scholarly journals Correlation of Net Atrioventricular Compliance with the Outcome of Successful Percutaneous Transvenous Mitral Valve Commissurotomy

2016 ◽  
Vol 8 (2) ◽  
pp. 99-109 ◽  
Author(s):  
Rajib Ghosh ◽  
Abdullah Al Shafi Majumder ◽  
MM Hossain ◽  
Abdul Momen ◽  
M Aziz ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Pulmonary Artery ◽  
Pressure Gradient ◽  
Left Atrial ◽  
Nyha Class ◽  
Prognostic Significance ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Significant Difference ◽  
Mean Pressure

Background: In patients with mitral stenosis the prognostic significance of net atrioventricular compliance has already been established. It was found that left atrial compliance significantly improve immediately after successful balloon mitral valvotomy. This study was conducted to evaluate the immediate improvement of atrioventricular compliance following percutaneous Transvenous mitral commissurotomy (PTMC) & to see the relation of post PTMC atrioventricular compliance with immediate clinical & other echocardiographic outcomes.Methods: This prospective observational study was undertaken in the Department of Cardiology, National Institute of Cardiovascular diseases, Dhaka. A total of 50 patients who had had successful PTMC were selected. All patients were evaluated clinically and echocardiographically 24 hours before PTMC, immediately after PTMC and 72 hours after PTMC.Results: Atrioventricular compliance improved significantly following PTMC (mean Cn 3.42 ± 1.64ml/mm Hg vs. 6.38 ± 2.81ml/mm Hg, p<0.001). After successful PTMC comparison of clinical & echocardiographic parameters revealed mitral valve area, pulmonary arterial systolic pressure, transmitral peak and mean pressure gradient and NYHA class for dyspnoea had statistically significant difference among patients with atrioventricular compliance >4 ml/mm of Hg and patients with atrioventricular compliance d”4ml/mm of Hg. NYHA class for heart failure, transmitral peak and mean pressure gradient, pulmonary artery systolic pressure were negatively correlated to atrioventricular compliance. Index left atrial anteroposterior diameter had no significant correlation with atrioventricular compliance.Conclusion: Successful PTMC is associated with immediate significant improvement in atrioventricular compliance. Atrioventricular compliance is inversely correlated with NYHA functional status, transmitral pressure gradient & pulmonary artery systolic pressure following successful PTMC. Post PTMC atrioventricular compliance is also positively correlated with pre PTMC atrioventricular compliance.Cardiovasc. j. 2016; 8(2): 99-109

scholarly journals Noninvasive evaluation of pulmonary artery pressure during exercise: the importance of right atrial hypertension

2019 ◽  
Vol 55 (2) ◽  
pp. 1901617 ◽  
Author(s):  
Masaru Obokata ◽  
Garvan C. Kane ◽  
Hidemi Sorimachi ◽  
Yogesh N.V. Reddy ◽  
Thomas P. Olson ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pressure Gradient ◽  
Systolic Pressure ◽  
Area Under The Curve ◽  
Right Atrial ◽  
Pulmonary Artery Systolic Pressure ◽  
Therapeutic Implications ◽  
Exercise Induced ◽  
The Right ◽  
Minimal Bias

IntroductionIdentification of elevated pulmonary artery pressures during exercise has important diagnostic, prognostic and therapeutic implications. Stress echocardiography is frequently used to estimate pulmonary artery pressures during exercise testing, but data supporting this practice are limited. This study examined the accuracy of Doppler echocardiography for the estimation of pulmonary artery pressures at rest and during exercise.MethodsSimultaneous cardiac catheterisation-echocardiographic studies were performed at rest and during exercise in 97 subjects with dyspnoea. Echocardiography-estimated pulmonary artery systolic pressure (ePASP) was calculated from the right ventricular (RV) to right atrial (RA) pressure gradient and estimated RA pressure (eRAP), and then compared with directly measured PASP and RAP.ResultsEstimated PASP was obtainable in 57% of subjects at rest, but feasibility decreased to 15–16% during exercise, due mainly to an inability to obtain eRAP during stress. Estimated PASP correlated well with direct PASP at rest (r=0.76, p<0.0001; bias −1 mmHg) and during exercise (r=0.76, p=0.001; bias +3 mmHg). When assuming eRAP of 10 mmHg, ePASP correlated with direct PASP (r=0.70, p<0.0001), but substantially underestimated true values (bias +9 mmHg), with the greatest underestimation among patients with severe exercise-induced pulmonary hypertension (EIPH). Estimation of eRAP during exercise from resting eRAP improved discrimination of patients with or without EIPH (area under the curve 0.81), with minimal bias (5 mmHg), but wide limits of agreement (−14–25 mmHg).ConclusionsThe RV–RA pressure gradient can be estimated with reasonable accuracy during exercise when measurable. However, RA hypertension frequently develops in patients with EIPH, and the inability to noninvasively account for this leads to substantial underestimation of exercise pulmonary artery pressures.

