Effect of Pulmonary Hypertension on Clinical Outcomes in Patients with Rheumatic Mitral Stenosis

Publication date: Available online 20 July 2019Source: The Annals of Thoracic SurgeryAuthor(s): Do Jung Kim, Sak Lee, Hyun-Chel Joo, Heirim Lee, Bumhee Park, Young-Nam Youn, Kyung-Jong Yoo, Seung Hyun LeeAbstractBackgroundLong-term outcomes of mitral valve replacement (MVR) recipients with pulmonary hypertension (PH) remain unclear. We determined the effect of concomitant PH on the clinical outcomes and late-onset progression of tricuspid regurgitation (TR) following MVR for rheumatic mitral stenosis.MethodsWe retrospectively reviewed 394 patients who underwent MVR between January 2000 and December 2013. PH was defined as systolic pulmonary arterial pressure (sPAP)>50 mmHg. Changes in echocardiographic parameters (preoperative to postoperative), TR progression (grade ≥II), and long-term survival were evaluated according to the presence of PH at MVR (non-PH, n=322; PH, n=72).ResultsThe 10-year overall survival rate was significantly lower in the PH group (79.7% vs. 90.7%, p=0.04), whereas the rate of freedom from TR progression was similar between groups (76.9% vs. 80.5%, p=0.373). High preoperative sPAP and right ventricular systolic pressure (RVSP) did not affect TR progression. However, substantial postoperative reductions in sPAP and RVSP protected against TR progression (hazard ratio [95% confidence interval]: 0.966 [0.942–0.991], p=0.008 and 0.973 [0.960–0.986], p
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research

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DiscussionWe suggest an open gastrectomy with roux-en-Y anastomosis as an alternative to the Nissen fundoplication for patients with connective tissue disease that develop terminal pulmonary consequences and require a lung transplant.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
This study aimed to explore how lncRNA Tug1 affected the pulmonary vascular remodeling in HPH. A mouse model of HPH and a pulmonary artery smooth muscle cell (PASMC) model of HPH (HPH-PASMCs) were established, where the expression of lncRNA Tug1 was determined. Then, the interaction among lncRNA Tug1, miR-374c, and Foxc1 was assessed. Finally, in order to determine the effects of lncRNA Tug1 on PASMC activities and pulmonary vascular remodeling after HPH, the expression of lncRNA Tug1 was silenced in HPH-PASMCs and HPH mice, with the proliferation, apoptosis, and migration of PASMCs as well as blood pressure in mice measur...
Source: Life Sciences - Category: Biology Source Type: research
The objective was to evaluate the association between fetal sex and adverse pregnancy outcome, whilst correcting for fetal growth and gestational age at delivery.Material and MethodsData were used from the Netherlands Perinatal Registry (1999 ‐2010). The study population comprised all white‐European women with a singleton delivery between 25+0 and 42+6 weeks of gestation. Fetuses with structural or chromosomal abnormalities were excluded. Outcomes were antepartum death, intrapartum/neonatal death (from onset of labor until 28 days after birth), perinatal death (antepartum death or intrpartum/neonatal death), a composit...
Source: Acta Obstetricia et Gynecologica Scandinavica - Category: OBGYN Authors: Tags: ORIGINAL RESEARCH ARTICLE Source Type: research
Pulmonary hypertension (PAH) among children and adults has been linked to premature birth, even after adjustments for known risk factors such as congenital heart disease and chronic lung disease. The aim of th...
Source: BMC Pediatrics - Category: Pediatrics Authors: Tags: Research article Source Type: research
Conclusions:Prevalence of PH in pediatric patients with OSA is low and none of the patients with PH had severe OSA. Current guidelines recommend PH screening in patients with severe OSA, yet OSA severity may not accurately predict risk. Factors evaluated in this study did not demonstrate an increased PH risk; additional research is necessary to improve screening in pediatric patients with OSA.Citation:Burns AT, Hansen SL, Turner ZS, Aden JK, Black AB, Hsu DP. Prevalence of pulmonary hypertension in pediatric patients with obstructive sleep apnea and a cardiology evaluation: a retrospective analysis.J Clin Sleep Med. 2019;1...
Source: Journal of Clinical Sleep Medicine : JCSM - Category: Sleep Medicine Source Type: research
Authors: Shin YR, Yang YH, Park YH, Park HK Abstract A 2.5-kg neonate with coarctation of the aorta and a small left ventricle experienced a severe pulmonary hypertensive crisis. An emergency pulmonary artery-to-systemic artery shunt was placed to break the positive feedback loop caused by pulmonary hypertension and functional mitral stenosis. This shunt provided immediate relief of suprasystemic pulmonary hypertension and the resultant low cardiac output. PMID: 31403029 [PubMed]
Source: Korean Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Tags: Korean J Thorac Cardiovasc Surg Source Type: research
Publication date: Available online 12 August 2019Source: The Lancet Respiratory MedicineAuthor(s): Steven D Nathan, Jürgen Behr, Harold R Collard, Vincent Cottin, Marius M Hoeper, Fernando J Martinez, Tamera J Corte, Anne M Keogh, Hanno Leuchte, Nesrin Mogulkoc, Silvia Ulrich, Wim A Wuyts, Zhen Yao, Francis Boateng, Athol U WellsSummaryBackgroundIdiopathic interstitial pneumonias are often complicated by pulmonary hypertension, increasing morbidity and mortality. There are no approved treatments for pulmonary hypertension associated with idiopathic interstitial pneumonia (PH-IIP). We aimed to evaluate the efficacy and...
Source: The Lancet Respiratory Medicine - Category: Respiratory Medicine Source Type: research
Publication date: Available online 12 August 2019Source: The Lancet Respiratory MedicineAuthor(s): Keith C Meyer
Source: The Lancet Respiratory Medicine - Category: Respiratory Medicine Source Type: research
CONCLUSION: In this large cohort of 183 MPN patients, TTE was used to diagnose PH, and 14 patients (7.7%) developed PH. This prevalence was lower than expected based on previously reported data, but it remains higher than in the general population. PMID: 31421946 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - Category: Internal Medicine Authors: Tags: Eur J Intern Med Source Type: research
Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare but debilitating and life-threatening complication of acute pulmonary embolism (PE). CTEPH is defined as a mean pulmonary artery pressure (mPAP) of at least 25  mmHg at rest, caused by persistent obstruction of pulmonary arteries after PE that has not resolved despite at least 3 months of therapeutic anticoagulation [1]. CTEPH results from persistent obstruction of pulmonary arteries and progressive vascular remodeling [2,3]. Non-dissolution of thrombo embolic material may result in the formation of organized fibrotic scar tissue, webs and bands, which obs...
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Editorial Source Type: research
More News: Cardiovascular & Thoracic Surgery | Hypertension | Pulmonary Hypertension | Rheumatology