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[PMID]:28460765
[Au] Autor:Lanjewar C; Phadke M; Singh A; Sabnis G; Jare M; Kerkar P
[Ad] Endereço:Department of Cardiology, Seth G.S. Medical College & King Edward VII Memorial Hospital, Mumbai, India.
[Ti] Título:Percutaneous balloon valvuloplasty with Inoue balloon catheter technique for pulmonary valve stenosis in adolescents and adults.
[So] Source:Indian Heart J;69(2):176-181, 2017 Mar - Apr.
[Is] ISSN:0019-4832
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Percutaneous balloon pulmonary valvuloplasty is the procedure of choice for uncomplicated severe or symptomatic pulmonary stenosis. The present study describes our experience in balloon pulmonary valvuloplasty using the Inoue balloon catheter in adolescent and adult patients. AIMS: To assess the immediate and mid-term outcomes of percutaneous balloon valvuloplasty with Inoue balloon catheter in adolescent and adult patients. METHODS AND RESULTS: Between June 2010 and July 2015, we performed percutaneous balloon pulmonary valvuloplasty with Inoue balloon catheter in 32 patients (59.37% females) aged 8 to 54 years (mean 23.6±11.5). Following the procedure, the mean right ventricular systolic pressure and the pulmonary valvular peak-to-peak systolic gradient decreased from (121.6±42.4 to 61.19±24.5mmHg, p=0.001) and (100.9±43.3 to 36.4±22.5mmHg, p=0.001), respectively. Twenty patients (Group A) showed immediate optimal results with post-procedure peak systolic gradient <36mmHg while 12 patients (Group B) had suboptimal results. An increase in pulmonary regurgitation by one grade was detected in 17 patients (53.2%). Twenty-three patients available for follow-up (mean duration, 2.75 years [range 0.25-5 years]) had a mean residual peak gradient of 23.6±2.51mmHg on Doppler echocardiography with attenuation of reactive RVOT stenosis in all Group B patients. There was no further increase in grade of pulmonary regurgitation or restenosis on mid-term follow-up. CONCLUSION: Percutaneous Inoue balloon technique is an attractive alternative with excellent mid-term results for adolescents and adults with isolated pulmonary stenosis.
[Mh] Termos MeSH primário: Valvuloplastia com Balão/métodos
Cateterismo Cardíaco/métodos
Estenose da Valva Pulmonar/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Ecocardiografia Doppler
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Estenose da Valva Pulmonar/diagnóstico
Estenose da Valva Pulmonar/fisiopatologia
Sístole
Fatores de Tempo
Resultado do Tratamento
Função Ventricular Direita/fisiologia
Pressão Ventricular
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:29366750
[Au] Autor:Williams JL; Cavus O; Loccoh EC; Adelman S; Daugherty JC; Smith SA; Canan B; Janssen PML; Koenig S; Kline CF; Mohler PJ; Bradley EA
[Ad] Endereço:The Ohio State University, Department of Physiology and Cell Biology, United States.
[Ti] Título:Defining the molecular signatures of human right heart failure.
[So] Source:Life Sci;196:118-126, 2018 Mar 01.
[Is] ISSN:1879-0631
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:AIMS: Right ventricular failure (RVF) varies significantly from the more common left ventricular failure (LVF). This study was undertaken to determine potential molecular pathways that are important in human right ventricular (RV) function and may mediate RVF. MATERIALS AND METHODS: We analyzed mRNA of human non-failing LV and RV samples and RVF samples from patients with pulmonary arterial hypertension (PAH), and post-LVAD implantation. We then performed transcript analysis to determine differential expression of genes in the human heart samples. Immunoblot quantification was performed followed by analysis of non-failing and failing phenotypes. KEY FINDINGS: Inflammatory pathways were more commonly dysregulated in RV tissue (both non-failing and failing phenotypes). In non-failing human RV tissue we found important differences in expression of FIGF, TRAPPAC, and CTGF suggesting that regulation of normal RV and LV function are not the same. In failing RV tissue, FBN2, CTGF, SMOC2, and TRAPP6AC were differentially expressed, and are potential targets for further study. SIGNIFICANCE: This work provides some of the first analyses of the molecular heterogeneity between human RV and LV tissue, as well as key differences in human disease (RVF secondary to pulmonary hypertension and LVAD mediated RVF). Our transcriptional data indicated that inflammatory pathways may be more important in RV tissue, and changes in FIGF and CTGF supported this hypothesis. In PAH RV failure samples, upregulation of FBN2 and CTGF further reinforced the potential significance that altered remodeling and inflammation play in normal RV function and failure.
