Right atrial function for the prediction of prognosis in connective tissue disease-associated pulmonary arterial hypertension: a study with two-dimensional speckle tracking

AbstractPulmonary arterial hypertension (PAH) is a serious and often fatal complication of connective tissue disease (CTD). Right atrial (RA) function is essential to maintaining adequate total right heart function in PAH. However, little is known about prognostic utility of RA function in CTD-PAH. RA longitudinal strain (LS) and strain rate (LSR) were evaluated in 53 consecutive patients (51 female, mean age 42  ± 15 years) with CTD-PAH, including systemic lupus erythematosus (SLE) (33.7%), mixed connective tissue disease (MCTD) (32.1%), primary Sjögren’s syndrome (pSS) (26.4%), and systemic sclerosis (SSc) (3.8%). At a mean follow-up of 19.3 ± 10.9 months, 20 patients (37.7%) were clinicall y worse. The group with clinical events had worse clinical conditions and poorer RA function at baseline compared with the group that had no clinical events. RA LS independently reflected World Health Organization functional class (WHO FC) after adjusting for RA area (RAA), tricuspid regurgitation ( TR) grade, right ventricular (RV) global longitudinal strain (GLS), and pulmonary vascular resistance (PVR) (P = 0.006). Receiver operator characteristic (ROC) curve analysis indicated that RA LS 
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research

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We present a young female patient (36 years) admitted to Department of Ophthalmology due to visual loss on the left eye. Magnetic resonance imaging showed demyelinating lesions in frontal and parietal lobe, periventricularly, in mesencephalon and right cerebellar hemisphere, and left optic neuritis; magnetic resonance angiography was normal. The patient's history revealed renal dysfunction, hypothyroidism, and miscarriage in the 6th month of pregnancy due to eclampsia, and Fabry disease in family (mother and two sisters). She was transferred to the Department of Neurology for further evaluation of the demyelinating disorde...
Source: Acta Clinica Croatica - Category: General Medicine Tags: Acta Clin Croat Source Type: research
ConclusionsContinuously delivering electrically generated NO through a Scoop catheter produces vasodilation of the pulmonary vasculature of awake lambs with pulmonary hypertension. Transtracheal NO delivery may provide a long-term treatment for patients with chronic pulmonary hypertension as an outpatient without requiring a mask or tracheal intubation.
Source: Nitric Oxide - Category: Chemistry Source Type: research
The objective was to correct the self-reported prevalence of systemic arterial hypertension (SAH) obtained from the Brazilian National Health Survey (PNS 2013). SAH prevalence estimates were corrected by means of sensitivity/specificity of information. Sensitivity and specificity values from a similar study (same self-report question, age range and gold standard) were used to this end. A sensitivity analysis was also performed, by using the upper and lower limits of confidence intervals as sensitivity and specificity parameters. The corrected prevalence of SAH for Brazil as a whole was 14.5% (self-reported: 22.1%). Women p...
Source: Cadernos de Saude Publica - Category: International Medicine & Public Health Authors: Tags: Cad Saude Publica Source Type: research
ConclusionsOur study analyzed the relationship of frailty and postoperative complications in patients with long bone fractures. Patients had increased likelihood of morbidity, independent of other comorbidities and demographic factors. The mFI may have a role as a simple, easy to use risk assessment tool in cases of orthopedic trauma.
Source: Journal of Clinical Orthopaedics and Trauma - Category: Orthopaedics Source Type: research
Neurocognitive impairment and musculoskeletal complications are among the most common complications of long-term allogeneic hematopoietic cell transplant (HCT) survivors, for which recommendations regarding routine screening and therapeutic interventions remain limited. Changes in cognitive functioning have been described in 40% of long-term allogeneic hematopoietic cell transplant survivors, and although the incidence of musculoskeletal complications has not been clearly defined, is very common- ranging from steroid-induced myopathy, myositis related to chronic graft-versus-host disease (GVHD), and fasciitis/scleroderma manifestations.
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Tags: 563 Source Type: research
Resetting the immune system through autologous hematopoietic stem cell transplant (autoHSCT) is a highly effective treatment in patients with autoimmune diseases (AID). AutoHSCT achieved long-term remission in patients with relapsed refractory and secondary progressive multiple sclerosis (Muraro 2017), superior to their previous standard of care (Burt 2019). AutoHSCT in scleroderma patients achieved superior outcomes in two randomized studies (Tyndall 2014, Sullivan 2018). These impressive results are achieved by both eradication of autoreactive immune effector cells and re-establishment of a self-tolerant immune system, i...
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Tags: 469 Source Type: research
AbstractThe prognostic impact of left atrial size in patients without systolic dysfunction nor atrial fibrillation (AF) has not been fully elucidated in Japan. We retrospectively analyzed data obtained from 4444 consecutive patients who had undergone both scheduled transthoracic echocardiography and electrocardiography in 2013 in our hospital. Those who presented with a history of myocardial infarctions, severe and moderate valvular diseases, low ejection fraction (  34 ml/m2. The primary outcome measure was a composite of all-cause death and major adverse cardiac events. A total of 2792 patients were categoriz...
Source: Heart and Vessels - Category: Cardiology Source Type: research
Major Depression — the clinical type — is not a normal part of aging. Though it can appear at any age, older adults are at an increased risk. The Centers for Disease Control and Prevention (CDC) distinguishes this condition from having “the blues” and likens it to other medical illnesses that are treatable, like diabetes or hypertension. Overwhelming sadness and anxiety can last for weeks at a time or much longer, with a wide range of other discouraging symptoms. Yet, there are things that can help.  Statistics tell us that later in life, at least one chronic disease will affect 80 percent of u...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Aging Depression depression risk Elderly seniors Source Type: blogs
Pulmonary hypertension (PH) is a clinical syndrome that is subdivided into five groups per the World Health Organization (WHO) classification, based largely on hemodynamic and pathophysiologic criteria. WHO Group 1  PH, termed pulmonary arterial hypertension (PAH), is a clinically progressive disease that can eventually lead to right heart failure and death, and it is hemodynamically characterized by pre-capillary PH and increased pulmonary vascular resistance in the absence of elevated left ventricular filli ng pressures.
Source: Respiratory Medicine - Category: Respiratory Medicine Authors: Tags: Review article Source Type: research
Objectives In agreement with other autoimmune diseases, systemic sclerosis (SSc) is associated with a strong sex bias. However, unlike lupus, the effects of sex on disease phenotype and prognosis are poorly known. Therefore, we aimed to determine sex effects on outcomes. Method We performed a prospective observational study using the latest 2013 data extract from the EULAR scleroderma trials and research (EUSTAR) cohort. We looked at (i) sex influence on disease characteristics at baseline and (ii) then focused on patients with at least 2 years of follow-up to estimate the effects of sex on disease progression and su...
Source: Annals of the Rheumatic Diseases - Category: Rheumatology Authors: Tags: Immunology (including allergy), Pulmonary hypertension, Connective tissue disease Clinical and epidemiological research Source Type: research
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