Adam S Himebauch, Wai Wong, Yan Wang, Francis X McGowan, Robert A Berg, Christopher E Mascio, Todd J Kilbaugh, Kimberly Y Lin, Samuel B Goldfarb, Steven M Kawut, Laura Mercer-Rosa, Nadir Yehya
The importance of preoperative cardiac function in pediatric lung transplantation is unknown. We hypothesized that worse preoperative right ventricular (RV) systolic and worse left ventricular (LV) diastolic function would be associated with a higher risk of primary graft dysfunction grade 3 (PGD 3) between 48 and 72 hours. We performed a single center, retrospective pilot study of children (<18 years) who had echocardiograms <1 year prior to lung transplantation between 2006 and 2019. Conventional and strain echocardiography parameters were measured, and PGD was graded...
October 19, 2020: Pediatric Transplantation
Nasrin N Aldawoodi, Jamie P Hoffman, Allan R Escher
Non-cardiac surgery in a high-risk patient with severe mitral stenosis (MS) and severe pulmonary hypertension (PH) presents a significant anesthetic challenge. Guidelines recommend using advanced hemodynamic monitors for specific cardiovascular goals. The gold standard for intraoperative monitoring in these cases is the pulmonary artery catheter (PAC) and transesophageal echocardiography (TEE). This case discusses the successful management of a severe MS patient undergoing cystoprostatectomy using a minimally invasive cardiovascular monitor (MICM) incorporating several hemodynamic parameters...
October 14, 2020: Curēus
Emir Yonas, Idrus Alwi, Raymond Pranata, Ian Huang, Michael Anthonius Lim, Eddy Jose Gutierrez, Muhammad Yamin, Bambang Budi Siswanto, Salim S Virani
BACKGROUND: Several comorbidities have been associated with an increased risk of severity and mortality in coronavirus disease 2019 (COVID-19), including hypertension, diabetes, cerebrovascular disease, chronic kidney disease, and chronic obstructive pulmonary disease. PURPOSE: In this systematic review and meta-analysis, we attempted to investigate the association between heart failure (HF) and poor outcome in patients with COVID-19. METHODS: We performed a systematic literature search from PubMed, EuropePMC, SCOPUS, Cochrane Central Database, and medRxiv with the search terms, "Heart failure" and "COVID-19"...
July 9, 2020: American Journal of Emergency Medicine
G Treffel, A Guillaumot, E Gomez, M Eyries, I Petit, J-F Chabot, A Chaouat
Pulmonary veno-occlusive disease (PVOD) is a rare cause of pulmonary hypertension. Heritable and sporadic forms have been distinguished. Hypoxemia, profound reduction in the diffusion of carbon monoxide and haemodynamic confirmation of pre-capillary pulmonary hypertension are the major diagnostic criteria. Thoracic CT scanning and a response to pharmaceutical therapy provide additional information to confirm the diagnosis. A 52-year-old patient, three of whose siblings had pulmonary hypertension, was admitted with dyspnoea, malaise and palpitations...
October 15, 2020: Revue des Maladies Respiratoires
Xiangyun Gai, Pengcheng Lin, Yanfeng He, Dianxiang Lu, Zhanqiang Li, Yongxin Liang, Yuhua Ma, Nanjia Cairang, Mingli Zuo, Yi Bao, Zhaxi Gazang, Xuehua Wu
Hypoxic pulmonary hypertension (HPH) is a progressive and irreversible disease that reduces survival. Echinacoside is a phenylethanoid glycoside from Tibetan herbs known for its vasorelaxant effect and for inhibiting the proliferation of rat pulmonary arterial smooth muscle cells. This study aimed to investigate the effect of echinacoside on HPH. Sprague Dawley rats were housed in a hypobaric hypoxia chamber (4500 m) for 28 days to obtain the HPH model. Echinacoside (3.75, 7.5, 15, 30 and 40 mg/kg) was administered by intraperitoneal injection from the 1st to the 28th day...