scholarly journals Quality of life status determinants in hypertrophic cardiomyopathy as evaluated by the Kansas City Cardiomyopathy Questionnaire

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Razvan Capota ◽  
Sebastian Militaru ◽  
Alin Alexandru Ionescu ◽  
Monica Rosca ◽  
Cristian Baicus ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hypertrophic Cardiomyopathy ◽  
Pulmonary Artery ◽  
Kansas City ◽  
Nyha Class ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Kansas City Cardiomyopathy Questionnaire ◽  
Health Related

Abstract Purpose The present study evaluated how heart failure (HF) negatively impacts health-related quality of life (HRQoL) in hypertrophic cardiomyopathy (HCM) patients and explored the major clinical determinants associated with HRQoL impairment in this population. Methods This was a cross-sectional single-center study of health-related HRQoL that included 91 consecutive patients with HCM. Evaluation was performed based on a comprehensive protocol that included the recommended diagnostic studies, as well as administration of the translated validated version of the Kansas City Cardiomyopathy Questionnaire (KCCQ) (CV Outcomes Inc) as a health status measure. Results The cohort included 52 (57%) males, median age 58 (20–85) years. The median global KCCQ score was 67 (12.5–100) corresponding to a moderate impairment in HRQoL. There was an inverse correlation between the median global KCCQ score and NYHA class (Kendall’s tau b coefficient r − 0.33, p = 0.001). Patients with pulmonary hypertension (PHT), defined as resting pulmonary artery systolic pressure of ≥ 45 mmHg, presented a significantly worse HRQoL as compared to those without PHT (median KCCQ score 56.2 vs 77.5, p = 0.013). The KCCQ score mildly correlated with age (r − 0.18, p = 0.014), history of syncope (r − 0.18, p = 0.045), estimated glomerular filtration rate (eGFR) (r 0.31, p < 0.001), plasmatic creatinine (r − 0.18, p = 0.017) and urea levels (r − 0.27, p < 0.001), left ventricular (LV) end-systolic dimensions (r − 0.18, p = 0.014), maximal provoked intraventricular gradient (r 0.20, p = 0.039), LV ejection fraction (r 0.15, p = 0.04), average E/e′ (r − 0.16, p = 0.039), pulmonary acceleration time (r 0.21, p = 0.007), pulmonary artery systolic pressure (r − 0.20, p = 0.016). In ordinal regression, the independent predictors of HRQoL were NYHA class and eGFR. Conclusions Patients with HCM and HF present a moderate degree of alteration in HRQoL. This is especially true for patients with PHT and more severe functional impairment. Renal failure and NYHA class are potential markers of HRQoL in clinical practice.

scholarly journals Electrocardiographic changes in Chronic Obstructive Pulmonary Disease patients with elevated Pulmonary Artery Systolic Pressure

2013 ◽  
Vol 8 (1) ◽  
pp. 12-15 ◽  
Author(s):  
S Humagain ◽  
S Keshari ◽  
R Gurung ◽  
P Pant ◽  
B Pokharel ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Artery ◽  
Pulmonary Disease ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Chronic Obstructive ◽  
Retrospective Case ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Significant Difference

