Etiology of Exercise-Induced Pulmonary Hypertension Can Be Differentiated by Echocardiography - Insight From Patients With Chronic Pulmonary Thromboembolism With Normal Resting Hemodynamics by Balloon Pulmonary Angioplasty.
Etiology of Exercise-Induced Pulmonary Hypertension Can Be Differentiated by Echocardiography - Insight From Patients With Chronic Pulmonary Thromboembolism With Normal Resting Hemodynamics by Balloon Pulmonary Angioplasty. Circ J. 2019 Oct 02;: Authors: Goda A, Takeuchi K, Kikuchi H, Finger M, Inami T, Sakata K, Soejima K, Satoh T Abstract BACKGROUND: Exercise-induced pulmonary hypertension (PH) is often seen in chronic thromboembolic PH (CTEPH) patients with normalized resting hemodynamics, but it is difficult to differentiate precapillary PH as pulmonary vascular dysfunction and post-capillary PH from occult-left ventricular dysfunction (LVD). The aim of this study was to examine whether the exercise-induced elevation of pulmonary arterial wedge pressure (PAWP) can be predicted by the echocardiographic index at rest.Methods and Results:A total of 71 CTEPH patients (67±11 years old, male/female=15/56) treated by pulmonary angioplasty with near-normal pulmonary arterial pressure (PAP) and normal PAWP at rest underwent symptom-limited exercise test using supine cycle ergometer with right heart catheterization. Exercise-induced elevation in PAWP of>20 mmHg during exercise was defined as occult-LVD. Resting echocardiography was performed within 3 months. In the occult-LVD (n=28), PAWP at rest after leg raising for exercise (14±4 vs. 11±3 mmHg, P
ConclusionManagement of pulmonary embolism in our cardiology department is characterized by the frequent use of non-invasive techniques on the diagnostic view and appeal to heparin on the therapeutic view.
ConclusionThe results of the this study confirm the important role of MDCTA in the evaluation of vascular, cardiac and parenchymal findings in the patients with CTEPH and identifying patients that would most benefit from surgical treatment by visualization of the segmental and subsegmental branches of the pulmonary arteries.
PMID: 31770028 [PubMed - in process]
AbstractThe present study was performed to screen for potential molecular biomarkers and to assess the underlying mechanisms of chronic thromboembolic pulmonary hypertension (CTEPH) by using sequencing data analysis of microRNAs (miRNAs) and circular RNAs (circRNAs). Total RNA was isolated from peripheral-blood samples from five CTEPH patients and from five normal individuals. Based upon the identification of differentially expressed miRNAs (Affymetrix miRNA chip) and circRNAs (Agilent circRNA chip), target predictions for these differentially expressed miRNAs and functional enrichment analyses of the miRNAs and circRNAs w...
In this study, we assessed the association of hypoxemia and localization of thrombus in order to clarify the adequate management for hypoxemic patients with CTEPH.Method: We performed a retrospective study of 132 CTEPH patients consecutively diagnosed between 2009 and 2017. Eleven patients with missing data, ventilatory impairment (FEV1.0 %predicted
Conclusion: Although the recognised morbidity and mortality, CTEPH is a treatable and potential curable disease; delayed referral is still a problem to be solved. Despite this, it is clear the clinical benefit of specific treatments.
Chronic thromboembolic pulmonary hypertension (CTEPH) is one of the most relevant forms of pulmonary hypertension (PH). While platelet role in the acute thrombosis and pulmonary embolism is well studied, in CTEPH the platelet role is less clear. Since platelet is a major source of thromboxane, a potent vasoconstrictor, platelets may have a significant role in CTEPH.Objectives: To compare the platelet count and volume of CTEPH patients and a control population (normopressoric patients without thromboembolic disease, submitted to right heart catheterization (RHC) during PH investigation).Methods: Retrospective analysis of co...
Conclusions: Endothelial TGFβ1 signaling via type I receptors and endothelin-1 contribute to mesenchymal lineage transition and thrombofibrosis, which were prevented by blocking endothelin receptors. Our findings may have relevant implications for the prevention and management of CTEPH. PMID: 31747868 [PubMed - as supplied by publisher]
2 trials report effective secondary prevention with low dose apixaban or rivaroxaban after the initial treatment period for VTE (Agnelli 2013 &Weitz 2017). This is a retrospective service evaluation of low dose DOAC over 1 year in patients with unprovoked VTE.Methods: At 3 months post PE or proximal DVT, patients are assessed for VTE and bleeding risk factors. Patients with unprovoked VTE (without chronic thromboembolic pulmonary hypertension, high risk inherited thrombophilia or antiphospholipid syndrome &