[Mh] Termos MeSH primário: Insuficiência Cardíaca/genética
Disfunção Ventricular Direita/genética
[Mh] Termos MeSH secundário: Adulto
Idoso
Biomarcadores/análise
Hipertensão Pulmonar Primária Familiar/patologia
Feminino
Regulação da Expressão Gênica/efeitos dos fármacos
Insuficiência Cardíaca/patologia
Ventrículos do Coração/metabolismo
Seres Humanos
Masculino
Meia-Idade
RNA Mensageiro/biossíntese
RNA Mensageiro/genética
Transdução de Sinais/genética
Disfunção Ventricular Esquerda/genética
Disfunção Ventricular Esquerda/patologia
Disfunção Ventricular Direita/patologia
Função Ventricular Direita
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers); 0 (RNA, Messenger)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180126
[St] Status:MEDLINE


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[PMID]:29327898
[Au] Autor:Krca B; Dzudovic B; Vukotic S; Ratkovic N; Subotic B; Vranes D; Rusovic S; Obradovic S
[Ti] Título:Association of different electrocardiographic patterns with shock index, right ventricle systolic pressure and diameter, and embolic burden score in pulmonary embolism.
[So] Source:Vojnosanit Pregl;73(10):921-6, 2016 Oct.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Background/Aim: Some electrocardiographic (ECG) patterns are characteristic for pulmonary embolism but exact meaning of the different ECG signs are not well known. The aim of this study was to determine the association between four common ECG signs in pulmonary embolism [complete or incomplete right bundle branch block (RBBB), S-waves in the aVL lead, S1Q3T3 sign and negative T-waves in the precordial leads] with shock index (SI), right ventricle diastolic diameter (RVDD) and peak systolic pressure (RVSP) and embolic burden score (EBS). Methods: The presence of complete or incomplete RBBB, S waves in aVL lead, S1Q3T3 sign and negative T-waves in the precordial leads were determined at admission ECG in 130 consecutive patients admitted to the intensive care unit of a single tertiary medical center in a 5-year period. Echocardiography examination with measurement of RVDD and RVSP, multidetector computed tomography pulmonary angiography (MDCT-PA) with the calculation of EBS and SI was determined during the admission process. Multivariable regression models were calculated with ECG parameters as independent variables and the mentioned ultrasound, MDCT-PA parameters and SI as dependent variables. Results: The presence of S-waves in the aVL was the only independent predictor of RVDD (F = 39.430, p < 0.001; adjusted R2 = 0.231) and systolic peak right ventricle pressure (F = 29.903, p < 0.001; adjusted R2 = 0.185). Negative T-waves in precordial leads were the only independent predictor for EBS (F = 24.177, p < 0.001; R2 = 0.160). Complete or incomplete RBBB was the independent predictor of SI (F = 20.980, p < 0.001; adjusted R2 = 0.134). Conclusion: In patients with pulmonary embolism different ECG patterns at admission correlate with different clinical, ultrasound and MDCT-PA parameters. RBBB is associated with shock, Swave in the aVL is associated with right ventricle pressure and negative T-waves with the thrombus burden in the pulmonary tree.
[Mh] Termos MeSH primário: Bloqueio de Ramo/diagnóstico
Eletrocardiografia
Frequência Cardíaca
Embolia Pulmonar/diagnóstico
Choque/diagnóstico
Função Ventricular Direita
Pressão Ventricular
[Mh] Termos MeSH secundário: Adulto
Idoso
Bloqueio de Ramo/etiologia
Bloqueio de Ramo/fisiopatologia
Angiografia por Tomografia Computadorizada
Ecocardiografia
Feminino
Seres Humanos
Masculino
Meia-Idade
Tomografia Computadorizada Multidetectores
Análise Multivariada
Valor Preditivo dos Testes
Embolia Pulmonar/etiologia
Embolia Pulmonar/fisiopatologia
Análise de Regressão
Fatores de Risco
Índice de Gravidade de Doença
Choque/etiologia
Choque/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150512011K


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[PMID]:29332912
[Au] Autor:Higo K; Kubota K; Miyanaga S; Miyata M; Nakajo M; Jinguji M; Ohishi M
[Ad] Endereço:Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University.
