Isometric Handgrip Stress Test during Right Heart Catheterization in Patients with Mitral Regurgitation -A Case Series Study-

Objectives: Stiff left atrial syndrome is an intriguing clinical phenomena characterized by reduced left atrial compliance, pulmonary venous hypertension and exacerbations of volume overload. We conducted a retrospective review of patients diagnosed with stiff left atrial syndrome at our center. Methods: All patients admitted to our hospital with volume overload and pulmonary venous hypertension who were diagnosed with stiff left atrial syndrome based on evidence by echocardiogram and right heart catheterization between July 2011 and July 2013 were included in this retrospective review. Results: Twentythree patients (mean age 73 ± 11 years, 39% male and 61% female) were diagnosed with stiff left atrial syndrome at our center. Thirty-five percent had persistent while 39% had permanent atrial fibrillation. Mean duration of atrial fibrillation was 7.6 ± 2.1 years. Forty-three percent of patients had long standing hypertension. There was no mitral regurgitation in 39% of patients while 48% had mild mitral regurgitation. On right heart catheterization, mean right atrial pressure was 12.6±4.8 mm of Hg, mean pulmonary arterial pressure was 33±7.2 mm of Hg, mean pulmonary capillary wedge pressure was 24.8± 4.2mm of Hg while peak V waves were seen at mean of 37.8± 5.3 mm of Hg. Mean left atrial volume index was 49.8±17.1 mL/m 2. After the initial diagnosis with a two year follow- up, there were no readmissions in 65% of patients who were on appropriate diuretic therapy and had regular clinical visits. Frequent readmissions were seen in 35% of patients inspite of appropriate diuretic therapy. All-cause mortality rate was 4.3% at two year follow up. Conclusion: In patients with stiff left atrial syndrome, the presence of left atrial dilation, long standing atrial fibrillation and hypertension are the key factors associated with pathogenesis and clinical course. Close follow up and monitoring of volume status is essential to prevent hospital readmissions and improve long term prognosis.

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P1425 Association between severity of mitral regurgitation and right ventricular function in patients with moderate to severe mitral regurgitation assessed by invasive hemodynamics measurements

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.854 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

M Omar

Keyword(s):

Mitral Regurgitation ◽

Pulmonary Artery ◽

Stroke Volume ◽

Right Ventricular ◽

Right Heart Catheterization ◽

Right Atrial ◽

Heart Catheterization ◽

Right Heart ◽

Ambulatory Patients ◽

Primary Mitral Regurgitation

Abstract Funding Acknowledgements - Background Primary mitral regurgitation (MR) will cause volume overload to the left ventricle (LV) but due to systolic reguritant flow the pulmonary circulation will be affected often leading to post-capillary pulmonary hypertension and thus increased afterload to the right heart. As a consequence right ventricular (RV) dysfunction may be a consequence of MR. Purpose To assess the association between RV function assessed with cardiac magnetic resonance imaging (CMRI) and hemodynamics at rest and during exercise in ambulatory patients with primary mitral regurgitation (MR). Methods In an observational study, patients with significant primary MR with effective regurgitant orifice ≥0.30 cm2 and LV ejection fraction >60% were examined with right heart catheterization during rest and exercise and CMRI at rest. Patients were examined in semi-supine position (30 degree). From right heart catheterization pulmonary artery systolic pressure (PAPs) was measured, where RV stroke work index (RVSWI = 0.0136*(mean pulmonary artery pressure – right atrial pressure *stroke volume index) and pulmonary artery compliance (PAC= stroke volume / (PAPsystolic – PAPdiastolic)) was calculated. Patients were dichotomized according to effective regurgitant orifice (ERO) (≤0.4 cm2). Results The two groups (total n = 46) have same baseline characters with no significant differences. In both groups resting RVEF was normal and no difference in RV stroke volume was seen between the groups at rest or with exercise. However RVSWi was significantly higher in patients with ERO > 0.4, (rest p = 0.0039, exercise p = 0.01), Figure. The increase in RVSWi was driven by increased sPAP and where significantly in ERO > 0.4 at rest at during exercise (rest p = 0.00027, exercise p = 0.0352). At rest PAC was significantly higher in ERO above 0.4, but during exercise no differences was found in the two groups. RVEF at rest measured by CMRI showed no correlation with RVSWi in the two groups (r = 0.11, p = 0.45) Conclusion In ambulatory patients with mitral regurgitation above 0.4 cm2, RVSW is associated with an increased right ventricle workload and contractility at rest and during exercise which especially is driven by increased post capillary pressure whereas pulmonary arterial compliance only is mildly affected. Abstract P1425 Figure. Ventricle function at rest/exercise

