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Right ventricular reserve in a piglet model of chronic pulmonary hypertension
Right ventricular (RV) response to exercise or pharmacological stress is not well documented in pulmonary hypertension (PH). We investigated the relationship between RV reserve and ventricular–arterial coupling. Surgical ligation of the left pulmonary artery was performed in 13 Large White piglets (PH group), thereafter weekly embolisations of the right lower lobe were performed for 5 weeks. A control group of six piglets underwent sham procedures. Right heart catheterisation and echocardiography were performed at week 6. Pressure–volume loops were recorded before and after dobutamine infusion. Induction o...
Source: European Respiratory Journal - February 28, 2015 Category: Respiratory Medicine Authors: Guihaire, J., Haddad, F., Noly, P.-E., Boulate, D., Decante, B., Dartevelle, P., Humbert, M., Verhoye, J.-P., Mercier, O., Fadel, E. Tags: Pulmonary vascular disease Original Articles: Pulmonary vascular diseases Source Type: research

{beta}-blockers in pulmonary arterial hypertension: evolving concepts of right heart failure
Current guidelines advise against the use of β-blockers in pulmonary arterial hypertension (PAH) to avoid systemic hypotension [1]. In addition, PAH patients have a fixed stroke volume, and are therefore highly dependent on heart rate to increase their cardiac output [2–4]. Indeed, Provencher et al. [5] showed that withdrawal of β-blockers significantly improved exercise capacity in portopulmonary hypertension. Peacock and Ross [6] described another case of portopulmonary hypertension, in which the use of a β-blocker to treat a supraventricular tachycardia in an already haemodynamically unstable patient was nearly fatal.
Source: European Respiratory Journal - August 31, 2015 Category: Respiratory Medicine Authors: de Man, F. S., Handoko, M. L. Tags: Pulmonary vascular disease Editorials Source Type: research

Pulmonary vascular resistance and compliance relationship in pulmonary hypertension
Right ventricular adaptation to the increased pulmonary arterial load is a key determinant of outcomes in pulmonary hypertension (PH). Pulmonary vascular resistance (PVR) and total arterial compliance (C) quantify resistive and elastic properties of pulmonary arteries that modulate the steady and pulsatile components of pulmonary arterial load, respectively. PVR is commonly calculated as transpulmonary pressure gradient over pulmonary flow and total arterial compliance as stroke volume over pulmonary arterial pulse pressure (SV/PApp). Assuming that there is an inverse, hyperbolic relationship between PVR and C, recent stud...
Source: European Respiratory Journal - September 30, 2015 Category: Respiratory Medicine Authors: Chemla, D., Lau, E. M. T., Papelier, Y., Attal, P., Herve, P. Tags: Pulmonary vascular disease Series Source Type: research

Unemployment in COPD: Results from the BOLD study
Conclusion: There was substantial variation in employment of COPD-patients, but the overall effect of COPD on unemployment was modest when we adjusted for geography, demographic factors and comorbidities.
Source: European Respiratory Journal - October 30, 2015 Category: Respiratory Medicine Authors: Gronseth, R., Erdal, M., Tan, W. C., Gislason, T., Juvekar, S. K., Salvi, S., Koul, P. A., Hafizi, H., Vollmer, W. M., Studnicka, M., Obaseki, D., Buist, A. S., Johannessen, A. Tags: 6.1 Epidemiology Source Type: research

Apelin improves cardiac output in patients with pulmonary arterial hypertension
Conclusion: Acute apelin administration in patients with PAH led to an improvement in cardiac output and pulmonary vascular resistance. APJ agonism may be a useful therapeutic target for treatment of PAH.
Source: European Respiratory Journal - October 30, 2015 Category: Respiratory Medicine Authors: Brash, L., Barnes, G., Brewis, M., Church, C., Gibbs, S., Howard, L., Johnson, M., McGlinchey, N., Simpson, J., Stirrat, C., Thomson, S., Watson, G., Welsh, D., Wilkins, M., Newby, D., Peacock, A. Tags: 4.3 Pulmonary Circulation and Pulmonary Vascular Disease Source Type: research

Phenotyping comorbidity in obstructive sleep apnea syndrome
Conclusion: Five distinct phenotypes of OSAS and its comorbidities were identified. Mapping the heterogeneity of OSAS may help identify at-risk groups early; Finally, determining predictors of comorbidity for the moderate and severe strata of these phenotypes implies a need to evaluate these factors when considering treatment options.
Source: European Respiratory Journal - October 30, 2015 Category: Respiratory Medicine Authors: Vavougios, G., Natsios, G., Pastaka, C., Zarogiannis, S., Gourgoulianis, K. Tags: 4.2 Sleep and Control of Breathing Source Type: research

Left ventricular-arterial coupling and cardiac remodeling in patients with idiopathic arterial pulmonary hypertension
Conclusions: The reduction of LVAC as the key feature of right heart remodeling was observed in patients with IPAH with dilated RV and decreased right ventricular ejection fraction.
Source: European Respiratory Journal - October 30, 2015 Category: Respiratory Medicine Authors: Dadacheva, Z., Belevskaya, A., Saidova, M., Martynyuk, T., Chazova, I. Tags: 4.3 Pulmonary Circulation and Pulmonary Vascular Disease Source Type: research

