scholarly journals A simple echocardiographic estimate of right ventricular-arterial coupling to assess severity and outcome in pulmonary hypertension on chronic lung disease

2019 ◽  
Vol 54 (3) ◽  
pp. 1802435 ◽  
Author(s):  
Khodr Tello ◽  
Hossein A. Ghofrani ◽  
Charlotte Heinze ◽  
Karsten Krueger ◽  
Robert Naeije ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Right Ventricular ◽  
Lung Disease ◽  
Chronic Lung Disease

PDE5A inhibition attenuates bleomycin-induced pulmonary fibrosis and pulmonary hypertension through inhibition of ROS generation and RhoA/Rho kinase activation

2008 ◽  
Vol 294 (1) ◽  
pp. L24-L33 ◽  
Author(s):  
Anna R. Hemnes ◽  
Ari Zaiman ◽  
Hunter C. Champion
Keyword(s):  
Pulmonary Hypertension ◽  
Interstitial Lung Disease ◽  
Pulmonary Fibrosis ◽  
Right Ventricular ◽  
Lung Disease ◽  
Rho Kinase ◽  
Saline Control ◽  
Ros Generation ◽  
Pde5 Inhibition ◽  
Phosphodiesterase Type

Pulmonary hypertension frequently complicates interstitial lung disease, where it is associated with a high mortality. Patients with this dual diagnosis often fare worse than those with pulmonary arterial hypertension (PAH) alone and respond poorly to standard PAH therapy, often dying of right ventricular (RV) failure. We hypothesize that nitric oxide synthase (NOS) uncoupling is important in the pathogenesis of interstitial lung disease-associated pulmonary hypertension, and this process can be abrogated by phosphodiesterase type 5 (PDE5) inhibition to improve pulmonary vascular remodeling and right ventricular function. Intratracheal bleomycin (4 U/kg) or saline control was administered to C57/BL6 mice after anesthesia. After recovery, animals were fed a diet of sildenafil (100 mg·kg−1·day−1) or vehicle for 2 wk when they underwent hemodynamic measurements, and tissues were harvested. Survival was reduced in animals treated with bleomycin compared with controls and was improved with sildenafil (100.0 vs. 73.7 vs. 84.2%, P < 0.05). RV/LV+S ratio was higher in bleomycin-alone mice with improvement in ratio when sildenafil was administered (33.00 ± 0.01% vs. 20.98 ± 0.01% P < 0.05). Histology showed less pulmonary vascular and RV fibrosis in the group cotreated with sildenafil. Bleomycin was associated with a marked increase in superoxide generation by DHE histological staining and luminol activity in both heart and lung. Treatment with sildenafil resulted in a concomitant reduction in superoxide levels in both heart and lung. These data demonstrate that PDE5 inhibition ameliorates RV hypertrophy and pulmonary fibrosis associated with intratracheal bleomycin in a manner that is associated with improved NOS coupling and a reduction in reactive oxygen species signaling.

Subcutaneous Treprostinil for Pulmonary Hypertension in Chronic Lung Disease of Infancy

PEDIATRICS ◽  
2014 ◽  
Vol 134 (1) ◽  
pp. e274-e278 ◽  
Author(s):  
D. J. Ferdman ◽  
E. B. Rosenzweig ◽  
W. A. Zuckerman ◽  
U. Krishnan
Keyword(s):  
Pulmonary Hypertension ◽  
Lung Disease ◽  
Chronic Lung Disease

scholarly journals Determinants and Impact of Heart Failure Readmission Following Transcatheter Aortic Valve Replacement

2020 ◽  
Vol 13 (7) ◽  
Author(s):  
Vincent Auffret ◽  
Abdelkader Bakhti ◽  
Guillaume Leurent ◽  
Marc Bedossa ◽  
Jacques Tomasi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Pulmonary Hypertension ◽  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Lung Disease ◽  
Chronic Lung Disease ◽  
Transcatheter Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
All Cause Mortality ◽  
Grade Iii

Background: Heart failure (HF) readmission is common post–transcatheter aortic valve replacement (TAVR). Nonetheless, limited data are available regarding its predictors and clinical impact. This study evaluated the incidence, predictors, and impact of HF readmission within 1-year post-TAVR, and assessed the effects of the prescription of HF therapies at discharge on the risk of HF readmission and death. Methods: Patients included in the TAVR registry of a single expert center from 2009 to 2017 were analyzed. Competing-risk and Cox regressions were performed to identify predictors of HF readmission and death. Results: Among 750 patients, 102 (13.6%) were readmitted for HF within 1-year post-TAVR. Overall, 53 patients (7.1%) experienced late readmissions (>30 days post-TAVR), and 17 (2.3%) had multiple readmissions. In ≈30% of readmissions, no trigger could be identified. Predominant causes of readmissions were changes in medication/nonadherence and supraventricular arrhythmia. Independent predictors of HF readmission included diabetes mellitus, chronic lung disease, previous acute HF, grade III or IV aortic regurgitation, and pulmonary hypertension both at discharge from the index hospitalization but not HF therapies. Overall, HF readmission did not significantly impact all-cause mortality (hazard ratio [HR], 1.36 [95% CI, 0.99–1.85]). However, late (HR, 1.90 [95% CI, 1.30–2.78]) and multiple HF readmissions (HR, 2.10 [95% CI,1.17–3.76]) were significantly associated with all-cause mortality. Prescription of renin-angiotensin system inhibitors at discharge was associated with a lower rate of all-cause mortality, especially among patients receiving doses of 25% to <50% (HR, 0.67 [95% CI, 0.48–0.94]) and 75% to 100% (HR, 0.61 [95% CI, 0.37–0.98]) of the optimal daily dose. Conclusions: HF readmission is common within 1-year of TAVR. Late and multiple HF readmissions associate with an increased risk of long-term all-cause mortality. Baseline comorbidities (diabetes, chronic lung disease, previous acute HF) and echocardiographic findings at discharge (grade III or IV aortic regurgitation, pulmonary hypertension) identified patients at high risk of HF readmission.

CHRONIC LUNG DISEASE AND ITS PROGRESSION TO PULMONARY HYPERTENSION: THE NEED FOR EARLY SCREENING

CHEST Journal ◽  
2019 ◽  
Vol 156 (4) ◽  
pp. A594-A595
Author(s):  
Temidayo Abe ◽  
Eric Chang ◽  
Gabrielle De Allie ◽  
Philip Bene ◽  
Parris Tanksley
Keyword(s):  
Pulmonary Hypertension ◽  
Lung Disease ◽  
Chronic Lung Disease ◽  
Early Screening
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