scholarly journals Brain Natriuretic Peptide and NT-proBNP Levels Reflect Pulmonary Artery Systolic Pressure in Trekkers at High Altitude

2013 ◽  
pp. 597-603 ◽  
Author(s):  
D. R. WOODS ◽  
A. MELLOR ◽  
J. BEGLEY ◽  
M. STACEY ◽  
J. O’HARA ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Brain Natriuretic Peptide ◽  
High Altitude ◽  
Natriuretic Peptide ◽  
Natriuretic Peptides ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Central Feature ◽  
Post Exercise ◽  
Echocardiographic Assessment

Our objective was to evaluate the utility of the natriuretic peptides BNP (brain natriuretic peptide) and NT-proBNP as markers of pulmonary artery systolic pressure (PASP) in trekkers ascending to high altitude (HA). 20 participants had BNP and NT-proBNP assayed and simultaneous echocardiographic assessment of PASP performed during a trek to 5150 m. PASP increased significantly (p=0.006) with ascent from 24±4 to 39±11 mm Hg at 5150 m. At 5150 m those with a PASP≥40 mm Hg (n=8) (versus those with PASP<40 mm Hg) had higher post-exercise BNP (pg/ml): 54.5±36 vs. 13.4±17 (p=0.012). Their resting BNP at 5150 m was also higher: 57.3±43.4 vs. 12.6±13 (p=0.017). In those with a pathological (≥400 pg/ml) rise in NT-proBNP at 5150 m (n=4) PASP was significantly higher: 45.9±7.5 vs. 32.2±6.2 mm Hg (p=0.015). BNP and NT-proBNP may reflect elevated PASP, a central feature of high altitude pulmonary oedema, at HA.

Proposition of quantitative parameters for pre- and early post-operative assessment in pulmonary thromboendarterectomy – An Indian prospective study

2021 ◽  
pp. 021849232110421
Author(s):  
Krishnarao N Bhosle ◽  
Saptarshi Paul ◽  
Suraj W Nagre
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Systolic Pressure ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Pulmonary Artery Systolic Pressure ◽  
Walk Test ◽  
Pulmonary Thromboendarterectomy ◽  
Thromboembolic Pulmonary Hypertension

Introduction Chronic thromboembolic pulmonary hypertension results from the incomplete resolution of the vascular obstruction associated with pulmonary embolism. Symptoms are exertional dyspnoea and fatigue, and over a period of time, right ventricular dysfunction sets in. Pulmonary thromboendarterectomy is an effective surgical remedy for this condition. Our study is an initial post-operative experience of pulmonary thromboendarterectomy and we have also tried to formulate quantitative parameters for the prediction of the post-operative course in patients who are undergoing surgery. Methods Twenty patients with chronic thromboembolic pulmonary hypertension underwent pulmonary thromboendarterectomy between July 2017 and January 2020. Pre-operatively, each patient was subjected to the (i) 6-min walk test, (ii) pre-operative brain natriuretic peptide values and (iii) pulmonary artery systolic pressure. Following the surgery and subsequent discharge, the patients were followed up at intervals of 15 days, 1, 3, 6, 9 months and at 1 year. At one year post-operatively, the same three quantitative tests were performed on each subject. Results Post-operatively, the mean 6-min walk distance was 499.75 m as against 341.35 m pre-operatively ( p < 0.0001). Mean brain natriuretic peptide was 8.69 pm/l as against 47.58 pm/l pre-operatively ( p < 0.0001). Mean pulmonary artery systolic pressure was 22.25 as against 67.1 pre-operatively ( p < 0.0001). Conclusion 6-Min walk test, brain natriuretic peptide and pulmonary artery systolic pressure could be considered as useful predictors of the haemodynamic severity of disease and predict the post-operative outcome.

scholarly journals Echocardiographic assessment of pulmonary artery systolic pressure following treadmill stress testing

2016 ◽  
Vol 18 (11) ◽  
pp. 1278-1282 ◽  
Author(s):  
Arshad A. Khan ◽  
Mohammad Al-Omary ◽  
Ian Renner ◽  
Ehtesham Ul Haque ◽  
Avedis Ekmejian ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Stress Testing ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Echocardiographic Assessment ◽  
Treadmill Stress

Nitric oxide and cardiopulmonary hemodynamics in Tibetan highlanders

2005 ◽  
Vol 99 (5) ◽  
pp. 1796-1801 ◽  
Author(s):  
Brian D. Hoit ◽  
Nancy D. Dalton ◽  
Serpil C. Erzurum ◽  
Daniel Laskowski ◽  
Kingman P. Strohl ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Blood Flow ◽  
Pulmonary Artery ◽  
High Altitude ◽  
Sea Level ◽  
Pulmonary Blood Flow ◽  
Geometric Mean ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Exhaled No

