scholarly journals Dust related respiratory pathology and pulmonary hypertension

2008 ◽  
pp. 77-80
Author(s):  
V. V. Razumov ◽  
N. A. Shatskikh ◽  
M. P. Zadorozhnaya

Hemodynamic parameters of right and left heart ventricles and both greater and lesser blood circulations were studied using Doppler echocardiography in 129 patients with arterial hypertension, 54 patients with dust related respiratory pathology and 97 subjects of two control groups. Relying on the results we concluded that (1) the right heart ventricle and pulmonary circulation are targets for arterial hypertension, (2) pressure increase in arteries of lesser circulation occurs at the initial stage of dust related respiratory disease, (3) and the research of pulmonary hemodynamics with functional load should be obligatory when examining relationship between the disease and the profession.

Author(s):  
Elena Klester ◽  
Karolina Klester ◽  
Yakov Shoikhet ◽  
Valentina Yarkova ◽  
Victor Nikitin ◽  
...  

1997 ◽  
Vol 272 (3) ◽  
pp. H1499-H1515 ◽  
Author(s):  
Y. Sun ◽  
M. Beshara ◽  
R. J. Lucariello ◽  
S. A. Chiaramida

A phenomenological model of the cardiopulmonary circulation is developed with a focus on the interaction between the right heart and the left heart. The model predicts the hemodynamic consequences of changing circulatory parameters in terms of a broad spectrum of pressure and flow waveforms. Hemodynamics are characterized by use of an electrical analog incorporating mechanisms for transseptal pressure coupling, pericardial volume coupling, intrathoracic pressure, and baroreflex control of heart rate. Computer simulations are accomplished by numerically integrating 28 differential equations that contain nonlinear and time-varying coefficients. Validity of the model is supported by its accurate fit to clinical pressure and Doppler echocardiographic recordings. The model characterizes the hemodynamic waveforms for mitral stenosis, mitral regurgitation, left heart failure, right heart failure, cardiac tamponade, pulsus paradoxus, and the Valsalva maneuver. The wave shapes of pulmonary capillary wedge pressure under the above conditions are also accurately represented. Sensitivity analysis reveals that simulated hemodynamics are insensitive to most individual model parameters with the exception of afterload resistance, preload capacitances, intrathoracic pressure, contractility, and pericardial fluid volume. Baseline hemodynamics are minimally affected by transseptal coupling (up to 2%) and significantly affected by pericardial coupling (up to 20%). The model should be useful for quantitative studies of cardiopulmonary dynamics related to the right-left heart interaction under normal and disease conditions.


2016 ◽  
Vol 311 (3) ◽  
pp. H689-H698 ◽  
Author(s):  
Sachindra Raj Joshi ◽  
Vidhi Dhagia ◽  
Salina Gairhe ◽  
John G. Edwards ◽  
Ivan F. McMurtry ◽  
...  

Heart failure, a major cause of morbidity and mortality in patients with pulmonary arterial hypertension (PAH), is an outcome of complex biochemical processes. In this study, we determined changes in microRNAs (miRs) in the right and left ventricles of normal and PAH rats. Using an unbiased quantitative miR microarray analysis, we found 1) miR-21-5p, miR-31-5 and 3p, miR-140-5 and 3p, miR-208b-3p, miR-221-3p, miR-222-3p, miR-702-3p, and miR-1298 were upregulated (>2-fold; P < 0.05) in the right ventricle (RV) of PAH compared with normal rats; 2) miR-31-5 and 3p, and miR-208b-3p were upregulated (>2-fold; P < 0.05) in the left ventricle plus septum (LV+S) of PAH compared with normal rats; 3) miR-187-5p, miR-208a-3p, and miR-877 were downregulated (>2-fold; P < 0.05) in the RV of PAH compared with normal rats; and 4) no miRs were up- or downregulated with >2-fold in LV+S compared with RV of PAH and normal. Upregulation of miR-140 and miR-31 in the hypertrophic RV was further confirmed by quantitative PCR. Interestingly, compared with control rats, expression of mitofusin-1 (MFN1), a mitochondrial fusion protein that regulates apoptosis, and which is a direct target of miR-140, was reduced in the RV relative to LV+S of PAH rats. We found a correlation between increased miR-140 and decreased MFN1 expression in the hypertrophic RV. Our results also demonstrated that upregulation of miR-140 and downregulation of MFN1 correlated with increased RV systolic pressure and hypertrophy. These results suggest that miR-140 and MFN1 play a role in the pathogenesis of PAH-associated RV dysfunction. Listen to this article's corresponding podcast at http://ajpheart.podbean.com/e/mir140-and-right-heart-hypertrophy/ .


