scholarly journals Pulmonary hemodynamics and diastolic function of right ventricle at isometric exercises in children with chronic bronchopulmonary pathology

2011 ◽  
Vol 10 (3) ◽  
pp. 105-110
Author(s):  
L. I. Agapitov ◽  
Yu. M. Belozerov ◽  
Yu. L. Mizernitsky ◽  
S. E. Tsyplenkova
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Diastolic Function ◽  
Pulmonary Artery Pressure ◽  
Isometric Exercise ◽  
Healthy Children ◽  
Pulmonary Hemodynamics ◽  
Artery Pressure ◽  
Mean Pulmonary Artery Pressure ◽  
The Right

We studied pulmonary hemodynamics and right ventricular diastolic function in 300 healthy children and 392 children with chronic bronchopulmonary pathology in an isometric exercise. Using echocardiography were determined systolic, diastolic, mean, pulmonary artery pressure, total pulmonary resistance, diastolic function of the right ventricle. Defined normal values of reactivity of pulmonary hemodynamics and diastolic function of the right ventricle in an isometric load. In patients with chronic bronchopulmonary pathology set higher increase of systolic, diastolic, mean, pulmonary artery pressure, decrease diastolic reserve the right ventricle compared to the control. The worst violations of pulmonary hemodynamics and diastolic function of the right ventricle during isometric load observed in patients with chronic Infectious-inflammatory and interstitial lung disease.

scholarly journals Evaluation of the morphology and mechanics of the right ventricle using echocardiography before and after transcatheter balloon pulmonary angioplasty in patients with chronic thromboembolic pulmonary

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
KIRILL Malikov ◽  
MARINA Kirichkova ◽  
MARIA Simakova ◽  
NARECK Marukyan ◽  
OLGA Moiseeva
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Pulmonary Artery Pressure ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Reverse Remodeling ◽  
Free Wall ◽  
Artery Pressure ◽  
Balloon Pulmonary Angioplasty ◽  
Before And After ◽  
The Right

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Chronic thromboembolic pulmonary hypertension (CTEPH) leads to a progressive increase in pulmonary vascular resistance (PVR) and pulmonary artery pressure (PAP) with the development of severe dysfunction of the right heart and heart failure. Mortality for three years with an average pressure in the pulmonary artery (PA) of more than 50 mmHg is more than 90%. Balloon pulmonary angioplasty (BPA) has a significant advantage over other methods of surgical treatment, but it requires the determination of additional non-invasive markers of effectiveness. Transthoracic echocardiography (TTE) remains the main method for assessing the morphology and function of the heart. Purpose Compare different indicators reflecting the severity of CTEPH with TTE indicators before and after BPA. To evaluate the effectiveness of using BPA for the treatment of patients with CTEPH using routine TTE and speckle tracking mode. Materials and methods For 18 months 30 patients without concomitant cardiovascular pathology were subjected to several BPA sessions. Before treatment, 50% of patients belonged to the 3 CTEPH functional class (FC), 40% to 2 FC, 10% to 1 FC. The average number of sessions was 4.7 ± 1.3. Before the first BPA and after the last, all the patients were performed: six-minute walk test (6MWT, metres), Borg scale (in points), test for NT-proBNP (pg/ml); TTE with assessment of the right ventricle (RV) and left ventricle (LV) including areas of the right atrium (aRA, cm2), mean pulmonary artery pressure (PUPM,mmHg),RV free wall strain (GLSFW, %), RV free wall strain rate (GLSRFW, sm/sec), RV free wall postsystolic shortening (PSSFW, %), tricuspid annular plane systolic excursion (TAPSE, sm), tricuspid annulus systolic velocity (TASV, sm/sec). Results. Before the first BPA session, the 6MWT in the patient group averaged 315.9 ± 9.08 metres, after - 439.5 ± 11.45 m; the Borg from 5.4 ± 0.94 points decreased to 4 ± 1.01 points; NT-proBNP before the treatment was 1513 ± 13.01 pg/ml, after - 171 ± 6.09; according to TTE the ratio of RV/ LV before and after treatment was 1.31 ± 0.02 and 0.97 ± 0.04; aRA was 29.3 ± 4.87 and 22.3 ± 3.53 cm2; basal RV - 52 ± 5.11 and 44 ± 7.26 mm; PUPM decreased from 76.6 ± 7.65 to 31.3 ± 3.78 mmHg; GLSFW from -14.69 ± 2.33 came to 17.5 ± 3.45 %; GLSRFW with -0.9 ± 0.09 to -1.7 ± 0.11 cm/sec; TAPSE from 16.7 ± 1.87 to 18.2 ± 2.34 cm; TASV from 10.11 ± 1.45 to 12.25 ± 1.98 cm/s, PSSFW before treatment was -18.4 ± 1.2%, after treatment in 66% of patients disappeared, in 34% became an average of 17.4 ± 0.9% The distribution of STEPH FC has also changed. Conclusion. BPA leads to an improvement in the tolerance of physical activity, clinical indicators, and parameters of central hemodynamics in the pulmonary circulation, evaluated according to direct manometry, and leads to reverse remodeling of the RV in the long term. Performing a staged BPA leads to an improvement in the functional parameters of contractility of the RV.