[Ti] Título:Impairment of Iodine-123-Metaiodobenzylguanidine ( I-MIBG) Uptake in Patients with Pulmonary Artery Hypertension.
[So] Source:Int Heart J;59(1):112-119, 2018 Jan 27.
[Is] ISSN:1349-3299
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:According to recent studies, lung uptake of iodine-123-metaiodobenzylguanidine ( I-MIBG) is impaired in many lung diseases and low lung uptake of I-MIBG suggests endothelial dysfunction of the pulmonary artery. I-MIBG scintigraphy in patients with pulmonary hypertension (PH) has not yet been clinically evaluated. We hypothesized that the lung uptake of I-MIBG is reduced in patients with PH and differs among PH subtypes. The purpose of the present study was to analyze the lung uptake of I-MIBG in patients with PH and compare it with the data obtained by echocardiography or right heart catheterization. I-MIBG scintigraphy was performed in 286 consecutive patients from 2003 to 2014. We enrolled 21 patients with PH and 8 control patients. The 21 patients with PH were categorized into those with pulmonary artery hypertension (PAH, n = 12) and those with chronic thromboembolic pulmonary hypertension (CTEPH, n = 9). The mean pulmonary artery pressure was not significantly different between patients with CTEPH and PAH (37.7 ± 6.8 versus 32.3 ± 5.3 mmHg respectively; P = 0.054). There were no significant differences in any other hemodynamic parameters between the two groups. The lung uptake of I-MIBG in PAH patients (early image: 1.54 ± 0.18, delayed image: 1.41 ± 0.16) was significantly lower than that of CTEPH patients (early image: 2.17 ± 0.25, P < 0.0001; delayed image: 1.99 ± 0.20, P = 0.0001, adjusted for age and World Health Organization classification) and controls (early image: 2.32 ± 0.27, P = 0.0007; delayed image: 1.92 ± 0.19, P = 0.0007). In conclusion, we found for the first time that the lung uptake of I-MIBG in patients with PAH is lower than that in patients with CTEPH and controls.
[Mh] Termos MeSH primário: 3-Iodobenzilguanidina/farmacocinética
Hipertensão Pulmonar/diagnóstico
Pulmão/metabolismo
Artéria Pulmonar/diagnóstico por imagem
Pressão Propulsora Pulmonar/fisiologia
Cintilografia/métodos
[Mh] Termos MeSH secundário: 3-Iodobenzilguanidina/administração & dosagem
Adulto
Idoso
Cateterismo Cardíaco
Ecocardiografia
Endotélio Vascular/fisiopatologia
Teste de Esforço
Feminino
Seres Humanos
Hipertensão Pulmonar/metabolismo
Hipertensão Pulmonar/fisiopatologia
Pulmão/diagnóstico por imagem
Masculino
Meia-Idade
Artéria Pulmonar/fisiopatologia
Compostos Radiofarmacêuticos/administração & dosagem
Compostos Radiofarmacêuticos/farmacocinética
Estudos Retrospectivos
Volume Sistólico/fisiologia
Tomografia Computadorizada por Raios X
Função Ventricular Esquerda/fisiologia
Função Ventricular Direita/fisiologia
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Radiopharmaceuticals); 35MRW7B4AD (3-Iodobenzylguanidine)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180206
[Lr] Data última revisão:
180206
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180116
[St] Status:MEDLINE
[do] DOI:10.1536/ihj.16-629


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[PMID]:29332910
[Au] Autor:Kato K; Kato T; Hayano S; Fukasawa Y; Numaguchi A; Hattori T; Saito A; Sato Y; Hayakawa M
[Ad] Endereço:Department of Pediatrics, Nagoya University Graduate School of Medicine.
[Ti] Título:Successful Infant Pneumonectomy with Unilateral Pulmonary Artery Occlusion Test.
[So] Source:Int Heart J;59(1):237-239, 2018 Jan 27.