2020 ◽  
Vol 27 (3) ◽  
pp. 89-106
Author(s):  
G. D. Radchenko ◽  
S. M. Kushnir ◽  
Yu. M. Sirenko

This paper presents clinical case of pulmonary hypertension associated with left heart diseases (PH-LHD) in 63 year old woman with heart failure and preserved ejection fraction (HFpEF). The history of disease (arterial hypertension, atrial fibrillation, diabetes mellitus, acute pulmonary embolism, obesity, chronic obstructive lung disease) and results of standard investigations (no signs of thrombi in pulmonary arteries, significant enlargement of right heart and normal size of left heart, high level of calculated systolic blood pressure in pulmonary artery, high level of B-type natriuretic peptide) did not help to classify the type of pulmonary hypertension (PH). Only after right heart catheterization it was possible to state right diagnosis – post capillary combined PH-LHD. There are also discussed the latest guidelines in diagnosis and treatment of HFpEF and PH-LHD. Some considerations in favor of new step algorithm for diagnosis of HFpEF that was proposed by European Cardiology Congress in Paris (2019) were done and there was demonstrated its possible use in Ukraine. Some questions of morphological and pathogenic differences between precapillary pulmonary arterial hypertension (PAH) and post-capillary PH-LHD were discussed. Conclusion about not using of specific PAH therapy in PH-LHD patients was based on some arguments. There are elucidated some drug interventions in patients with HFpEF. Especial emphasized the necessity of risk factor and concomitant state corrections, including life style modification and non-drug treatment.


2019 ◽  
Vol 4 (3) ◽  
pp. 219-224
Author(s):  
Gabor Kovacs ◽  
Horst Olschewski

Pulmonary vascular disease represents one of the most frequent complications in systemic sclerosis leading to increased mortality. The recognition and appropriate clinical management of early pulmonary vascular disease could significantly improve the prognosis of affected patients. Early pulmonary vascular disease is characterized by the histological signs of pulmonary vascular remodeling, mildly increased mean pulmonary arterial pressure (21–24 mmHg) at rest, abnormal pulmonary hemodynamics during exercise, decreased exercise capacity, and a high risk for development of pulmonary arterial hypertension. Pulmonary hemodynamics can be investigated during exercise by echocardiography or by right heart catheterization both representing important clinical tools for the screening and confirmation of early pulmonary vascular disease. Further studies are needed to better understand the clinical course of systemic sclerosis patients with early pulmonary vascular disease and to define the characteristics of patients that will or will not profit from pulmonary arterial hypertension treatment.


1997 ◽  
Vol 20 (12) ◽  
pp. 684-691 ◽  
Author(s):  
F.R. Waldenberger

Mechanical assisted circulation by the means of cardiac assist devices is a routine procedure in modern cardiac surgery and cardiology. We investigated the impact of mechanical unloading on regional myocardial “stunning” and the influence of assisted circulation on left heart and right heart failure persevered by an ultimate addition of pulmonary hypertension in experimental set ups. We found that mechanical unloading either during ischemia or in the early reperfusion phase attenuates stunning and enhances the return of synchronous heart performance. In our global dysfunction model we showed that the right heart is dispensable. Sufficient inflow to the left heart is provided unless pulmonary hypertension is present. Also additional left heart support can not overcome the deleterious situation and in select cases only additional right heart support can prevent the “low LVAD output” syndrome. We conclude that mechanical assisted circulation and mechanical unloading are beneficial in case of regional and global dysfunction persevered by pulmonary hypertension, however, the knowledge about interactions of assist systems and the circulation has to be improved in order to optimize clinical assist device performance.


Sign in / Sign up

Export Citation Format

Share Document