scholarly journals Serum soluble suppression of tumorigenicity-2 level associates with severity of pulmonary hypertension associated with uncorrected atrial septal defect

2020 ◽  
Vol 10 (2) ◽  
pp. 204589402091583 ◽  
Author(s):  
Reza S. Pratama ◽  
Anggoro B. Hartopo ◽  
Dyah W. Anggrahini ◽  
Vera C. Dewanto ◽  
Lucia K. Dinarti
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Right Ventricle ◽  
Atrial Septal Defect ◽  
Pulmonary Artery Pressure ◽  
Septal Defect ◽  
Eisenmenger Syndrome ◽  
Secundum Atrial Septal Defect ◽  
Artery Pressure ◽  
Mean Pulmonary Artery Pressure

Uncorrected atrial septal defect undergoes right ventricle chronic volume overload which may lead to pulmonary hypertension and Eisenmenger Syndrome. The soluble suppression of tumorigenicity-2 is a left ventricle strain biomarker; however, its role in right ventricle strain is unclear. This study aimed to investigate the implication of serum soluble suppression of tumorigenicity-2 in adult uncorrected atrial septal defect. This was a cross-sectional study. We enrolled 81 adult uncorrected secundum atrial septal defect patients. Clinical and hemodynamic data were collected. Serum samples were withdrawn from the pulmonary artery during right heart catheterization. Serum soluble suppression of tumorigenicity-2 and NT-proBNP levels were measured. Subjects were divided into three groups based on clinical and hemodynamic severity. The correlation of soluble suppression of tumorigenicity-2 with patients' data and comparison among groups were analyzed. A p value <0.05 was considered statistically significant. Results showed that, there were significant correlations between serum soluble suppression of tumorigenicity-2 and mean pulmonary artery pressure ( r = 0.203, p = 0.035) and right ventricle end-diastolic diameter ( r = 0.203, p <0.05). Median serum soluble suppression of tumorigenicity-2 level was incrementally increased from group I (atrial septal defect and no-pulmonary hypertension), group II (left-to-right atrial septal defect and pulmonary hypertension), to group III (Eisenmenger Syndrome): (17.4 ng/mL, 21.8 ng/mL, and 29.4 ng/mL, respectively). A post-hoc analysis showed that serum soluble suppression of tumorigenicity-2 level was significantly different between groups I and III ( p = 0.01). Serum N terminal pro brain natriuretic peptide (NT-proBNP) level was consistently associated with worse clinical and hemodynamic parameters. No correlation was found between serum soluble suppression of tumorigenicity-2 and NT-proBNP level. In conclusion, serum soluble suppression of tumorigenicity-2 level had significant positive correlation with mean pulmonary artery pressure and right ventricle end-diastolic diameter in uncorrected secundum atrial septal defect patients. Higher serum soluble suppression of tumorigenicity-2 level was associated with the presence of pulmonary hypertension and Eisenmenger Syndrome in uncorrected secundum atrial septal defect patients.