Background Chronic Obstructive Pulmonary Disease (COPD) is a common global problem and most common medical problem in Nepal having significant morbidity and mortality. One of the pathogenesis of COPD in long run is the elevation of Pulmonary Artery Systolic Pressure (PASP) leading to right heart failure. A simple investigation - an Electrocardiograph (ECG) is assessed to co-relate with elevated PASP measured by Echocardiography in COPD patients of Dhulikhel Hospital. Methods and Materials A retrospective case control study of 342 COPD patients was done with assessment of ECG to co-relate with elevated PASP and with normal PASP. Data were analyzed using SPSS 17. Result There was significant difference in mean age, P amplitude in Lead II, III and aVF, QRS axis and R wave in V1 and S in V6 between two groups. Conclusion ECG changes are fairly sensitive and specific for elevation of PASP. DOI: http://dx.doi.org/10.3126/njh.v8i1.8330 Nepalese Heart Journal Vol.8(1) 2011 pp.12-15

Correlation of Limb Bioimpedance to Echocardiographic Indicators of Congestion in Patients with NYHA Class II/III Heart Failure (Preprint)

2018 ◽  
Author(s):  
Andrew Accardi ◽  
Thomas Heywood ◽  
Anne Daleiden-Burns
Keyword(s):  
Heart Failure ◽  
Pulmonary Artery ◽  
Fluid Overload ◽  
Nyha Class ◽  
Systolic Pressure ◽  
Class Ii ◽  
Atrial Pressure ◽  
Right Atrial ◽  
Right Atrial Pressure ◽  
Pulmonary Artery Systolic Pressure

BACKGROUND The treatment of heart failure (HF) in the United States is estimated to exceed $30 billion each year and is anticipated to increase to a staggering $70 billion by the year 2030. This makes the management of HF one of the leading challenges Medicare will face in the years to come. Traditional methods to detect impending congestion such as body weight and physical examination findings are often non-specific and lack sensitivity making them inadequate to recognize fluid overload and prevent decompensation. It has been suggested that bioimpedance spectroscopy (BIS) can be used as a surrogate marker for detecting fluid overload and therefore, serve as an adjunct to clinical exam findings. OBJECTIVE This study examines the relationship between a BIS device and echocardiographic parameters associated with volume overload with same day measurements in the first 8 patients with NYHA Class II/III HF on an IRB approved protocol. METHODS Each patient was followed 3 times a week for 4 weeks within the hospital outpatient setting. At each visit BIS measures were recorded for whole body as well as arms and legs. Additionally, signs and symptoms, weight and echocardiograph findings were all recorded. RESULTS Correlations of BIS measurements with echo parameters were performed. The leg impedance measurement correlated strongly with echo findings; inferior vena cava (IVC) size (p=0.001), right atrial pressure (RAP) (p<0.001), and pulmonary artery systolic pressure (PAS) measurements (p<0.001). CONCLUSIONS Preliminary findings demonstrated excellent correlations with BIS measurements and IVC size, right atrial pressure and pulmonary artery systolic pressure measurements which suggest a possible alternative method to detect fluid overload despite the small sample size. Trending a patient's impedance using the SOZO device at home or the practitioner's office may assist clinicians in providing more accurate, individualized HF care.  CLINICALTRIAL . IRB approval was obtained for this study (Scripps IRB #IRB-16-6852).

scholarly journals Sympathetic innervation of canine pulmonary artery and morphometric and functional analysis in dehydromonocrotaline-induced models after pulmonary artery denervation

2020 ◽  
Vol 31 (5) ◽  
pp. 708-717
Author(s):  
Xiaomin Jiang ◽  
Juan Zhang ◽  
Ling Zhou ◽  
Jie Luo ◽  
Jinsong Wang ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Pulmonary Artery ◽  
Sympathetic Nerve ◽  
Nerve Conduction ◽  
Nerve Conduction Velocity ◽  
Sympathetic Innervation ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Control Group ◽  
Mean Pressure