[Is] ISSN:1349-3299
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:The use of unilateral pulmonary artery occlusion (UPAO) test for the preoperative evaluation of pneumonectomy was reported in adult patients. On the contrary, in infants, no strategies have yet been recommended to predict hemodynamics after pneumonectomy, nor has use of the UPAO test been reported. We describe the first case of infant with abnormal pulmonary circulation in whom successful pneumonectomy was performed after preoperative evaluation using UPAO test. Right pneumonectomy was planned for an 8-month-old girl, because of decreased right pulmonary function, high risk of pneumothorax, and impaired left lung expansion due to overexpansion caused by severe left bronchial stenosis and bronchomalacia. However, she had also prolonged pulmonary hypertension and there was difficulty in accurate echocardiographic evaluation of its severity due to concomitant left pulmonary artery stenosis. Furthermore, contrast-enhanced computer tomography suggested a certain degree of right pulmonary venous flow, discordant with the result showing scarce right pulmonary flow in perfusion scintigraphy. Predicting postoperative hemodynamic changes was therefore considered difficult. To evaluate these concerns, we performed cardiac catheterization and UPAO test to simulate postoperative hemodynamics. Pulmonary arteriography showed decreased but significant right pulmonary arterial and venous flows. Measurements including pulmonary artery pressure and cardiac index showed no marked changes after occlusion. Based on UPAO test results, the operation was successfully performed and hemodynamics remained stable postoperatively. The UPAO test may be useful for infants with cardiopulmonary impairment to evaluate the tolerability of pneumonectomy.
[Mh] Termos MeSH primário: Anormalidades Múltiplas
Broncomalácia/cirurgia
Testes de Função Cardíaca/métodos
Pneumonectomia/métodos
Artéria Pulmonar/fisiopatologia
Circulação Pulmonar/fisiologia
Estenose de Artéria Pulmonar/cirurgia
[Mh] Termos MeSH secundário: Angiografia
Broncomalácia/congênito
Broncomalácia/diagnóstico
Feminino
Seres Humanos
Lactente
Artéria Pulmonar/diagnóstico por imagem
Cintilografia
Estenose de Artéria Pulmonar/congênito
Estenose de Artéria Pulmonar/diagnóstico
Resistência Vascular
Função Ventricular Direita/fisiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180206
[Lr] Data última revisão:
180206
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180116
[St] Status:MEDLINE
[do] DOI:10.1536/ihj.16-606


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[PMID]:29033578
[Au] Autor:Oketona OA; Balogun MO; Akintomide AO; Ajayi OE; Adebayo RA; Mene-Afejuku TO; Oketona OT; Bamikole OJ
[Ad] Endereço:Fort Nelson General Hospital, Fort Nelson, BC, Canada.
[Ti] Título:Right ventricular systolic function in hypertensive heart failure.
[So] Source:Vasc Health Risk Manag;13:353-360, 2017.
[Is] ISSN:1178-2048
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Heart failure (HF) is a major cause of cardiovascular admissions and hypertensive heart failure (HHF) is the most common cause of HF admissions in sub-Saharan Africa, Nigeria inclusive. Right ventricular (RV) dysfunction is being increasingly recognized in HF and found to be an independent predictor of adverse outcomes in HF. This study aimed to determine the prevalence of RV systolic dysfunction in HHF by several echocardiographic parameters. METHODOLOGY: One hundred subjects with HHF were recruited consecutively into the study along with 50 age and sex-matched controls. All study participants gave written informed consent, and had a full physical examination, blood investigations, 12-lead electrocardiogram, and transthoracic echocardiography. RV systolic function was assessed in all subjects using different methods based on the American Society of Echocardiography guidelines for echocardiographic assessment of the right heart in adults. This included tricuspid annular plane systolic excursion (TAPSE), RV myocardial performance index (MPI), and RV systolic excursion velocity by tissue Doppler (S'). RESULTS: RV systolic dysfunction was found in 53% of subjects with HHF by TAPSE, 56% by RV MPI, and 48% by tissue Doppler systolic excursion S'. RV systolic dysfunction increased with reducing left ventricular ejection fraction (LVEF) in subjects with HHF. CONCLUSION: A high proportion of subjects with HHF were found to have RV systolic functional abnormalities using TAPSE, RV MPI, and RV S'. Prevalence of RV systolic dysfunction increased with reducing LVEF.