December 2020: Journal of Pharmacological Sciences
Cini Sudhakara Prasad, Shine Kumar, Sudha Sumathy, Radhamony Kunjukutty, Nitu Puthenveettil, Amitabh Chanchal Sen, Jeya Bawani Sivabalakrishnan, Raman Krishna Kumar
OBJECTIVE: To describe maternal and fetal outcomes and N Terminal pro-brain natriuretic peptide (NT-proBNP) trends in pregnancy with pulmonary arterial hypertension (PAH). METHODS: The medical records of all pregnant women with PAH referred to Pulmonary Hypertension Clinic were retrospectively reviewed and analyzed. RESULTS: We identified 35 pregnancies in 22 women (mean age 27.9 ± 4.7 years, mean weight 50.6 ± 8.1 kg). The diagnoses were Eisenmenger syndrome (16, 72...
October 18, 2020: Journal of Maternal-fetal & Neonatal Medicine
Regan E Giesinger, Phil T Levy, J Lauren Ruoss, Mohamed El Dib, Khorshid Mohammad, Pia Wintermark, Patrick J McNamara
BACKGROUND: Hypotension and hypoxemic respiratory failure are common among neonates with hypoxic-ischemic encephalopathy (HIE) undergoing therapeutic hypothermia (TH). Right ventricular (RV) dysfunction is associated with adverse neurodevelopment. Individualized management utilizing targeted neonatal echocardiography (TnECHO) may enhance care. METHODS: We evaluated the influence of TnECHO programs on cardiovascular practices in HIE/TH patients utilizing a 77-item REDCap survey...
October 18, 2020: Pediatric Research
Lou M Almskog, Agneta Wikman, Jonas Svensson, Michael Wanecek, Matteo Bottai, Jan van der Linden, Anna Ågren
High prevalence of thrombotic events in severely ill COVID-19 patients have been reported. Pulmonary embolism as well as microembolization of vital organs may in these individuals be direct causes of death. The identification of patients at high risk of developing thrombosis may lead to targeted, more effective prophylactic treatment. The primary aim of this study was to test whether rotational thromboelastometry (ROTEM) at admission indicates hypercoagulopathy and predicts the disease severity, assessed as care level, in COVID-19 patients...
October 17, 2020: Journal of Thrombosis and Thrombolysis
Cheng Cheng, Ziqian Wang, Li Wang, Jiuliang Zhao, Qian Wang, Xinping Tian, Mengtao Li, Xiaofeng Zeng
OBJECTIVE: This study aimed to identify the clinical characteristics of systemic lupus erythematosus-primary biliary cholangitis (SLE-PBC) patients and to compare the manifestations and prognosis with systemic lupus erythematosus (SLE) patients. METHODS: Twenty-one inpatients with concomitant SLE and primary biliary cholangitis (PBC) were identified in our hospital. Baseline clinical manifestations, laboratory results, disease activity, and organ damage, as well as changes in disease manifestations and therapies, were retrospectively analyzed...
October 16, 2020: Clinical Rheumatology
Yukun Cao, Xiaoyu Han, Jin Gu, Yumin Li, Jia Liu, Osamah Alwalid, Yue Cui, Xin Zhang, Chuansheng Zheng, Yanqing Fan, Hanping Wu, Heshui Shi
The aim of this study was to assess the prognostic value of baseline clinical and high resolution CT (HRCT) findings in patients with severe COVID-19. In this retrospective, two-center study, we included two groups of inpatients with severe COVID-19 who had been discharged or died in Jin Yin-tan hospital and Wuhan union hospital between January 5, 2020, and February 22, 2020. Cases were confirmed by real-time polymerase chain reaction. Demographic, clinical, and laboratory data, and HRCT imaging were collected and compared between discharged and deceased patients...
