  
Won Young Lee
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Main Pulmonary Artery ◽  
Artery Pressure ◽  
Bilateral Lung

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 />

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