[Mh] Termos MeSH primário: Insuficiência Cardíaca/epidemiologia
Hipertensão/epidemiologia
Disfunção Ventricular Direita/epidemiologia
Função Ventricular Direita
[Mh] Termos MeSH secundário: Idoso
Estudos de Casos e Controles
Estudos Transversais
Ecocardiografia Doppler
Eletrocardiografia
Feminino
Insuficiência Cardíaca/diagnóstico
Insuficiência Cardíaca/fisiopatologia
Seres Humanos
Hipertensão/diagnóstico por imagem
Hipertensão/fisiopatologia
Masculino
Meia-Idade
Nigéria/epidemiologia
Prevalência
Prognóstico
Volume Sistólico
Sístole
Disfunção Ventricular Direita/diagnóstico
Disfunção Ventricular Direita/fisiopatologia
Função Ventricular Esquerda
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171017
[St] Status:MEDLINE
[do] DOI:10.2147/VHRM.S142429


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[PMID]:29030379
[Au] Autor:Cronin EM; Jones P; Seth MC; Varma N
[Ad] Endereço:From the Hartford HealthCare Heart and Vascular Institute, Hartford Hospital, CT (E.M.C.); Boston Scientific, St. Paul, MN (P.J., M.C.S.); and Section of Cardiac Electrophysiology and Pacing, Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, OH (N.V.). edmond.cro
[Ti] Título:Right Ventricular Pacing Increases Risk of Appropriate Implantable Cardioverter-Defibrillator Shocks Asymmetrically: An Analysis of the ALTITUDE Database.
[So] Source:Circ Arrhythm Electrophysiol;10(10), 2017 Oct.
[Is] ISSN:1941-3084
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Right ventricular pacing (RVP) increases risk of atrial fibrillation in patients with implantable cardioverter-defibrillators (ICDs), but ventricular proarrhythmia is less clear. We analyzed a large remote monitoring database to assess this question. METHODS AND RESULTS: Patients with single- or dual-chamber ICDs, engaged in remote monitoring for at least 6 months and with unchanged tachycardia programming, were included. %RVP was derived for each weekly transmission. ICD electrograms preceding the first shock were adjudicated. Among 425 625 transmissions received from 8435 patients, 389 appropriate shocks occurred over a mean follow-up of 15.0±8.8 months. In a time-dependent Cox proportional hazards model, transmissions with 80% to 98% RVP were associated with a hazard ratio of 1.56 for an appropriate shock in the subsequent week compared with <1% RVP (95% CI, 1.01-2.41; =0.04). By contrast, ≥98% RVP trended toward a lower risk of an appropriate shock (hazard ratio, 0.61; 95% CI, 0.33-1.12; =0.108). Lifetime cumulative %RVP was closely correlated with weekly %RVP ( =0.907) and was similarly associated with increased risk of appropriate shocks at 80% to 98% RVP (hazard ratio, 1.57; 95% CI, 1.01-2.44; =0.046) but not at ≥98% RVP (hazard ratio, 0.49; 95% CI, 0.24-1.01; =0.052). These results were driven by dual-chamber devices, but unaffected by PVC counts or programming. Male sex and age were also associated with appropriate ICD shocks. CONCLUSIONS: Increasing frequency of RVP is associated with a progressively increased risk of appropriate ICD shocks until ≥98% RVP. RVP may have ventricular proarrhythmia because of competition of paced and intrinsic rhythm in ICD patients.
[Mh] Termos MeSH primário: Dispositivos de Terapia de Ressincronização Cardíaca
Terapia de Ressincronização Cardíaca/métodos
Desfibriladores Implantáveis
Cardioversão Elétrica/instrumentação
Função Ventricular Direita
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Terapia de Ressincronização Cardíaca/efeitos adversos
Dispositivos de Terapia de Ressincronização Cardíaca/efeitos adversos
Bases de Dados Factuais
Desfibriladores Implantáveis/efeitos adversos
Cardioversão Elétrica/efeitos adversos
Técnicas Eletrofisiológicas Cardíacas
Feminino
Seres Humanos
Masculino
Meia-Idade
Valor Preditivo dos Testes
Modelos de Riscos Proporcionais
Falha de Prótese
Tecnologia de Sensoriamento Remoto
Fatores de Risco
Processamento de Sinais Assistido por Computador
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171015
[St] Status:MEDLINE


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[PMID]:29029709
[Au] Autor:Hsu N; Wang T; Friedman O; Barjaktarevic I
[Ad] Endereço:Division of Pulmonary and Critical Care, David Geffen School of Medicine at UCLA, Los Angeles, CA.