October 16, 2020: Scientific Reports
Tahzeeb Fatima, Peter M Nilsson, Carl Turesson, Mats Dehlin, Nicola Dalbeth, Lennart T H Jacobsson, Meliha C Kapetanovic
BACKGROUND: Gout is predicted by a number of comorbidities and lifestyle factors. We aimed to identify discrete phenotype clusters of these factors in a Swedish population-based health survey. In these clusters, we calculated and compared the incidence and relative risk of gout. METHODS: Cluster analyses were performed to group variables with close proximity and to obtain homogenous clusters of individuals (n = 22,057) in the Malmö Preventive Project (MPP) cohort...
October 16, 2020: Arthritis Research & Therapy
Aizhamal Tabyshova, Berik Emilov, Maarten J Postma, Niels H Chavannes, Talant Sooronbaev, Job F M van Boven
Prevalence data of respiratory diseases (RDs) in Central Asia (CA) and Russia are contrasting. To inform future research needs and assist government and clinical policy on RDs, an up-to-date overview is required. We aimed to review the prevalence and economic burden of RDs in CA and Russia. PubMed and EMBASE databases were searched for studies that reported prevalence and/or economic burden of RDs (asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis, interstitial lung diseases (ILD), lung cancer, pulmonary hypertension, and tuberculosis (TB)) in CA (Kyrgyzstan, Uzbekistan, Tajikistan, Kazakhstan, and Turkmenistan) and Russia...
October 14, 2020: International Journal of Environmental Research and Public Health
Lieke M van den Heuvel, Samara M A Jansen, Suzanne I M Alsters, Marco C Post, Jasper J van der Smagt, Frances S Handoko-De Man, J Peter van Tintelen, Hans Gille, Imke Christiaans, Anton Vonk Noordegraaf, HarmJan Bogaard, Arjan C Houweling
Pulmonary arterial hypertension (PAH) is a severe, life-threatening disease, and in some cases is caused by genetic defects. This study sought to assess the diagnostic yield of genetic testing in a Dutch cohort of 126 PAH patients. Historically, genetic testing in the Netherlands consisted of the analysis of BMPR2 and SMAD9. These genes were analyzed in 70 of the 126 patients. A (likely) pathogenic (LP/P) variant was detected in 22 (31%) of them. After the identification of additional PAH associated genes, a next generation sequencing (NGS) panel consisting of 19 genes was developed in 2018...
October 13, 2020: Genes
Siladitta Biswas, Baktybek Kojonazarov, Stefan Hadzic, Michael Majer, Ganimete Bajraktari, Tatyana Novoyatleva, Hossein Ardeschir Ghofrani, Friedrich Grimminger, Werner Seeger, Norbert Weissmann, Jens Schlossmann, Ralph Theo Schermuly
PKGs are serine/threonine kinases. PKG1 has two isoforms-PKG1α and β. Inositol trisphosphate receptor (IP3 R)-associated cGMP-kinase substrate 1 (IRAG1) is a substrate for PKG1β. IRAG1 is also known to further interact with IP3 RI, which mediates intracellular Ca2+ release. However, the role of IRAG1 in PH is not known. Herein, WT and IRAG1 KO mice were kept under normoxic or hypoxic (10% O2 ) conditions for five weeks. Animals were evaluated for echocardiographic variables and went through right heart catheterization...
October 13, 2020: Cells
Praveen Chandrasekharan, Munmun Rawat, Satyan Lakshminrusimha
Oxygen is a pulmonary vasodilator and plays an important role in mediating circulatory transition from fetal to postnatal period. Oxygen tension (PO2 ) in the alveolus (PAO2 ) and pulmonary artery (PaO2 ) are the main factors that influence hypoxic pulmonary vasoconstriction (HPV). Inability to achieve adequate pulmonary vasodilation at birth leads to persistent pulmonary hypertension of the newborn (PPHN). Supplemental oxygen therapy is the mainstay of PPHN management. However, optimal monitoring and targeting of oxygenation to achieve low pulmonary vascular resistance (PVR) and optimizing oxygen delivery to vital organs remains unknown...
