Pulmonary Circulation最新文献_第10页

Severe bronchospasm and acute respiratory failure associated with inhaled prostacyclin therapy. 与吸入前列环素治疗相关的严重支气管痉挛和急性呼吸衰竭。

IF 2.6 4区医学

Pulmonary Circulation Pub Date : 2024-06-07 eCollection Date: 2024-04-01 DOI: 10.1002/pul2.12396

Donna Steinbacher, Brian Murray, Thomas Devlin, Shannon S Carson, H James Ford

引用次数: 0

Assessing quality of life in pulmonary arterial hypertension: An independent prognostic marker. 评估肺动脉高压患者的生活质量：一个独立的预后指标

IF 2.6 4区医学

Pulmonary Circulation Pub Date : 2024-06-02 eCollection Date: 2024-04-01 DOI: 10.1002/pul2.12380

Glenn Edward Malcolm Reeves, Julie Shepherd, Nicholas John Collins, Scott Twaddell, Rajinder Harjit Singh

{"title":"Assessing quality of life in pulmonary arterial hypertension: An independent prognostic marker.","authors":"Glenn Edward Malcolm Reeves, Julie Shepherd, Nicholas John Collins, Scott Twaddell, Rajinder Harjit Singh","doi":"10.1002/pul2.12380","DOIUrl":"10.1002/pul2.12380","url":null,"abstract":"Pulmonary arterial hypertension (PAH, or PH Group 1), a disease of aberrant pulmonary vascular remodeling, causing progressive right heart failure (RHF) due to elevation of pulmonary vascular resistance (PVR). Patient mortality risk stratification guides choice and intensity of pharmacological intervention and is assessed by haemodynamics (especially PVR) as well as noninvasive tools including WHO functional class (FC), 6-min walk distance (6MWD), and NT-proBNP levels. Quality of life (QOL) assessment is acknowledged as a central aspect of patient-centered care, but our study sought to extend QOL's role as an additional noninvasive risk marker that could further refine risk stratification and hence therapeutic choices within a \"treatment to target\" paradigm (aiming to achieve low-risk status). This study found that QOL assessment using the PAH-SYMPACT© physical activity tool provided enhanced, independent mortality risk information, with one unit rise in this score associated with a 41% increase in likelihood risk (odds ratio 1.41, 95% confidence interval: 1.01-1.98 (p < 0.05)) of falling within intermediate versus low-group category. We therefore found further support for additional prognostic value being conferred by measurement of QOL as part of routine PAH evaluation, reinforcing its critical role.","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"14 2","pages":"e12380"},"PeriodicalIF":2.6,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11144421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

John Newman, M.D. remembered. 约翰-纽曼，医学博士。

IF 2.6 4区医学

Pulmonary Circulation Pub Date : 2024-05-27 eCollection Date: 2024-04-01 DOI: 10.1002/pul2.12389

C Gregory Elliott

引用次数: 0

Diagnosis and management of chronic thromboembolic pulmonary hypertension (CTEPH) in sickle cell disease: A review. 镰状细胞病慢性血栓栓塞性肺动脉高压（CTEPH）的诊断和管理：综述。

IF 2.6 4区医学

Pulmonary Circulation Pub Date : 2024-05-27 eCollection Date: 2024-04-01 DOI: 10.1002/pul2.12362

Kadija Hersi, Gautam V Ramani, Jennie Y Law, Ahmed S Sadek, Anjali Vaidya, Mark T Gladwin, Steven J Cassady

引用次数: 0

Identifying consistent echocardiographic thresholds for risk stratification in pulmonary arterial hypertension. 确定肺动脉高压风险分层的一致超声心动图阈值。

IF 2.2 4区医学

Pulmonary Circulation Pub Date : 2024-05-24 eCollection Date: 2024-04-01 DOI: 10.1002/pul2.12361

Bettia E Celestin, Shadi P Bagherzadeh, Kenzo Ichimura, Everton J Santana, Pablo Amador Sanchez, Tobore Tobore, Anna R Hemnes, Anton Vonk Noordegraaf, Michael Salerno, Roham T Zamanian, Andrew J Sweatt, Francois Haddad

{"title":"Identifying consistent echocardiographic thresholds for risk stratification in pulmonary arterial hypertension.","authors":"Bettia E Celestin, Shadi P Bagherzadeh, Kenzo Ichimura, Everton J Santana, Pablo Amador Sanchez, Tobore Tobore, Anna R Hemnes, Anton Vonk Noordegraaf, Michael Salerno, Roham T Zamanian, Andrew J Sweatt, Francois Haddad","doi":"10.1002/pul2.12361","DOIUrl":"10.1002/pul2.12361","url":null,"abstract":"Several indices of right heart remodeling and function have been associated with survival in pulmonary arterial hypertension (PAH). Outcome analysis and physiological relationships between variables may help develop a consistent grading system. Patients with Group 1 PAH followed at Stanford Hospital who underwent right heart catheterization and echocardiography within 2 weeks were considered for inclusion. Echocardiographic variables included tricuspid annular plane systolic excursion (TAPSE), right ventricular (RV) fractional area change (RVFAC), free wall strain (RVFWS), RV dimensions, and right atrial volumes. The main outcome consisted of death or lung transplantation at 5 years. Mathematical relationships between variables were determined using weighted linear regression and severity thresholds for were calibrated to a 20% 1-year mortality risk. PAH patients (n = 223) had mean (SD) age of 48.1 (14.1) years, most were female (78%), with a mean pulmonary arterial pressure of 51.6 (13.8) mmHg and pulmonary vascular resistance index of 22.5(6.3) WU/m2. Measures of right heart size and function were strongly related to each other particularly RVFWS and RVFAC (R 2 = 0.82, p < 0.001), whereas the relationship between TAPSE and RVFWS was weaker (R 2 = 0.28, p < 0.001). Death or lung transplantation at 5 years occurred in 78 patients (35%). Guided by outcome analysis, we ascertained a uniform set of parameter thresholds for grading the severity of right heart adaptation in PAH. Using these quantitative thresholds, we, then, validated the recently reported REVEAL-echo score (AUC 0.68, p < 0.001). This study proposes a consistent echocardiographic grading system for right heart adaptation in PAH guided by outcome analysis.","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"14 2","pages":"e12361"},"PeriodicalIF":2.2,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11116946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Left main coronary artery compression in precapillary pulmonary hypertension. 毛细血管前肺动脉高压的左冠状动脉主干受压。

