Prognostic Value of Preoperative Pulmonary Arterial Capacitance for Patients Undergoing Aortic Valve Replacement for Severe Aortic Valve Stenosis.

CONCLUSIONS: In these patients undergoing AVR for severe AS, even in the absence of PH, preoperative reduced PAC was independently associated with adverse surgical outcomes. It seems that preoperative PAC has potential as an independent predictor of long-term prognosis after AVR for severe AS. PMID: 31484840 [PubMed - as supplied by publisher]
Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research

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We present a case report of a heart failure patient after heart transplantation due to end-stage ischemic cardiomyopathy with significant clinical and echocardiographic improvement 3 months after the introduction of sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor. This new class of drugs is proved to be beneficial in heart failure patients, especially with reduced ejection fraction (HFrEF), but they have not yet been used in heart failure patients after heart transplantation. We believe that the increase of left ventricular systolic function, improvement of global longitudinal strain, and reduction of pu...
Source: Indian Journal of Pharmacology - Category: Drugs & Pharmacology Authors: Source Type: research
We examined the correlates of R-V/A and traditional echocardiographic indices of RVSD, over the spectrum of pulmonary hypertension and tertiles of mean pulmonary artery pressures (PAPm). Methods In 2016–2017, we studied 81 consecutive patients for heart transplant/advanced heart failure. Inclusion criteria were NIDCM, reduced ejection fraction (≤40%) and sinus rhythm. R-V/A was computed as the RV/pulmonary elastances ratio (R-Elv/P-Ea), derived from a combined right heart catheterization/transthoracic- echocardiographic assessment [right heart catheterization/transthoracic-echocardiographic (RHC/TTE)]. Results...
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Research articles: Heart failure Source Type: research
Authors: Toroghi HM, Lo KB, Ziccardi MR, Horn B, Kanjanahattakij N, Malik E, Penalver J, Rangaswami J, Gupta S, Amanullah A Abstract Worsening renal function in patients with heart failure with preserved ejection fraction is associated with poor outcomes. Pulmonary arterial capacitance is a novel right heart catheterization derived hemodynamic metric representing pulmonary arterial tree distensibility and right ventricle afterload. Given the strong association between heart failure, pulmonary hypertension, and kidney function, the goal of this study is to investigate the correlation between Pulmonary arterial capac...
Source: Reviews in Cardiovascular Medicine - Category: Cardiology Tags: Rev Cardiovasc Med Source Type: research
We report our care of a 48-year-old woman suffering from right heart failure and massive fluid overload due to severe pulmonary hypertension secondary to a combination of left-heart disease and status after recurrent pulmonary embolisms. Alterations in Doppler-derived intrarenal venous flow patterns and a novel renal venous stasis index were used to evaluate improvement in renal venous congestion during recompensation. Due to refractory congestion despite optimal medical treatment and continuous veno-venous hemodialysis, a peritoneal dialysis catheter was placed to relieve the massive ascites. The paracentesis of ascites l...
Source: Reviews in Cardiovascular Medicine - Category: Cardiology Tags: Rev Cardiovasc Med Source Type: research
The prognostic impact of right ventricular (RV) dysfunction and of pulmonary hypertension (PH) in patients affected by chronic heart failure (CHF) has been well described by several invasive and non-invasive diagnostic tools [1 –7]. More recently, it has been demonstrated that taking into account the coupling between the afterload and the function of the right ventricle may prove more useful than considering this information separately. The tricuspid annular plane systolic excursion (TAPSE)/ systolic pulmonary artery pre ssure (PASP), a surrogate marker of RV-vascular coupling have already proven to be effective indi...
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Source Type: research
ConclusionsDiffuse RV fibrosis, as measured by ECV, is present in PH ‐HFpEF and is associated with adverse RV structural and functional remodelling but not degree of pulmonary vasculopathy. In PH‐HFpEF, diffuse RV fibrosis may occur out of proportion to the degree of RV afterload.
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
Purpose of review Right ventricular (RV) dysfunction following thoracotomy and pulmonary resection is a known phenomenon but questions remain about its mechanism, risk factors, and clinical significance. Acute RV dysfunction can present intraoperatively and postoperatively, persisting for 2 months after surgery. Recent findings Recently, the pulmonology literature has emphasized pulmonary arterial capacitance, rather than pulmonary vascular resistance, as a marker to predict disease progression and outcome in patients with pulmonary hypertension and heart failure. Diagnostic focus has emerged on the use of cardiac MRI...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: THORACIC ANESTHESIA: Edited by Albert C. Perrino, Jr Source Type: research
Publication date: Available online 24 December 2019Source: Heart &LungAuthor(s): Sikandar H Khan, Shalini Manchanda, Ninotchka L Sigua, Erika Green, Philani B Mpofu, Siu Hui, Babar A. KhanAbstractBackgroundIn-hospital respiratory outcomes of non-surgical patients with undiagnosed obstructive sleep apnea (OSA), particularly those with significant comorbidities are not well defined. Undiagnosed and untreated OSA may be associated with increased cardiopulmonary morbidity.Study objectivesEvaluate respiratory failure outcomes in patients identified as at-risk for OSA by the Berlin Questionnaire (BQ).MethodsThis was a retros...
Source: Heart and Lung: The Journal of Acute and Critical Care - Category: Respiratory Medicine Source Type: research
AbstractAimsRemodelling of the extracellular matrix (ECM) is a key mechanism involved in the development and progression of heart failure (HF) but also functional in associated pulmonary hypertension (PH). Our aim was to identify plasma ECM proteins associated to end ‐stage HF and secondary PH in relation to haemodynamics, before and after heart transplantation (HT).Methods and resultsTwenty ECM plasma proteins were analysed with proximity extension assay in 20 controls and 26 HF patients pre ‐HT and 1 year post‐HT. Right heart catherization haemodynamics were assessed in the patients during the preoperative evaluati...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
CONCLUSION: Baseline characteristics and epidemiology were different between MUV and single-valve procedures. The in-hospital mortality and postoperative complications for MUV procedures remained considerably higher and determinants of mortality were relatively different across procedures types. These findings serve as a benchmark for further studies, as well as suggest a continued search for explanations of MUV outcomes. PMID: 31895035 [PubMed - in process]
Source: The Heart Surgery Forum - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Heart Surg Forum Source Type: research
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