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Towards the implementation of optimal cardiac magnetic resonance risk stratification in PAH
Chest. 2023 Jul 30:S0012-3692(23)01066-8. doi: 10.1016/j.chest.2023.07.028. Online ahead of print.ABSTRACTBACKGROUND: The 2022 European pulmonary hypertension (PH) guidelines incorporate cardiac magnetic resonance (CMR) imaging metrics in the risk stratification of pulmonary arterial hypertension (PAH) patients. Thresholds to identify patients at estimated 1-year mortality risks of <5%, 5-20% and >20% are introduced. However, these cut-off values are mostly single center based and require external validation.RESEARCH QUESTIONS: What are the discriminative prognostic properties of the current cardiac magnetic resonanc...
Source: Chest - August 1, 2023 Category: Respiratory Medicine Authors: L R Celant J N Wessels J T Marcus L J Meijboom H J Bogaard F S de Man A Vonk Noordegraaf Source Type: research

How we do it: evaluation of dyspnea and exercise intolerance after acute pulmonary embolism
Chest. 2022 Jul 2:S0012-3692(22)01215-6. doi: 10.1016/j.chest.2022.06.036. Online ahead of print.ABSTRACTLong-term dyspnea and exercise intolerance are common clinical problems after acute PE. Unfortunately, no single test can distinguish among the range of potential pathological outcomes after PE. We illustrate a stepwise approach to post-PE evaluation that uses a hierarchical series of clinically validated diagnostic tests. The algorithm is represented by the acronym SEARCH, which stands for symptom screening, exercise testing, arterial perfusion, resting echocardiography, confirmatory chest imaging and (right) heart cat...
Source: Chest - July 6, 2022 Category: Respiratory Medicine Authors: Timothy A Morris Timothy M Fernandes Richard Channick Source Type: research

Pulmonary vascular and right ventricular burden during exercise in interstitial lung disease.
CONCLUSIONS: ILD with resting and exercise PH is associated with increased exercise RV work, reduced pulmonary vascular reserve and reduced peak VO2. The findings highlight the role of pulmonary vascular and RV burden to ILD exercise limit. PMID: 32173491 [PubMed - as supplied by publisher]
Source: Chest - March 11, 2020 Category: Respiratory Medicine Authors: Oliveira RKF, Waxman AB, Hoover PJ, Dellaripa PF, Systrom DM Tags: Chest Source Type: research

Idiopathic and Systemic Sclerosis associated Pulmonary Arterial Hypertension: A Comparison of Demographic, Haemodynamic and Magnetic Resonance Imaging Characteristics and Outcomes.
CONCLUSION: The reasons for poorer outcomes in SSc-PAH are likely to be multifactorial including, but not limited to, older age and reduced gas transfer. PMID: 28223154 [PubMed - as supplied by publisher]
Source: Chest - February 17, 2017 Category: Respiratory Medicine Authors: Ramjug S, Hussain N, Hurdman J, Billings C, Charampopoulos A, Elliot CA, Kiely DG, Sabroe I, Rajaram S, Swift AJ, Condliffe R Tags: Chest Source Type: research

Pulmonary Embolism Response to Fragmentation, Embolectomy, and Catheter Thrombolysis (PERFECT): Initial Results from a Prospective Multicenter Registry.
CONCLUSIONS: Catheter-directed therapy improves clinical outcomes in acute PE patients while minimizing the risk of major bleeding. At experienced centers, CDT is a safe and effective treatment for both acute massive and submassive PE. CLINICAL TRIAL REGISTRATION: NCT01097928, available at http://clinicaltrials.gov/show/NCT01097928. PMID: 25856269 [PubMed - as supplied by publisher]
Source: Chest - April 9, 2015 Category: Respiratory Medicine Authors: Kuo WT, Banerjee A, Kim PS, DeMarco FJ, Levy JR, Facchini FR, Unver K, Bertini MJ, Sista AK, Hall MJ, Rosenberg JK, DeGregorio MA Tags: Chest Source Type: research

Acute Hemodynamic Effects of Riociguat in Patients with Pulmonary Hypertension Associated with Diastolic Heart Failure (DILATE-1): A Randomized, Double-Blind, Placebo-Controlled, Single-Dose Study.
Conclusions:In patients with HFpEF and PH, riociguat was well tolerated, had no significant effect on mPAP, and improved exploratory hemodynamic and echocardiographic parameters. Trial registry:ClinicalTrials.gov; No.: NCT01172756; URL: www.clinicaltrials.gov. Background: Deficient nitric oxide- soluble guanylate cyclase (sGC)-cGMP signaling results from endothelial dysfunction and may underlie impaired cardiac relaxation in patients with heart failure with preserved left ventricular ejection fraction (HFpEF) and pulmonary hypertension (PH). The acute hemodynamic effects of riociguat, a novel sGC stimulator, were char...
Source: Chest - July 3, 2014 Category: Respiratory Medicine Authors: Bonderman D, Pretsch I, Steringer-Mascherbauer R, Jansa P, Rosenkranz S, Tufaro C, Bojic A, Lam CS, Frey R, Ochan Kilama M, Unger S, Roessig L, Lang IM Tags: Chest Source Type: research

Echocardiography of the pulmonary circulation and right ventricular function: exploring the physiologic spectrum in 1480 normal subjects.
CONCLUSIONS. This study delineates an estimate of pulmonary hemodynamics in a wide age range cohort of healthy subjects. Pulmonary pressures increased with age and BMI as expected. PMID: 24306729 [PubMed - as supplied by publisher]
Source: Chest - December 5, 2013 Category: Respiratory Medicine Authors: D'Andrea A, Naeije R, Grünig E, Caso P, D'Alto M, Palma ED, Nunziata L, Riegler L, Scarafile R, Cocchia R, Vriz O, Citro R, Calabrò R, Russo MG, Bossone E Tags: Chest Source Type: research