[Ti] Título:Medical Management of Pulmonary Embolism: Beyond Anticoagulation.
[So] Source:Tech Vasc Interv Radiol;20(3):152-161, 2017 Sep.
[Is] ISSN:1557-9808
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pulmonary embolism (PE) is a common medical condition that carries significant morbidity and mortality. Although diagnosis, anticoagulation, and interventional clot-burden reduction strategies represent the focus of clinical research and care in PE, appropriate risk stratification and supportive care are crucial to ensure good outcomes. In this chapter, we will discuss the medical management of PE from the time of presentation to discharge, focusing on the critical care of acute right ventricular failure, anticoagulation of special patient populations, and appropriate follow-up testing after acute PE.
[Mh] Termos MeSH primário: Anticoagulantes/uso terapêutico
Coagulação Sanguínea/efeitos dos fármacos
Insuficiência Cardíaca/terapia
Embolia Pulmonar/terapia
Disfunção Ventricular Direita/terapia
[Mh] Termos MeSH secundário: Doença Aguda
Testes de Coagulação Sanguínea
Terapia Combinada
Cuidados Críticos
Monitoramento de Medicamentos
Insuficiência Cardíaca/etiologia
Insuficiência Cardíaca/fisiopatologia
Seres Humanos
Valor Preditivo dos Testes
Embolia Pulmonar/sangue
Embolia Pulmonar/complicações
Embolia Pulmonar/diagnóstico
Respiração Artificial
Medição de Risco
Fatores de Risco
Resultado do Tratamento
Triagem
Filtros de Veia Cava
Disfunção Ventricular Direita/etiologia
Disfunção Ventricular Direita/fisiopatologia
Função Ventricular Direita
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anticoagulants)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171015
[St] Status:MEDLINE


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[PMID]:28961271
[Au] Autor:Di Franco A; Kim J; Rodriguez-Diego S; Khalique O; Siden JY; Goldburg SR; Mehta NK; Srinivasan A; Ratcliffe MB; Levine RA; Crea F; Devereux RB; Weinsaft JW
[Ad] Endereço:Department of Medicine, Weill Cornell Medical College, New York City, New York, United States of America.
[Ti] Título:Multiplanar strain quantification for assessment of right ventricular dysfunction and non-ischemic fibrosis among patients with ischemic mitral regurgitation.
[So] Source:PLoS One;12(9):e0185657, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Ischemic mitral regurgitation (iMR) predisposes to right ventricular (RV) pressure and volume overload, providing a nidus for RV dysfunction (RVDYS) and non-ischemic fibrosis (NIF). Echocardiography (echo) is widely used to assess iMR, but performance of different indices as markers of RVDYS and NIF is unknown. METHODS: iMR patients prospectively underwent echo and cardiac magnetic resonance (CMR) within 72 hours. Echo quantified iMR, assessed conventional RV indices (TAPSE, RV-S', fractional area change [FAC]), and strain via speckle tracking in apical 4-chamber (global longitudinal strain [RV-GLS]) and parasternal long axis orientation (transverse strain). CMR volumetrically quantified RVEF, and assessed ischemic pattern myocardial infarction (MI) and septal NIF. RESULTS: 73 iMR patients were studied; 36% had RVDYS (EF<50%) on CMR among whom LVEF was lower, PA systolic pressure higher, and MI size larger (all p<0.05). CMR RVEF was paralleled by echo results; correlations were highest for RV-GLS (r = 0.73) and lowest for RV-S' (r = 0.43; all p<0.001). RVDYS patients more often had CMR-evidenced NIF (54% vs. 7%; p<0.001). Whereas all RV indices were lower among NIF-affected patients (all p≤0.006), percent change was largest for transverse strain (48.3%). CMR RVEF was independently associated with RV-GLS (partial r = 0.57, p<0.001) and transverse strain (r = 0.38, p = 0.002) (R = 0.78, p<0.001). Overall diagnostic performance of RV-GLS and transverse strain were similar (AUC = 0.93[0.87-0.99]|0.91[0.84-0.99], both p<0.001), and yielded near equivalent sensitivity and specificity (85%|83% and 80%|79% respectively). CONCLUSION: Compared to conventional echo indices, RV strain parameters yield stronger correlation with CMR-defined RVEF and potentially constitute better markers of CMR-evidenced NIF in iMR.
