Pulmonary arterial hypertension patients with and without cardiovascular risk factors: results from the ambition trial

Registry data indicate that the demographics of patients with pulmonary arterial hypertension (PAH) have changed over time.1-7 At least in Western countries, the proportion of patients being diagnosed at a more advanced age and/or with more risk factors for left ventricular diastolic dysfunction is increasing.8,9 Clinical outcomes are worse in such patients, relative to their younger counterparts who have fewer risk factors for left ventricular diastolic dysfunction.8,9 These observations have led to some uncertainty in how best to categorise and treat these patients based on the current clinical classification of pulmonary hypertension.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Original Clinical Science Source Type: research

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This study analysed the effect of inhaled iloprost and oral sildenafil combination therapy (ilo-sil) on pulmonary haemodynamic parameters in patients with secondary pulmonary hypertension.
Source: Heart, Lung and Circulation - Category: Cardiology Authors: Tags: Original Article Source Type: research
AbstractPurposeThe pulmonary artery (PA) in patients with pulmonary hypertension (PH) becomes dilated. We analyzed the postoperative changes of the main PA after lung transplantation (LuTx).MethodsThe subjects of this retrospective study were 68 LuTx recipients, divided into a PH group (n = 36) and a non-PH group (n = 32), based on preoperative right heart catheterization findings. The PA diameter was measured on chest computed tomography. We evaluated the correlation between the mean pulmonary arterial pressure (mPAP) and the main PA diameter and compared the main PA diameters before and 3 ...
Source: Surgery Today - Category: Surgery Source Type: research
Abstract Pulmonary hypertension is a term used to describe a complex multifactorial group of conditions diagnosed by an elevated mean pulmonary artery pressure of 20 mm Hg or higher on right heart catheterization. The diagnosis of pulmonary hypertension in pregnancy is important, as it is associated with high rates of maternal morbidity and mortality, even with modern management. Diagnostic testing is important for establishing the diagnosis, type, and severity of pulmonary hypertension, which in turn, dictates treatment options. Echocardiographic assessment is the first step in diagnosis and the gold standard for...
Source: Obstetrics and Gynecology - Category: OBGYN Authors: Tags: Obstet Gynecol Source Type: research
Conclusion: Idiopathic pulmonary arterial hypertension is associated with poor prognosis and survival despite advancements of disease specific therapies. Higher mortality in our study is due to delayed presentation and diagnosis. Also lack of availability of prostacyclins and lung transplantation in advanced stages of disease contribute to higher mortality in Indian setup. Non-invasive echocardiographic factors and six minute walk distance are important prognostic factors that help in disease severity stratification to identify patients in need of intensive medical management. PMID: 31571454 [PubMed - in process]
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
This study was supported by grants from the National Institutes of Health and the American Heart Association; and by the Foundation for Anesthesia Education and Research.
Source: UCLA Newsroom: Health Sciences - Category: Universities & Medical Training Source Type: news
Application of extracorporeal life support (ECLS) for advanced pulmonary hypertension (PH) is evolving and may be deployed as a bridge to lung transplantation (BTT) or non-BTT bridge back to chronic PH clinical state as bridge to recovery (BTR) in the setting an acute PH trigger or through non-transplant surgery (BTNTS) or after lung transplantation (BPT).
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: Original Clinical Science Source Type: research
Application of extracorporeal life support (ECLS) for advanced pulmonary hypertension (PH) is evolving and may be deployed as a bridge to transplantation (BTT) or in one of several non-BTT uses, such as bridge to recovery (BTR) to the chronic PH clinical state in the setting of an acute PH trigger, bridge through non-transplant surgery (BTNTS), or bridge post-transplantation (BPT).
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: ORIGINAL CLINICAL SCIENCE Source Type: research
CONCLUSION: An increased RV:LV ratio measured at CTPA provides a simple, non-invasive method of risk stratification in patients with suspected ILD-PH. This should prompt closer follow up, more aggressive treatment and consideration of lung transplantation. PMID: 31351047 [PubMed - as supplied by publisher]
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
AbstractDextrocardia is a rare congenital condition which presents important challenges for surgical management. We discuss a patient with dextrocardia, atrial septal defect, and Eisenmenger syndrome, which ultimately led to decompensated end ‐stage lung disease and heart‐lung transplant. Venous‐venous extracorporeal membrane oxygenation was an important strategy to bridge the patient until donor organs became available. Transplantation of a heart‐lung block allowed for the treatment of the patient's underlying congenital heart d efect, anatomic reversal of dextrocardia with appropriate venous and arterial connecti...
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: CASE REPORT Source Type: research
Abstract INTRODUCTION AND OBJECTIVE: Pulmonary hypertension (PH) complicating idiopathic pulmonary fibrosis (IPF) is challenging to diagnose given inaccuracy of transthoracic echocardiogram (TTE) measurements. However, it has significant prognostic implications and is therefore important to accurately identify. METHODS: We conducted a cross-sectional study of patients with IPF who underwent RHC as part of their evaluation. A variety of commonly available noninvasive variables were evaluated for their ability to predict pulmonary arterial pressure in a linear regression model, including the traditionally used ...
Source: Respiratory Care - Category: Respiratory Medicine Authors: Tags: Clin Respir J Source Type: research
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