Abstract 17062: A Novel Non-Invasive Index to Characterize Right Ventricle-Pulmonary Arterial Vascular Coupling in Children

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_1) ◽  
Author(s):  
Philip Levy ◽  
Kel Vin Woo ◽  
Amanda T Hauck ◽  
Aaron Hamvas ◽  
Gautam K Singh
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Pulmonary Artery Pressure ◽  
Reliable Estimate ◽  
Artery Pressure ◽  
Non Invasive ◽  
Mean Pulmonary Artery Pressure ◽  
Wide Range ◽  
Pulmonary Arterial ◽  
Force Relationship

Introduction: The right ventricle (RV) is a pulsatile pump, the efficiency or work of which depends on proper hemodynamic coupling with the compliant pulmonary arterial vasculature (PV). RV-PV coupling derived by right heart catheritization (RHC) measures the ratio of ventricular elastance (Ees, contractility) to arterial elastance (Ea, afterload) and is based on the work-energy principle that states a change in energy is equal to the work expended by a force through displacement. Non-invasive echocardiography derived surrogates to the Ees/Ea ratio that account for the length-force relationship have been proposed, but their clinical correlation as estimates of RV-PV coupling remain to be established. Hypothesis: We hypothesize that the non-invasive index of RV length-force relationship is a reliable measure of invasive RV-PV coupling (Ees/Ea) in children. Methods: Prospectively acquired simultaneous echocardiography-derived ratio of tricuspid annular plane systolic excursion to pulmonary artery acceleration time (TAPSE/PAAT) and RHC-derived Ees/Ea were compared using regression analysis in a cohort of 125 children (median age, 5 years; IQR, 1-13 years) with a wide range of pulmonary hemodynamics. Ees/Ea was calculated using the single beat method from RHC measures with the following equation: (RV systolic pressure - mean pulmonary artery pressure) / mean pulmonary artery pressure. TAPSE (mm), as a measure of RV contractile reserve, was substituted for length, and PAAT (msec), a reliable estimate of RV afterload, was exchanged for force. PAAT was adjusted for RV ejection time (PAATi=PAAT/RVET) to account for heart rate variability. Results: TAPSE/PAAT and TAPSE/PAATi both correlated with invasive Ees/Ea (r = 0.81, p<0.01 and r=0.76, p<0.01, respectively, Figure). TAPSE/PAAT and TAPSE/PAATi were both decreased (p<0.001) in children with pulmonary hypertension by RHC (mPAP>25 mmHg and PVRi>3 WU.m2). With ROC analysis, TAPSE/PAAT < 0.13 m/sec and TAPSE/PAATi < 38 mm detected Ees/Ea < 1.0 with sensitivity of 95% and specificity of 91% with an AUC of 0.90 (95% CI, 0.85-0.96). Conclusions: TAPSE/PAAT and TAPSE/PAATi , non-invasive indices of the length-force relationship, provide reliable estimates of invasive RV-PV coupling in children.

Effect of norepinephrine and 5-hydroxytryptamine on the pulmonary circulation of the spinal dog

1959 ◽  
Vol 196 (5) ◽  
pp. 1045-1048 ◽  
Author(s):  
Gabriel G. Nahas ◽  
I. MacDonald
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Intact Animal ◽  
Pressure Change ◽  
Artery Pressure ◽  
Mean Pulmonary Artery Pressure ◽  
Similar Dose ◽  
Spinal Section ◽  
The Mean ◽  
The Right

One microgram of norepinephrine per kilogram of body weight injected in a 1-ml volume into the right atrium had little direct effect on the mean pulmonary artery pressure of dogs with intact nerve supply. The changes observed occurred simultaneously with systemic changes. In the spinal vagotomized dog, a similar dose produced a rise in mean pulmonary artery pressure which preceded any other pressure change. The isolated pulmonary hypertension produced in the intact animal by an identical dose of 5 HT is not modified after vagotomy or spinal section.