[Mh] Termos MeSH primário: Fibrose
Imagem por Ressonância Magnética/métodos
Insuficiência da Valva Mitral/diagnóstico por imagem
Função Ventricular Direita
[Mh] Termos MeSH secundário: Idoso
Ecocardiografia
Feminino
Seres Humanos
Masculino
Meia-Idade
Insuficiência da Valva Mitral/fisiopatologia
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171103
[Lr] Data última revisão:
171103
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170930
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185657


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[PMID]:28938958
[Au] Autor:Adir Y; Guazzi M; Offer A; Temporelli PL; Cannito A; Ghio S
[Ad] Endereço:Pulmonary Division, Lady Davis Carmel Medical Center, Faculty of Medicine, The Technion, Institute of Technology, Haifa, Israel. Electronic address: adir-sh@zahav.net.il.
[Ti] Título:Pulmonary hemodynamics in heart failure patients with reduced or preserved ejection fraction and pulmonary hypertension: Similarities and disparities.
[So] Source:Am Heart J;192:120-127, 2017 Oct.
[Is] ISSN:1097-6744
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The current understanding of pulmonary hypertension (PH) due to left ventricular diseases does not distinguish heart failure (HF) with reduced ejection fraction (HFrEF) from HF and preserved ejection fraction (HFpEF), in terms of pulmonary hemodynamics. The value of pulmonary vascular compliance (PCa) and diastolic pulmonary gradient (DPG) as predictors of survival in either HF syndrome is controversial. The aims of our study were to compare the pulmonary hemodynamics in the two HF phenotypes, given similar values of pulmonary artery wedge pressure (PAWP), and to evaluate the impact of PCa and DPG on survival. METHODS: We retrospectively reviewed the charts of 168 PH-HFrEF and 86 PH-HFpEF patients. The independent association of PCa and DPG with prognosis was assessed by means of a Cox proportional hazard model. All cause survival was analyzed over an average follow-up period of 50 months. RESULTS: PH-HFpEF patients had a significantly higher DPG than PH-HFrEF patients (6.1±7.1 vs 1.8±4.5 mmHg, adjusted P=.025). PCa was similar in PH-HFpEF and PH-HFrEF. PCa was a significant predictor of survival, according to previously described preset cutoffs (2.15 mL/mmHg in HFrEF and 1.1 mL/mmHg in HFpEF) and based on a continuous scale; whereas DPG had no impact on survival in both patients groups. CONCLUSION: Our findings suggest that for similar levels of PAWP, pulmonary circulation may be stiffer in patients with HFpEF-PH than patients with HFrEF-PH, leading to higher DPGs. Nonetheless, PCa rather than DPG emerged as the stronger predictor of survival in both left-sided PH phenotypes.
[Mh] Termos MeSH primário: Insuficiência Cardíaca/fisiopatologia
Hemodinâmica/fisiologia
Hipertensão Pulmonar/fisiopatologia
[Mh] Termos MeSH secundário: Idoso
Cateterismo Cardíaco
Diástole
Ecocardiografia
Feminino
Seguimentos
Insuficiência Cardíaca/complicações
Insuficiência Cardíaca/diagnóstico
Seres Humanos
Hipertensão Pulmonar/complicações
Hipertensão Pulmonar/diagnóstico
Masculino
Meia-Idade
Prognóstico
Circulação Pulmonar
Estudos Retrospectivos
Volume Sistólico
Fatores de Tempo
Resistência Vascular
Função Ventricular Direita
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170929
[Lr] Data última revisão:
170929
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170924
[St] Status:MEDLINE



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