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Circulating sLR11 levels predict severity of pulmonary hypertension due to left heart disease

PLoS ONE ◽

10.1371/journal.pone.0261753 ◽

2021 ◽

Vol 16 (12) ◽

pp. e0261753

Author(s):

Yusuke Joki ◽

Hakuoh Konishi ◽

Hiroyuki Ebinuma ◽

Kiyoshi Takasu ◽

Tohru Minamino

Keyword(s):

Pulmonary Hypertension ◽

Heart Disease ◽

Mitral Regurgitation ◽

Pulmonary Artery ◽

Right Heart Catheterization ◽

Heart Catheterization ◽

Severe Mitral Regurgitation ◽

Left Heart ◽

Right Heart ◽

Left Heart Disease

Background Heart failure is a severe condition often involving pulmonary hypertension (PH). Soluble low-density lipoprotein receptor with 11 ligand-binding repeats (sLR11) has been associated with pulmonary artery hypertension. We examined whether sLR11 correlates with PH in left heart disease and can be used as a predictive marker. Method We retrospectively analyzed patients with severe mitral regurgitation who underwent right heart catheterization before surgery for valve replacement or valvuloplasty from November 2005 to October 2012 at Juntendo University. We measured sLR11 levels before right heart catheterization and analyzed correlations with pulmonary hemodynamics. We compared prognoses between a group with normal sLR11 (≤9.4 ng/ml) and a group with high sLR11 (>9.4 ng/ml). Follow-up was continued for 5 years, with end points of hospitalization due to HF and death due to cardiovascular disease. Results Among 34 patients who met the inclusion criteria, sLR11 correlated with mean pulmonary artery pressure (r = 0.54, p<0.001), transpulmonary pressure gradient (r = 0.42, p = 0.012), pulmonary vascular resistance (r = 0.36, p<0.05), and log brain natriuretic peptide (BNP). However, logBNP did not correlate with pulmonary vascular resistance (p = 0.6). Levels of sLR11 were significantly higher in the 10 patients with PH (14.4±4.3 ng/ml) than in patients without PH (9.9±3.9 ng/ml; p = 0.002). At 5 years, the event rate was higher in the high-sLR11 group than in the normal-sLR11 group. The high-sLR11 group showed 5 hospitalizations due to HF (25.0%) and 2 deaths (10.0%), whereas the normal-sLR11 group showed no hospitalizations or deaths. Analyses using receiver operating characteristic curves showed a higher area under the concentration-time curve (AUC) for sLR11 level (AUC = 0.85; 95% confidence interval (CI) = 0.72–0.98) than for BNP (AUC = 0.80, 95%CI = 0.62–0.99) in the diagnosis of PH in left heart disease. Conclusions Concentration of sLR11 is associated with severity of PH and offers a strong predictor of severe mitral regurgitation in patients after surgery.

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Acute hemodynamic effects of NO and sildenafil during right heart catheterization in PAH and nonPAH-PH

Pneumologie ◽

10.1055/s-0035-1551930 ◽

2015 ◽

Vol 69 (05) ◽

Author(s):

V Foris ◽

G Kovacs ◽

P Douschan ◽

X Kqiku ◽

C Hesse ◽

...

Keyword(s):

Right Heart Catheterization ◽

Heart Catheterization ◽

Hemodynamic Effects ◽

Right Heart

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Correlation of Data Obtained by Radiocardiography and Right-Heart Catheterization in Cardiac Patients

Nuklearmedizin ◽

10.1055/s-0037-1621365 ◽

1968 ◽

Vol 07 (02) ◽

pp. 125-129

Author(s):

J. Měštan ◽

V. Aschenbrenner ◽

A. Michaljanič

Keyword(s):

Capillary Pressure ◽

Transit Time ◽

Right Heart Catheterization ◽

Heart Catheterization ◽

Right Heart ◽

Pulmonary Capillary ◽

Filling Time ◽

Pulmonary Capillary Pressure ◽

The Mean ◽

Pulmonary Transit Time

SummaryIn patients with acquired and congenital valvular heart disease correlations of the parameters of the radiocardiographic curve (filling time of the right heart, minimal pulmonary transit time, peak-to-peak pulmonary transit time, and the so-called filling time of the left heart) with the mean pulmonary artery pressure and the mean pulmonary “capillary” pressure were studied. Further, a regression equation was determined by means of which the mean pulmonary “capillary” pressure can be predicted.