When O2 availability is reduced unavoidably, as it is at high altitude, a potential mechanism to improve O2 delivery to tissues is an increase in blood flow. Nitric oxide (NO) regulates blood vessel diameter and can influence blood flow. This field study of intrapopulation variation at high altitude tested the hypothesis that the level of exhaled NO (a summary measure of pulmonary synthesis, consumption, and transfer from cells in the airway) is directly proportional to pulmonary, and thus systemic, blood flow. Twenty Tibetan male and 37 female healthy, nonsmoking, native residents at 4,200 m (13,900 ft), with an average O2 saturation of hemoglobin of 85%, participated in the study. The geometric mean partial pressure of NO exhaled at a flow of 17 ml/s was 23.4 nmHg, significantly lower than that of a sea-level reference group. However, the rate of NO transfer out of the airway wall was seven times higher than at sea level, which implied the potential for vasodilation of the pulmonary blood vessels. Mean pulmonary blood flow (measured by cardiac index) was 2.7 ± 0.1 (SE) l/min, and mean pulmonary artery systolic pressure was 31.4 ± 0.9 (SE) mmHg. Higher exhaled NO was associated with higher pulmonary blood flow; yet there was no associated increase in pulmonary artery systolic pressure. The results suggest that NO in the lung may play a key beneficial role in allowing Tibetans at 4,200 m to compensate for ambient hypoxia with higher pulmonary blood flow and O2 delivery without the consequences of higher pulmonary arterial pressure.

scholarly journals Effect of Successful Percutaneous Transvenous Mitral Commissurotomy on Pulmonary Function

2017 ◽  
Vol 32 (1) ◽  
pp. 45-49 ◽  
Author(s):  
Umme Salma Khan ◽  
AKM Monwarul Islam ◽  
Abdullah Al Shafi Majumder
Keyword(s):  
Pulmonary Artery ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Before And After ◽  
Procedural Complications ◽  
Percutaneous Transvenous Mitral Commissurotomy ◽  
Echocardiographic Assessment ◽  
The Mean ◽  
Hemodynamic Measurements

A total of 58 patients of severe mitral stenosis with Wilkins score < 10 were studied, all of them underwent PTMC. Spirometry and peak expiratory flow rate were done before and after PTMC. A follow up echocardiographic assessment of successful PTMC and pulmonary artery systolic pressure were taken. Two patients died of PTMC related procedural complications. There was no dropout. Hemodynamic measurements obtained by echocardiography showed improvement of mean mitral valve area from 0.764 ± 0.1257 cm2 to 1.404 ± 0.1194 cm2 after PTMC (p < 0.001). Transmitral peak pressure gradient decreased from 26.43 + 5.62 mmHg to 11.36 + 2.40 mmHg after PTMC (p < 0.001). Pulmonary artery systolic pressure was decreased from 57.73 ± 17.03 mmHg to 31.27± 8.30 mmHg after the procedure (p < 0.001). pulmonary functions - The mean FEV1 was increased from 60.18 ± 13.054 to 78.32 ± 11.874 after PTMC (p<0.001). The mean FVC was 53.80+ 12.313 before PTMC, which significantly improved to 68.57 + 11.662. PEF also showed an improvement from 223.75 + 62.3215 to 372.05 + 62.2. (p<0.001).Bangladesh Heart Journal 2017; 32(1) : 45-49

Effect of acute lower respiratory tract infection on pulmonary artery pressure in children with post-tricuspid left-to-right shunt

2021 ◽  
pp. 1-5
Author(s):  
Sakshi Sachdeva ◽  
Shyam S. Kothari ◽  
Saurabh K. Gupta ◽  
Sivasubramanian Ramakrishnan ◽  
Anita Saxena
Keyword(s):  
Tract Infection ◽  
Pulmonary Artery ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Lower Respiratory Tract Infection ◽  
Pulmonary Artery Pressure ◽  
Lower Respiratory Tract ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Artery Pressure

Abstract We sought to examine the influence of clinically severe lower respiratory tract infection on pulmonary artery pressure in children having CHD with post-tricuspid left-to-right shunt, as it may have physiological and clinical implications. In a prospective single-centre observational study, 45 children with post-tricuspid left-to-right shunt and clinically severe lower respiratory tract infection were evaluated during the illness and 2 weeks after its resolution. Pulmonary artery systolic pressure was estimated non-invasively using shunt gradient by echocardiography and systolic blood pressure measured non-invasively. Median pulmonary artery systolic pressure during lower respiratory tract infection was only mildly (although statistically significantly) elevated during lower respiratory tract infection [60 (42–74) versus 53 (40–73) mmHg, (p < 0.0001)]. However, clinically significant change in pulmonary artery systolic pressure defined as the increase of >10 mmHg was present in only 9 (20%) patients. In the absence of hypoxia or acidosis, only a small minority (9%, n = 4) showed significant pulmonary artery systolic pressure rise >10 mmHg. In the absence of hypoxia or acidosis, severe lower respiratory tract infection in patients with acyanotic CHD results in only mild elevation of pulmonary artery systolic pressure in most of the patients.

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