Serum expression of Rho kinase, endothelin-1, and nitric oxide in pediatric patients with congenital heart disease accompanied by pulmonary hypertension

Asian J Surg. 2021 Nov 26:S1015-9584(21)00724-7. doi: 10.1016/j.asjsur.2021.11.025. Online ahead of print.NO ABSTRACTPMID:34844829 | DOI:10.1016/j.asjsur.2021.11.025
Source: Asian Journal of Surgery - Category: Surgery Authors: Source Type: research

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Abstract: Pulmonary arterial hypertension (PAH) is a rare and progressive cardiopulmonary disease, characterized by pulmonary vasculopathy. The disease can lead to increase pulmonary arterial pressures and eventual right ventricle failure due to elevated afterload. The prevalence of PAH in patients admitted to the intensive care unit (ICU) is unknown, and pulmonary hypertension (PH) in the ICU is more commonly the result of left heart disease or hypoxic lung injury (PH due to left heart disease and PH due to lung diseases and/or hypoxia, respectively), as opposed to PAH. Management of patients with PAH in the ICU is co...
Source: Journal of Cardiovascular Pharmacology - Category: Cardiology Tags: Review Article Source Type: research
Background There are limited data about the range of diseases, natural history, age-appropriate end-points and optimal care for children with pulmonary hypertension (PH), including the need for developing high-quality patient registries of children with diverse forms of PH to enhance care and research. Our objective was to characterise the distribution and clinical features of diseases associated with paediatric PH, including natural history, evaluation, therapeutic interventions and outcomes, as defined by the World Symposium on Pulmonary Hypertension (WSPH) classification. Methods 1475 patients were enrolled into a mult...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Pulmonary vascular disease, Paediatric pulmonology Original Articles: Pulmonary hypertension and paediatrics Source Type: research
Background Although mild pulmonary hypertension is known to be associated with increased mortality, its impact on premature mortality is largely unknown. Methods We studied the distribution of estimated right ventricular systolic pressure (eRVSP) among a total of 154 956 adults with no evidence of left heart disease investigated with echocardiography. We then examined individually linked mortality, premature mortality and associated life-years lost (LYL) according to eRVSP levels. Results The cohort comprised 70 826 men and 84 130 women (aged 61.3±17.7 and 61.4±18.4 years, respectively). Overall, ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Pulmonary vascular disease Original Articles: Pulmonary hypertension Source Type: research
Compr Physiol. 2021 Dec 29;12(1):2731-2767. doi: 10.1002/cphy.c210016.ABSTRACTThe expanding use of continuous-flow left ventricular assist devices (CF-LVADs) for end-stage heart failure warrants familiarity with the physiologic interaction of the device with the native circulation. Contemporary devices utilize predominantly centrifugal flow and, to a lesser extent, axial flow rotors that vary with respect to their intrinsic flow characteristics. Flow can be manipulated with adjustments to preload and afterload as in the native heart, and ascertainment of the predicted effects is provided by differential pressure-flow (H-Q)...
Source: Comprehensive Physiology - Category: Physiology Authors: Source Type: research
RARITAN, NJ, Dec. 20, 2021 – The Janssen Pharmaceutical Companies of Johnson &Johnson announced today that the U.S. Food and Drug Administration (FDA) has approved two pediatric indications for XARELTO® (rivaroxaban): the treatment of venous thromboembolism (VTE, or blood clots) and reduction in the risk of recurrent VTE in patients from birth to less than 18 years after at least five days of initial parenteral (injected or intravenous) anticoagulant treatment; and thromboprophylaxis (prevention of blood clots and blood-clot related events) in children aged two years and older with congenital heart disease wh...
Source: Johnson and Johnson - Category: Pharmaceuticals Tags: Innovation Source Type: news
The Potts shunt is a palliative procedure designed to improve pulmonary blood flow in those with cyanotic heart disease; in its reversed form, it is now used to palliate patients with refractory pulmonary hypertension. Although the patient population is high risk, recent successful experiences by a handful of institutions has legitimized this approach, to the point where it may eclipse primary lung transplant in efficacy.1-3 Nevertheless, many questions remain unanswered about the reversed Potts shunt, including, When should it be implemented in the course of disease? How should it be performed (ie, sternotomy vs thoracoto...
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Commentary Source Type: research
SPRING HOUSE, PENNSYLVANIA, December 3, 2021 – The Janssen Pharmaceutical Companies of Johnson &Johnson today announced new TREMFYA® (guselkumab) efficacy and safety data from the Phase 3b COSMOS trial published in Annals of the Rheumatic Diseases (ARD), evaluating this selective interleukin (IL)-23 inhibitor in adults with active psoriatic arthritis (PsA) who demonstrated inadequate efficacy or intolerance to tumor necrosis factor inhibition (TNFi).1 Results showed significantly higher proportions of patients treated with TREMFYA had improvement in joint signs and symptoms and complete skin clearance versus ...
Source: Johnson and Johnson - Category: Pharmaceuticals Tags: Innovation Source Type: news
Conclusions Sildenafil overdose can cause serious symptoms such as hypotension. However, in our case, the sildenafil overdose was well tolerated, even by a young patient with underlying heart and lung disease. We show that choices in the management of sildenafil intoxication can be made based on the knowledge of sildenafil pharmacokinetics in young children.
Source: Pediatric Emergency Care - Category: Emergency Medicine Tags: Original Articles Source Type: research
Current non-invasive prediction tools for pulmonary hypertension due to left heart disease (PH-LHD) in suspected pulmonary arterial hypertension (PAH) patients lack sensitivity. We hypothesized that machine learning (ML) can improve the prediction of PH-LHD in a mixed population of PAH and PH-LHD patients.To build the ML model, potential non-invasive PH-LHD predictors, including demographics, medical history, echocardiographic, lung function test, lab and ECG variables, were recorded from medical files of 213 PAH and 174 PH-LHD patients from the University Hospitals of Leuven PH centre database. The dataset was randomly sp...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Pulmonary hypertension Source Type: research
PAH patients over the age of 75 yrs are generally excluded from clinical trials.Here we present characteristics and outcomes of patients>75 yrs from EXPOSURE (EUPAS 19085), an international, observational PAH study.Between Sep 2017 and Nov 2020, out of the 382 new selexipag users with follow-up information, 41 (11%) were>75 yrs. Patient characteristics at selexipag initiation are in the table. Selexipag was initiated as triple combination, double combination and monotherapy in 35 (85%), 3 (7%) and 2 (5%) patients, respectively. During the mean (SD) exposure period of 10.3 (8.9) months, 16 (39%) patients discontinued ...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Pulmonary hypertension Source Type: research
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