October 13, 2020: Children
Elaine N Gitonga, Junwu Wang, Shengwei Yu, Na Wu, Haitao Shen
Pneumonia is a well-recognized respiratory infection associated with substantial morbidity and mortality. Despite its effects on the respiratory system, pneumonia can cause or exacerbate cardiovascular complications through various mechanisms. The two main mechanisms that are described in this case report are hypoxia-induced pulmonary hypertension and the effect of sepsis on the cardiovascular system. Pulmonary hypertension (PH) is a disease characterized by raised pulmonary arterial pressure due to a progressive increase in pulmonary vascular resistance, inevitably leading to right ventricular (RV) afterload...
September 2020: Annals of Palliative Medicine
Rodrigo Cartin-Ceba, Charles Burger, Karen Swanson, Hugo Vargas, Bashar Aqel, Andrew P Keaveny, Julie Heimbach, Timucin Taner, Scott Nyberg, Charles Rosen, Hector Cajigas, Hilary DuBrock, Michael J Krowka
BACKGROUND: Portopulmonary hypertension (POPH) is the presence of pulmonary arterial (PA) hypertension in patients with portal hypertension and is associated with significant morbidity and mortality. In a cohort of POPH patients, we describe the clinical outcomes of POPH patients who underwent liver transplantation (LT). METHODS: Retrospectively collected data from a prospectively assembled cohort of all consecutive POPH adults evaluated in three transplant centers from 1996 to 2019...
October 12, 2020: Transplantation
Rodolfo Citro, Gianluca Pontone, Michele Bellino, Angelo Silverio, Giuseppe Iuliano, Andrea Baggiano, Robert Manka, Severino Iesu, Carmine Vecchione, Federico Miguel Asch, Jelena Rima Ghadri, Christian Templin
The management of patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be difficult due to the need for dedicated in-hospital pathways, protective measures for healthcare professionals and isolated beds of intensive care, particularly in areas overwhelmed by wide viral spread. Although pneumonia is the most common clinical manifestation in coronavirus disease 2019 (COVID-19), a variety of cardiovascular complications have been reported. An integrated diagnostic algorithm in SARS-CoV-2-infected patients with suspected cardiac involvement (laboratory findings of myocardial injury and electrocardiographic changes) may help to avoid unnecessary examinations and minimize the risk of operator infection...
October 13, 2020: Trends in Cardiovascular Medicine
Nicholas A Kolaitis, Roham T Zamanian, Vinicio A de Jesus Perez, David B Badesch, Raymond L Benza, Charles D Burger, Murali M Chakinala, Jean M Elwing, Jeremy Feldman, Matthew R Lammi, Stephen C Mathai, John W McConnell, Kenneth W Presberg, Jeffrey C Robinson, Jeffery Sager, Oksana A Shlobin, Marc A Simon, Steven M Kawut, David V Glidden, Jonathan P Singer, Teresa De Marco
RATIONALE: Single-center studies demonstrated that methamphetamine use is associated with pulmonary arterial hypertension (Meth-APAH). We used the Pulmonary Hypertension Association Registry to evaluate the national distribution of Meth-APAH, and to compare its impact on patient-reported and clinical outcomes relative to idiopathic PAH. OBJECTIVES: To determine if patients with Meth-APAH differ from those with idiopathic PAH in demographics, regional distribution in the US, hemodynamics, health-related quality of life, PAH-specific treatment, and health care utilization...
October 16, 2020: Annals of the American Thoracic Society
Edmundo Vázquez-Cornejo
As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients with hypertension and other cardiovascular comorbidities develop more severe coronavirus disease (COVID)-19 and are at high risk of death, a controversy arose about the use of antihypertensives as angiotensin-converting enzyme inhibitors (ACEis) and angiotensin II receptor blockers (ARBs). Such drugs might increase the expression of the fundamental receptor of this new infectious agent: the angiotensin-converting enzyme 2 (ACE2)...
2020: Boletín Médico del Hospital Infantil de México
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