Abstract OBJECTIVES We aimed to describe the anatomic distribution of periarterial pulmonary sympathetic nerves and to observe the long-term morphometric and functional changes after pulmonary artery denervation (PADN), a novel therapy for pulmonary arterial hypertension (PAH). METHODS A total of 45 beagles were divided into a sympathetic innervation group (n = 3, 33.3% were females), a PAH group (n = 35, 34.3% were females) and a control group (n = 7, 28.5% were females). The PAH group was randomly divided into no-PADN (n = 7), instant-PADN (n = 7), 1M-PADN (n = 7), 2M-PADN (n = 7) and 3M-PADN (n = 7) subgroups. The sympathetic innervation group was sacrificed to reveal the sympathetic innervation of pulmonary arteries. PAH was induced by injecting dehydromonocrotaline (DHMCT) through the right atrium. The pulmonary capillary wedge pressure, right ventricular systolic pressure, right ventricular mean pressure, pulmonary artery systolic pressure and pulmonary artery mean pressure of each group were continuously measured. The cardiac output was detected to calculate the pulmonary vascular resistance. PAH and control groups were subjected to immunofluorescence assay, sympathetic nerve conduction velocity measurement and transmission electron microscopy. RESULTS The no-PADN group had significantly higher PVSP, PVMP, pulmonary artery systolic pressure, pulmonary artery mean pressure and pulmonary vascular resistance but lower cardiac output than those of the control group (P &lt; 0.05). Instant-PADN, 1M-PADN, 2M-PADN and 3M-PADN groups had significantly lower PVSP, PVMP, pulmonary artery systolic pressure, pulmonary artery mean pressure and pulmonary vascular resistance but higher cardiac output than those of the no-PADN group (P &lt; 0.05). Most sympathetic nerves were located within 2.5 mm of the intimae of the bifurcation and proximal trunk, mainly in the left trunk. The diameter and cross-sectional area of myelinated fibres in the PAH group were significantly larger than those of the control group. Sympathetic nerve conduction velocity of the PAH group gradually decreased, and nerve fibres were almost demyelinated 3 months after PADN. CONCLUSIONS PADN effectively relieved dehydromonocrotaline-induced canine PAH and decreased sympathetic nerve conduction velocity.

scholarly journals Increased Mortality in Patients With Preoperative and Persistent Postoperative Pulmonary Hypertension Undergoing Mitral Valve Surgery for Mitral Regurgitation: A Cohort Study

2021 ◽  
Vol 10 (5) ◽  
Author(s):  
Michael V. Genuardi ◽  
Daniel Shpilsky ◽  
Adam Handen ◽  
Gabrielle VanSpeybroeck ◽  
Ann Canterbury ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Pulmonary Artery ◽  
Systolic Pressure ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Pulmonary Artery Systolic Pressure ◽  
Severe Mitral Regurgitation ◽  
Risk Of Death

Background Preoperative pulmonary hypertension (PH) is associated with excess mortality among patients with severe mitral regurgitation undergoing mitral valve surgery (MVS). However, the links between PH phenotype, pulmonary vascular remodeling, and persistent postoperative PH are not well understood. We aimed to describe the associations between components of pulmonary hemodynamics as well as postoperative residual PH with longitudinal mortality in patients with severe mitral regurgitation who received MVS. Methods and Results Patients undergoing MVS for severe mitral regurgitation from 2011 to 2016 were retrospectively identified within our health system (n=488). Mean pulmonary artery pressure and other hemodynamic variables were determined by presurgical right‐heart catheterization. Postoperative pulmonary artery systolic pressure was assessed on echocardiogram 42 to 365 days post‐MVS. Longitudinal survival over a mean 3.9 years of follow‐up was evaluated using Cox proportional hazards modeling to compare survival after adjustment for demographics, surgical characteristics, and comorbidities. Pre‐MVS prevalence of PH was high at 85%. After adjustment, each 10‐mm Hg increase in preoperative mean pulmonary artery pressure was associated with a 1.38‐fold increase in risk of death (95% CI, 1.13–1.68). Elevated preoperative pulmonary vascular resistance, transpulmonary gradient, and right atrial pressure were similarly associated with increased mortality. Among 231 patients with postoperative echocardiogram, evidence of PH on echocardiogram (pulmonary artery systolic pressure ≥35 mm Hg) was associated with increased risk of death (hazard ratio [HR], 2.02 [95% CI, 1.17–3.47]); however, this was no longer statistically significant after adjustment (HR, 1.55 [95% CI, 0.85–2.85]). Conclusions In patients undergoing MVS for mitral regurgitation, preoperative PH, and postoperative PH were associated with increased mortality.

scholarly journals Outcome of cases of Mitral Stenosis after Percutenuous Transvenous Mitral Commissurotomy (PTMC)