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Evaluating Vitality and Periodontal Sensitivity of Teeth Adjacent to the Site of Open Sinus Lift Surgery before and after Treatment: A Case Series Study

Journal of Long-Term Effects of Medical Implants ◽

10.1615/jlongtermeffmedimplants.2020035426 ◽

2020 ◽

Vol 30 (2) ◽

pp. 77-81

Author(s):

Amir Moeintaghavi ◽

Negar Azami ◽

Mohammad Sadegh Zohrevand ◽

Farid Shiezadeh ◽

Hamid Jafarzadeh ◽

...

Keyword(s):

Case Series ◽

Sinus Lift ◽

Case Series Study ◽

Before And After ◽

Series Study

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A Case Series Study of Negative Pressure Platform Wound Device

Case Medical Research ◽

10.31525/ct1-nct04080011 ◽

2019 ◽

Author(s):

Keyword(s):

Negative Pressure ◽

Case Series ◽

Case Series Study ◽

Series Study

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Safety Study Based on Transcranial Electrical Stimulation in Chile: a Case Series Study

Case Medical Research ◽

10.31525/ct1-nct04245059 ◽

2020 ◽

Author(s):

Keyword(s):

Electrical Stimulation ◽

Case Series ◽

Transcranial Electrical Stimulation ◽

Safety Study ◽

Case Series Study ◽

Series Study

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Perfil microbiológico en los pacientes con diagnóstico de sinusitis nosocomial hospitalizados en la Unidad de Cuidados Intensivos del Hospital de San José durante el período de Febrero de 2013 a Marzo de 2015. Microbiological profile in patients diagnosed with nosocomial sinusitis hospitalized in the Intensive Care Unit of the Hospital of San Jose during the period February 2013 to March 2015.

ACTA DE OTORRINOLARINGOLOGÍA & CIRUGÍA DE CABEZA Y CUELLO ◽

10.37076/acorl.v45i4.122 ◽

2018 ◽

Vol 45 (4) ◽

pp. 261-266

Author(s):

Jorge Luis Alfredo Herrera Ariza ◽

Mario Alejandro Villabón ◽

Ángela Carolina Rojas Ruiz ◽

Iván Fernando Moncada

Keyword(s):

Disease Control ◽

Maxillary Sinus ◽

Case Series ◽

San Jose ◽

Study Materials ◽

Case Series Study ◽

Nosocomial Sinusitis ◽

Centers For Disease Control ◽

Microbial Agents ◽

Series Study

Objetivo: Determinar los agentes microbianos más frecuentes en pacientes de UCI con diagnóstico de sinusitis nosocomial en el Hospital de San José, período de dos años. Diseño: Estudio observacional tipo serie de casos. Materiales y métodos: Se incluyeron pacientes mayores de 18 años con una estancia hospitalaria mayor a 48 horas, que desarrollaron sinusitis nosocomial de acuerdo a los criterios de los Centers for Disease Control (CDC). Uso de dos técnicas: punción y lavado de seno maxilar. Resultados: 19 pacientes que cumplen los criterios de sinusitis nosocomial. Edad promedio 55 años, predominio sexo masculino. El 94.7% tuvo sonda orogástrica, 89.5% intubación orotraqueal y 89.5% ventilación mecánica. Hubo aislamiento polimicrobiano de gram positivos, gram negativos, anaerobios y hongos. La mortalidad en UCI fue 32%. Conclusiones: Se presenta una adecuada sensibilidad al tratamiento con vancomicina y piperacilina tazobactam en esta patología. El rendimiento diagnóstico es igual al realizar lavado y punción del seno maxilar.Objetive: To determine the microbial agents on UCI patients who have beendiagnosed with nosocomial sinusitis at the San Jose Hospital, (Bogota, Colombia) in a two-year period. Design: Case series study. Materials and methods: Patients who were older than 18-year olds, with a hospitalization longer than 48 hours who developed nosocomial sinusitis, according to the criteria established by the Centers for Disease Control (CDC) were included. Two techniques were employed for data collection: puncture and maxillary sinus wash. Results: 19 patients fulfill the criteria requirements for nosocomial sinusitis. Average age was 55 years old. Population mostly was composed by male individuals. 94.7% had a gastric tube intervention; 89.5% had tracheal intubation 89.5% mechanical ventilation. Polymicrobial isolation with gram positive, gram negative, anaerobic and fungi were identified. Mortality in critical care unites was 32%. Conclusions: An adequate sensitivity to treatment with vancomycin and piperacillin tazobactam was evidenced in this pathology.To perform a washing or maxillary sinus puncture had the same efficiency fordiagnosing this disease.

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