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 />

Prognostic importance of mitral e′ velocity in constrictive pericarditis

2020 ◽  
Author(s):  
Jeong Hoon Yang ◽  
William R Miranda ◽  
Rick A Nishimura ◽  
Kevin L Greason ◽  
Hartzell V Schaff ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Constrictive Pericarditis ◽  
Multivariable Analysis ◽  
Artery Pressure ◽  
Myocardial Disease ◽  
Mean Pulmonary Artery Pressure ◽  
Diastolic Velocity ◽  
Long Term Mortality

Abstract Aims  Increased medial mitral annulus early diastolic velocity (e′) plays an important role in the echocardiographic diagnosis of constrictive pericarditis (CP) and mitral e′ velocity is also a marker of underlying myocardial disease. We assessed the prognostic implication of mitral e′ for long-term mortality after pericardiectomy in patients with CP. Methods and results  We studied 104 surgically confirmed CP patients who underwent echocardiography and cardiac catheterization within 7 days between 2005 and 2013. Patients were classified as primary CP (n = 45) or mixed CP (n = 59) based on the clinical history of concomitant myocardial disease. On multivariable analysis, medial e′ velocity and mean pulmonary artery pressure were independently associated with long-term mortality post-pericardiectomy. There were significant differences in survival rates among the groups divided by cut-off values of 9.0 cm/s and 29 mmHg for medial e′ and mean pulmonary artery pressure, respectively (both P &lt; 0.001). Ninety-two patients (88.5%) had elevated pulmonary artery wedge pressure (PAWP) (≥15 mmHg); there was no significant correlation between medial E/e′ and PAWP (r = 0.002, P = 0.998). However, despite the similar PAWP between primary CP and mixed CP groups (21.6 ± 5.4 vs. 21.2 ± 5.8, P = 0.774), all primary CP individuals with elevated PAWP had medial E/e′ &lt;15 as opposed to 34 patients (57.6%) in the mixed CP group (P &lt; 0.001). Conclusion  Increased mitral e′ velocity is associated with better outcomes in patients with CP. A paradoxical distribution of the relationship between E/e′ and PAWP is present in these patients but there is no direct inverse correlation between them.

A stabilization period of 5 minutes is adequate when measuring pulmonary artery pressures after turning

1993 ◽  
Vol 2 (6) ◽  
pp. 474-477 ◽  
Author(s):  
PA Shinners ◽  
MO Pease
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Artery Pressure ◽  
Supine Position ◽  
Surgical Intensive Care Unit ◽  
Pressure Measurements ◽  
Artery Pressure ◽  
Group A ◽  
Group B ◽  
The Right ◽  
Stabilization Period

OBJECTIVE: To compare hemodynamic measurements made before turning and at 5 and 30 minutes after turning, and to determine whether the stabilization period affects the difference between supine and side-lying pulmonary artery pressures. METHODS: This study was performed in the cardiothoracic surgical intensive care unit of a midwestern university hospital. The 31 postoperative open-heart surgical patients, 26 men and 5 women aged 41 to 76 years (64 +/- 9.3, mean +/- SD) with pulmonary artery catheters in place, were divided into two groups to compare supine to side-lying pressures and the time intervals between the position changes. The supine-first subjects (Group A) were placed in the supine position for baseline measurements and turned to either the right or left side-lying position for the 5- and 30-minute pulmonary artery pressure measurements. The side-first subjects (Group B) were placed in either the right or left side-lying position for baseline measurements and then in the supine position for the 5- and 30-minute pulmonary artery pressure measurements. RESULTS: Pulmonary artery pressures, heart rate and arterial pressure were not significantly different at 5 and 30 minutes. Supine pulmonary artery pressures in Group A were not significantly different from supine pressures in Group B. Side-lying pulmonary artery pressures in Group A were not significantly different from side-lying pressures in Group B. Side-lying vs supine pulmonary artery pressures were significantly different in both Group A and Group B. CONCLUSION: The current practice of turning and settling the patient, zeroing the transducer and proceeding to make the pulmonary artery pressure readings appears to be valid. The stabilization period after turning does not explain the differences found between side-lying and supine pulmonary artery pressures.

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