Hemodynamic profiles in patients with chronic thromboembolic disease before and after pulmonary endarterectomy
Conclusions: Our observations point to an abnormal pulmonary vascular response to exercise and a decreased ventilatory efficiency as mechanisms underlying the exercise limitation observed in CTE patients. PEA resulted in improvements in circulatory responses indicative for an improved stroke volume response upon exercise and ventilatory efficiency.
Source: European Respiratory Journal - October 30, 2015 Category: Respiratory Medicine Authors: Van Kan, C., Van der Plas, M., Reesink, H., Van Steenwijk, R., Tepaske, R., Kloek, J., Bresser, P. Tags: 4.3 Pulmonary Circulation and Pulmonary Vascular Disease Source Type: research

OSA complication score as novel reference to assess systemic inflammation in sleep apnoea
Breathing disorders during sleep increase the risk of many serious complications and pathophysiological abnormalities. The obstructive sleep apnoea syndrome (OSAS) and related comorbidities are accompanied by systemic inflammation. In our conducting study on immune response in OSAS we observed significant changes related to comorbidities. Thus we constructed our own OSA complications score (OCS).The aim of our study was to assess the usefulness of this score in evaluation of character and severity of inflammation. OCS was calculated for 50 OSA patients by adding up the following factors: obesity, diabetes, hypertension, is...
Source: European Respiratory Journal - October 30, 2015 Category: Respiratory Medicine Authors: Piechuta, A., Osinska, I., Bielicki, P., Skirecki, T., Domagala-Kulawik, J. Tags: 4.2 Sleep and Control of Breathing Source Type: research

Predicting survival in hospitalized pulmonary hypertension patients
Conclusion: Survival appears related to better stroke volumes and cardiac function. Further analysis of continuous trends will enable the development of goal directed therapies for acute RVF cardiogenic shock in PH patients.
Source: European Respiratory Journal - October 30, 2015 Category: Respiratory Medicine Authors: Steiger, N., Thomeas, V., Gomberg-Maitland, M. Tags: 4.3 Pulmonary Circulation and Pulmonary Vascular Disease Source Type: research

Accuracy of impedance cardiography to measure cardiac output at rest in pulmonary hypertension
Conclusion: This pilot study validates the measurement of CO by IP in patients with PH (group 1 or 4). This suggests a potential role of the non-invasive IP in the follow up of PH patients.
Source: European Respiratory Journal - October 30, 2015 Category: Respiratory Medicine Authors: Noel-Savina, E., Tetu, L., Prevot, G., Dupuis, M., Pillard, F., Riviere, D., Didier, A. Tags: 4.3 Pulmonary Circulation and Pulmonary Vascular Disease Source Type: research

Cardiac remodeling and left ventricular-arterial coupling in patients with chronic thromboembolic pulmonary hypertension
Conclusions: Long-term RV pressure overload resulted in impairment of LV diastolic function and decreased LVAC may be due to interventricular interaction.
Source: European Respiratory Journal - October 30, 2015 Category: Respiratory Medicine Authors: Belevskaya, A., Dadacheva, Z., Saidova, M., Martynyuk, T., Chazova, I. Tags: 4.3 Pulmonary Circulation and Pulmonary Vascular Disease Source Type: research

Upfront combination therapy in the treatment of scleroderma-associated pulmonary arterial hypertension: Results of an open label trial
Conclusions: Upfront combination therapy resulted in significant changes in hemodynamics, RV structure and function, and RV-pulmonary vascular coupling as well as functional status at 36 weeks of therapy. When compared to previous clinical trials, these data suggest initial combination therapy is very effective for SSc-PAH.
Source: European Respiratory Journal - October 30, 2015 Category: Respiratory Medicine Authors: Hassoun, P., Zamanian, R., Damico, R., Khair, R., Kolb, T., Tedford, R., Hulm, O., Pisanello, C., Sato, T., Corona-Villalobos, C., Zimmerman, S., Gashouta, M., Minai, O., Torres, F., Chin, K., Girgis, R., Mathai, S. Tags: 4.3 Pulmonary Circulation and Pulmonary Vascular Disease Source Type: research

Perioperative screening for obstructive sleep apnoea and treatment outcomes: where are the data?
Obstructive sleep apnoea (OSA) is common illness found worldwide, with a reported prevalence ranging from 9% to 24% among the general population [1]. In the USA, approximately 92% of women and 82% of men with moderate-to-severe OSA remain undiagnosed [2]. OSA carries several short- and long-term health consequences. These may range from perioperative complications to the risk of having uncontrolled hypertension, stroke, coronary artery disease and dysrhythmias, to name a few [3–8].
Source: European Respiratory Journal - June 29, 2016 Category: Respiratory Medicine Authors: Surani, S. R., Varon, J. Tags: Sleep medicine Editorials Source Type: research

Cardio-metabolic disorder in grandparents associated with asthma in offspring: Results from a European 3-generation analysis
Conclusion: These preliminary results are similar to those observed previously in Northern-Europe. Grand-father CMD was associated with subsequent asthma in offspring independently of a family history of asthma. This may have important implications with regard to public health intervention.
Source: European Respiratory Journal - November 7, 2016 Category: Respiratory Medicine Authors: Carsin, A.-E., Real, F., Basagana, X., Accordini, S., Dharmage, S., Schlünssen, V., Benediktsdottir, B., Leynaert, B., Janson, C., Sunyer, J., Dratva, J., Jarvis, D., Svanes, C. Tags: 6.4 Genes and Environment Source Type: research

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