scholarly journals GAGAL JANTUNG KIRI DAN HIPERTENSI PULMONAL

2017 ◽  
Vol 1 (1) ◽  
pp. 9-21
Author(s):  
Djanggan Sargowo
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Ejection Fraction ◽  
Right Ventricular Dysfunction ◽  
Left Heart ◽  
Left Heart Failure ◽  
Non Invasive ◽  
Hemodynamic Variables ◽  
History Of ◽  
The Right

In patients with left heart failure, pulmonary hypertension and right ventricular dysfunction is a common condition and has important implications in the development of disease, disability and death, so it required special attention. Pulmonary hypertension is the most common form with approximately 65-80% of cases. Although today is already highly developed understanding of the pathophysiology and clinical assessment, as well as setting the hemodynamic definition and classification of pulmonary hypertension in left heart failure, but the interrelation hemodynamics in pulmonary hypertension combination of pre- and post-capillary is still very complex, and there is no evidence-based recommendations the handling of pulmonary hypertension is left heart failure. Here, we will discuss the prevalence and significance of pulmonary hypertension and cardiac dysfunction Right in patients with both heart failure with ejection fraction decreased, as well as heart failure with ejection fraction, as well as provides an overview of the pathophysiology of the complex due to the interaction of cardiopulmonary left heart failure, which can supports the evolution of the phenotype of the left ventricle into the right ventricle phenotype through the travel history of heart failure. Next, we will discuss fenoitp pulmonary hypertension by combining the clinical context, the assessment of non-invasive and invasive hemodynamic variables in a structured diagnostic assessment.

scholarly journals Pulmonary vascular mechanical consequences of ischemic heart failure and implications for right ventricular function

2019 ◽  
Vol 316 (5) ◽  
pp. H1167-H1177 ◽  
Author(s):  
Jennifer L. Philip ◽  
Thomas M. Murphy ◽  
David A. Schreier ◽  
Sydney Stevens ◽  
Diana M. Tabima ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Pulmonary Fibrosis ◽  
Ejection Fraction ◽  
Right Ventricle ◽  
Pulmonary Vasculature ◽  
Left Heart ◽  
Left Heart Failure ◽  
Reduced Ejection Fraction ◽  
Pathologic Features

Left heart failure (LHF) is the most common cause of pulmonary hypertension, which confers an increase in morbidity and mortality in this context. Pulmonary vascular resistance has prognostic value in LHF, but otherwise the mechanical consequences of LHF for the pulmonary vasculature and right ventricle (RV) remain unknown. We sought to investigate mechanical mechanisms of pulmonary vascular and RV dysfunction in a rodent model of LHF to address the knowledge gaps in understanding disease pathophysiology. LHF was created using a left anterior descending artery ligation to cause myocardial infarction (MI) in mice. Sham animals underwent thoracotomy alone. Echocardiography demonstrated increased left ventricle (LV) volumes and decreased ejection fraction at 4 wk post-MI that did not normalize by 12 wk post-MI. Elevation of LV diastolic pressure and RV systolic pressure at 12 wk post-MI demonstrated pulmonary hypertension (PH) due to LHF. There was increased pulmonary arterial elastance and pulmonary vascular resistance associated with perivascular fibrosis without other remodeling. There was also RV contractile dysfunction with a 35% decrease in RV end-systolic elastance and 66% decrease in ventricular-vascular coupling. In this model of PH due to LHF with reduced ejection fraction, pulmonary fibrosis contributes to increased RV afterload, and loss of RV contractility contributes to RV dysfunction. These are key pathologic features of human PH secondary to LHF. In the future, novel therapeutic strategies aimed at preventing pulmonary vascular mechanical changes and RV dysfunction in the context of LHF can be tested using this model. NEW & NOTEWORTHY In this study, we investigate the mechanical consequences of left heart failure with reduced ejection fraction for the pulmonary vasculature and right ventricle. Using comprehensive functional analyses of the cardiopulmonary system in vivo and ex vivo, we demonstrate that pulmonary fibrosis contributes to increased RV afterload and loss of RV contractility contributes to RV dysfunction. Thus this model recapitulates key pathologic features of human pulmonary hypertension-left heart failure and offers a robust platform for future investigations.