2004 ◽  
Vol 3 (3) ◽  
pp. 25
Author(s):  
Syed Ali Ahasan ◽  
ATM Iqbal Hasan ◽  
ATM Iqbal Hasan ◽  
SK Maruffuzaman ◽  
MA Bari
Keyword(s):  
Pressure Gradient ◽  
Mitral Stenosis ◽  
Surgical Intervention ◽  
Peak Pressure ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Atrial Size ◽  
Mean Pressure ◽  
Mitral Valvotomy ◽  
Valve Area

This prospective study was carried out in the National Institute of Cardiovascular Diseases and Hospital (NIC VD), Dhaka, Bangladesh during the period January 2002 to December 2002. The result of percutenuous ballon mitral valvotomy were evaluated in 153 cases of mitral stenosis patients (mean age 36±15 years) with symptomatic rheumatic mitral stenosis with single Inoue ballon technique PTMC results significant increase mitral valve area. 79.18 to 1.86 ±.37. Transmitral mean pressure gradient 19.6 ± 8.9 to 3.7±38, Decrease mean left atrial size 41.33±9.3 to 30.56±8.16 and Pulmonary artery systolic pressure 56±24 to 39 ±17, Peak pressure gradient (PPG) 19.6±8.9 to 8.7 ±3.8, But lower incidence of mitral regurgitation, only two cases developed MR grade Ill which were treated medically, one patient develop moderate haemopericardium which was treated conservatively. One patient was failed due to severe tight MS of valve area 0.5. No surgical intervention was needed.

scholarly journals Percutaneus Mitral Valvuloplasty in Adult Patients with Rheumatic Mitral Stenosis - Results of 200 Cases

1970 ◽  
Vol 6 (2) ◽  
pp. 65-69
Author(s):  
Md Khairul Anam ◽  
Fazlur Rahman ◽  
Khondoker Shahid Hussain ◽  
Mir Jamal Uddin ◽  
Chaudhury Meshat Ahmed ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Stenosis ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Mitral Valve Area ◽  
Mean Pressure ◽  
Mitral Commissurotomy ◽  
Procedural Success ◽  
Medical University ◽  
Valve Area

This prospective study was carried out in the department of cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka and National Institute of Cardiovascular Disease (NICVD), Dhaka between July 2006 to July 2010. Total 200 patients underwent percutaneous mitral commissurotomy. Mitral valve dilatation resulted in increase in mitral valve area from .6±0.26 to 1.70±.38cm2 (p<0.001). Mitral valve mean pressure gradient declined from 23.00±5.38 to 6.8±2.98mmHg (p<0.001). The pulmonary artery systolic pressure decreased from 73.8±19.30 to 29.26±11.80mmHg (p<0.001). Procedural success, as defined as final mitral valve area >1.5cm2 or >50% increase in area, was achieved in 95% patients. Serious complications occured in 10 patients Death occurred in two patient (1%). Minor complication such as vasovagal reaction (5%), balloon rupture without sequel (0.5%), pericardiocentesis (.5%), mitral regurgitation (3%), hypotension (1%), seizure (2%), drug reaction (1%) were also noted. The adverse hemodynamic effect of mitral stenosis may be relieved by percutaneous transvenous mitral commissurotomy but it is not without risk. The morbidity & mortality is very low in properly selected patient. This study demonstrate excellent short term clinical & hamodynamic outcome of this procedure and very low procedure related complications.Key words: Mitral Stenosis; Balloon Valvuloplasty DOI: 10.3329/uhj.v6i2.7246University Heart Journal Vol. 6, No. 2, July 2010 pp.65-69

Abstract P331: Association of Extraosseous Calcification With Pulmonary Hypertension in Patients Evaluated for Kidney Transplantation

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Melissa C Caughey ◽  
Aditi Puri ◽  
Randal K Detwiler ◽  
Abhijit V Kshirsagar ◽  
Hubert J Ford ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Kidney Transplantation ◽  
Mitral Regurgitation ◽  
Pulmonary Artery ◽  
Diastolic Dysfunction ◽  
Left Atrial ◽  
Systolic Pressure ◽  
Left Ventricular ◽  
Pulmonary Artery Systolic Pressure ◽  
Dialysis Vintage

