Pulmonary Hypertension No Bar to Single-Lung TransplantPulmonary Hypertension No Bar to Single-Lung Transplant
Pulmonary hypertension (PH) does not significantly affect outcome of single-lung transplantation, possibly increasing the number of potential recipients, according to Wisconsin-based researchers. Reuters Health Information
Clinical Transplantation, EarlyView.
Chronic thromboembolic pulmonary hypertension (CTEPH) results from persistent pulmonary vascular obstructions, presumably due to inflammatory thrombosis. Because estimates of thrombus volume at diagnosis have no predictive value, we investigated the role of the thrombosis marker D-dimer and the inflammation marker C-reactive protein (CRP) for predicting outcomes in CTEPH.
We report a very rare case of pulmonary chromomycosis caused by Scedosporium prolificans that developed after lung transplantation and was successfully treated with endobronchial topical amphotericin B instillation. The subject was a woman in her 50s with a history of bilateral lobar lung transplantation from living donors for idiopathic pulmonary hypertension. Eight years after the lung transplantation, chest radiography X-ray and computed tomography showed an abnormal shadow in the right lung.
The pathobiology of chronic thromboembolic pulmonary hypertension (CTEPH) is poorly understood. Metabolic dysregulation is prominent in idiopathic pulmonary arterial hypertension (IPAH). Using an “omics” approach, we sought to determine the metabolic fingerprint of CTEPH patients compared to IPAH and healthy controls.
We hypothesized that dynamic measures of pulmonary arterial compliance (Cpa), and elastance (Epa), RV elastance (Ees), and RV-PA coupling would improve prediction of post-op mean PA pressure (PAP), Length of Stay (LOS), ICU duration (ICUd) and need for inotropes (NFI) compared to prediction based solely on pre-op PAP, CO and PVR in patients with chronic thromboembolic pulmonary hypertension (CTEPH) undergoing pulmonary thromboendaterectomy (PTE).
Exercise right heart catheterization (RHC), currently used to identify occult pulmonary hypertension (PH), may have additional applications. An elevated total pulmonary resistance (TPR), the change in mean pulmonary arterial pressure (mPAP) divided by the change in cardiac output during exercise, has been associated with worse clinical outcomes. We hypothesize that the combination of the TPR and the PCWP during exercise ( ∆TPRex) reflects pulmonary arterial disease and is a marker of outcomes.
LVAD therapy in patients with pulmonary hypertension (PH) has shown improvements in pulmonary vascular resistance (PVR) but benefits of this strategy of mechanical unloading pre heart transplantation (HTx) remains uncertain. Here, we determine if patients with PH who are bridge to transplant (BTT) with an LVAD have improved outcomes after HTx.
Right ventricular (RV) dysfunction in patients with pulmonary hypertension due to chronic lung disease (Group 3 PH) is not well described. We compared RV function in Group 3 and Group 1 PH patients, and investigated the correlates of RV function in Group 3 PH patients.
Chronic thromboembolic pulmonary hypertension (CTEPH), is a progressive condition characterized by persistent occlusion of the pulmonary arteries by organized thrombus and a pulmonary arteriopahty. CTEPH is potentially curable with pulmonary thrombo-endarterectomy (PTE). The pathophysiological mechanisms that lead to the development of CTEPH and progressive arteriopathy has not been fully elucidated. We hypothesize that Endothelin-1(ET1), a potent endogenous vasoconstrictor and smooth muscle mitogen may contribute to the development of CTEPH.
Endothelial to Mesenchymal Transition (EndMT) is a complex biological process in which endothelial cells transdifferentiate to collagen producing mesenchymal cells. The phenomenon of EndMT has been associated with development of vascular remodeling in monocrotaline rat model of pulmonary arterial hypertension (PAH). However, data on its role in pulmonary vascular remodeling in heart failure (HF) leading to pulmonary hypertension (PH) is lacking. The presence of End MT in lungs in association with pulmonary vascular remodeling could indicate its role in development of PH.