scholarly journals Sildenafil improves clinical and functional status of an elderly postmenopausal female with ‘out of proportion’ PH associated with left heart disease

2013 ◽  
Vol 80 (4) ◽  
Author(s):  
Michele Correale ◽  
Antonio Totaro ◽  
Armando Ferraretti ◽  
Matteo Di Biase ◽  
Natale Daniele Brunetti
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Ejection Fraction ◽  
Elderly Woman ◽  
Preserved Ejection Fraction ◽  
Left Heart ◽  
Left Heart Failure ◽  
Clinical And Functional Status ◽  
Postmenopausal Female

We report a case of an elderly woman with heart failure with preserved ejection fraction and pulmonary hypertension (HFpEF-PH), refractory to conventional therapy for left heart failure and successfully treated by sildenafil.

scholarly journals Intravascular Talcosis due to Intravenous Drug Use Is an Underrecognized Cause of Pulmonary Hypertension

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Christopher C. Griffith ◽  
Jay S. Raval ◽  
Larry Nichols
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Drug Use ◽  
Intravenous Drug ◽  
Granulomatous Disease ◽  
Intravenous Drug Use ◽  
Left Heart ◽  
Foreign Material ◽  
History Of ◽  
The Right

Intravenous injection of illegal drugs or medications meant for oral administration can cause granulomatous disease of the lung. This intravascular talcosis results in pulmonary fibrosis and pulmonary hypertension. Nine cases of histologically confirmed intravascular talcosis were reviewed with specific attention given to the clinical histories in these patients. Five autopsy cases were included in this series with detailed investigation in the anatomic features associated with intravascular talcosis and pulmonary hypertension. All nine patients showed perivascular and/or intravascular deposition of polarizable foreign material in their lungs. Intravascular talcosis as a result of previous intravenous drug use was not clinically suspected in any patient despite clinically diagnosed pulmonary hypertension in five. All patients showed dilatation of the right and left heart, but none had dilatation of the aortic valve. Congestive heart failure with hepatosplenomegaly was also common. We conclude that intravascular talcosis is an underdiagnosed cause of pulmonary hypertension in patients with known history of intravenous drug use.

Right Heart Phenotype in Heart Failure With Preserved Ejection Fraction

2021 ◽  
Author(s):  
Marco Guazzi ◽  
Robert Naeije
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Right Ventricular ◽  
Ventricular Dysfunction ◽  
Imaging Techniques ◽  
Treatment Options ◽  
Right Ventricular Dysfunction ◽  
Preserved Ejection Fraction ◽  
Right Heart ◽  
The Right

The health burden of heart failure with preserved ejection fraction is increasingly recognized. Despite improvements in diagnostic algorithms and established knowledge on the clinical trajectory, effective treatment options for heart failure with preserved ejection fraction remain limited, mainly because of the high mechanistic heterogeneity. Diagnostic scores, big data, and phenomapping categorization are proposed as key steps needed for progress. In the meantime, advancements in imaging techniques combined to high-fidelity pressure signaling analysis have uncovered right ventricular dysfunction as a mediator of heart failure with preserved ejection fraction progression and as major independent determinant of poor outcome. This review summarizes the current understanding of the pathophysiology of right ventricular dysfunction in heart failure with preserved ejection fraction covering the different right heart phenotypes and offering perspectives on new treatments targeting the right ventricle in its function and geometry.

scholarly journals Heart rate variability in severe right or left heart failure: the role of pulmonary hypertension and resistances

2004 ◽  
Vol 6 (2) ◽  
pp. 181-185 ◽  
Author(s):  
Laurent Fauchier ◽  
Dominique Babuty ◽  
Alexandre Melin ◽  
Pierre Bonnet ◽  
Pierre Cosnay ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Rate ◽  
Pulmonary Hypertension ◽  
Heart Rate Variability ◽  
Left Heart ◽  
Left Heart Failure
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