Background: Pulmonary hypertension (PH) is commonly reported in patients with end-stage renal disease (ESRD), and is associated with early graft failure and death in kidney transplant recipients. Calcifications of the lung, pulmonary vessels, heart, and kidney are frequently observed with ESRD, the consequence of secondary hyperparathyroidism. It follows that pulmonary artery vasculopathy, notably from extraosseous calcification, may contribute to PH. A popular, but unestablished, theory is that the stiffened pulmonary artery is unable to accommodate elevations in right ventricular stroke volume caused by arteriovenous (AV) hemodialysis shunts. We hypothesized that extraosseous calcification is related to PH in patients evaluated for kidney transplantation, and that the association is largely driven by AV shunts. Methods: Established in 2006, the UNC Cardiorenal Registry offers ongoing enrollment to all patients with stage 4 or 5 chronic kidney disease (CKD) referred for pretransplant cardiac evaluation. Pulmonary artery systolic pressure (PASP) was derived from routine echocardiograms within 6 months of the registry visit. All echocardiograms followed a standardized protocol, and were interpreted by the same cardiologist. PH was defined by a tricuspid regurgitant jet velocity >2.8 m/s, corresponding to a PASP >40 mmHg. Classification of grade 2 diastolic dysfunction (impaired left ventricular relaxation with elevated left atrial pressure) required a transmitral E/A ratio ≥ 0.8, and a transmitral to myocardial relaxation E/e’ ratio ≥ 15. Mitral annular calcification (MAC) was visually assessed, and considered evidence of extraosseous calcification. Associations between MAC and PH were analyzed with logistic regression, adjusted for age, sex, BMI, diastolic dysfunction, mitral regurgitation, left atrial dilation, and hematocrit. Results: From 2006-2013, 795 registry patients were screened preoperatively by echocardiography. Most were male (56%) and black (61%) with a mean age of 56 years. The majority (74%) received dialysis (13% peritoneal, 61% hemodialysis), for an average 2.8 years prior to the registry visit. PH, MAC, and AV shunts were present in 17%, 28%, and 62%; respectively. Relative to patients without MAC, those with MAC had higher odds of PH (OR adj =1.80; 95% CI: 1.17 – 2.78), which was not impacted by adjustment for AV shunts (OR adj = 1.78; 95% CI: 1.15 – 2.76). Further adjustment for years of dialysis modestly attenuated the association (OR adj = 1.55; 95% CI: 0.99 – 2.43). Conclusion: MAC is associated with higher odds of PH in severe CKD, irrespective of factors associated with PASP in the general population (age, sex, BMI), sources of pulmonary congestion (diastolic dysfunction, mitral regurgitation, and left atrial dilation), and causes of hyperdynamic circulation (hematocrit). The association is independent of hemodialysis shunts and dialysis vintage.

Effect of acute lower respiratory tract infection on pulmonary artery pressure in children with post-tricuspid left-to-right shunt

2021 ◽  
pp. 1-5
Author(s):  
Sakshi Sachdeva ◽  
Shyam S. Kothari ◽  
Saurabh K. Gupta ◽  
Sivasubramanian Ramakrishnan ◽  
Anita Saxena
Keyword(s):  
Tract Infection ◽  
Pulmonary Artery ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Pulmonary Artery Pressure ◽  
Lower Respiratory Tract ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Artery Pressure

Abstract We sought to examine the influence of clinically severe lower respiratory tract infection on pulmonary artery pressure in children having CHD with post-tricuspid left-to-right shunt, as it may have physiological and clinical implications. In a prospective single-centre observational study, 45 children with post-tricuspid left-to-right shunt and clinically severe lower respiratory tract infection were evaluated during the illness and 2 weeks after its resolution. Pulmonary artery systolic pressure was estimated non-invasively using shunt gradient by echocardiography and systolic blood pressure measured non-invasively. Median pulmonary artery systolic pressure during lower respiratory tract infection was only mildly (although statistically significantly) elevated during lower respiratory tract infection [60 (42–74) versus 53 (40–73) mmHg, (p < 0.0001)]. However, clinically significant change in pulmonary artery systolic pressure defined as the increase of >10 mmHg was present in only 9 (20%) patients. In the absence of hypoxia or acidosis, only a small minority (9%, n = 4) showed significant pulmonary artery systolic pressure rise >10 mmHg. In the absence of hypoxia or acidosis, severe lower respiratory tract infection in patients with acyanotic CHD results in only mild elevation of pulmonary artery systolic pressure in most of the patients.

Sign in / Sign up

Export Citation Format

Share Document