IF 2.6 4区医学

Pulmonary Circulation Pub Date : 2024-05-22 eCollection Date: 2024-04-01 DOI: 10.1002/pul2.12391

Ruxandra Badea, Roxana Enache, Lucian M Predescu, Pavel Platon, Nicu Catana, Dan Deleanu, Andrei George Iosifescu, Noela Radu, Teodora Radu, Georgiana Olaru-Lego, Ioan M Coman, Bogdan A Popescu

{"title":"Left main coronary artery compression in precapillary pulmonary hypertension.","authors":"Ruxandra Badea, Roxana Enache, Lucian M Predescu, Pavel Platon, Nicu Catana, Dan Deleanu, Andrei George Iosifescu, Noela Radu, Teodora Radu, Georgiana Olaru-Lego, Ioan M Coman, Bogdan A Popescu","doi":"10.1002/pul2.12391","DOIUrl":"10.1002/pul2.12391","url":null,"abstract":"Pulmonary hypertension (PH) is a progressive and invalidating condition despite available therapy. Addressing complications such as left main coronary artery compression (LMCo) due to the dilated pulmonary artery (PA) may improve symptoms and survival. Nevertheless, clear recommendations are lacking. The aim of this study is to analyze the prevalence, characteristics, predictive factors and impact of LMCo in a heterogenous precapillary PH population in a single referral center. Two hundred sixty-five adults with various etiologies of precapillary PH at catheterization were reviewed. Coronary angiography (CA) was performed for LMCo suspicion. Revascularization was performed in selected cases. Outcomes were assessed at a mean follow-up of 3.9 years. LMCo was suspected in 125 patients and confirmed in 39 (31.2%), of whom 21 (16.8%) had 50%-90% stenoses. Nine revascularizations were performed, with clinical improvement. The only periprocedural complication was a stent migration. LMCo was associated with PH etiology (p 0.003), occuring more frequently in congenital heart disease-associated PH (61.5% of all LMCo cases, 66.6% of LMCo ≥ 50%). Predictors of LMCo ≥50% were PA ≥ 37.5 mm (Sn 81%, Sp 74%) and PA-to-aorta ≥1.24 (Sn 81%, Sp 69%), with increased discrimination when considering RV end-diastolic area. LMCo ≥ 50% without revascularization presented clinical deterioration and worse survival (p 0.019). This analysis of a heterogeneous pre-capillary PH population provides LMCo prevalence estimation, predictive factors (PA size, PA-to-aorta, RV end-diastolic area and PH etiology) and long-term impact. While LMCo impact on survival is inconclusive, untreated LMCo ≥ 50% has worse prognosis. LMCo revascularization may be performed safely and with good outcomes.","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"14 2","pages":"e12391"},"PeriodicalIF":2.6,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11112051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Therapeutic effects of treat and repair strategy in pediatric patients with pulmonary arterial hypertension and simple congenital heart defects. 治疗和修复策略对肺动脉高压和简单先天性心脏缺损儿科患者的治疗效果。

IF 2.6 4区医学

Pulmonary Circulation Pub Date : 2024-05-15 eCollection Date: 2024-04-01 DOI: 10.1002/pul2.12387

Xiaofeng Wang, Shilin Wang, Zhongyuan Lu, Wenlong Wang, Xu Wang

{"title":"Therapeutic effects of treat and repair strategy in pediatric patients with pulmonary arterial hypertension and simple congenital heart defects.","authors":"Xiaofeng Wang, Shilin Wang, Zhongyuan Lu, Wenlong Wang, Xu Wang","doi":"10.1002/pul2.12387","DOIUrl":"10.1002/pul2.12387","url":null,"abstract":"Surgical indications for patients with pulmonary arterial hypertension (PAH) and congenital heart defects are controversial. The treat and repair strategy has demonstrated efficacy in adult populations, but there have been no studies on pediatric patients. This study included pediatric patients with PAH and simple congenital heart defects who underwent corrective repair between 2012 and 2021. According to the preoperative treatment strategies, the patients were divided into a regular strategy group (Group 1) and a treat-and-repair strategy group (Group 2). Postoperative recovery and follow-up results were compared between the two groups. A total of 33 patients were included in this study. Group 1 consisted of 19 patients, whereas Group 2 consisted of 14 patients. The pulmonary vascular resistance index in Group 2 was higher than that in Group 1 (10.9 ± 4.1 vs. 8.2 ± 1.6 WU, p = 0.031). There were no differences in postoperative recovery between the two groups (p > 0.05). During follow-up, five patients were lost (three in Group 1 and two in Group 2). The median follow-up period was 59 months. One patient died in Group 1, and two patients died in Group 2. There was no significant difference in the survival curve (p = 0.39). At the last follow-up, another seven patients had experienced a non-low-risk condition, with a total of three non-low-risk patients in Group 1 and seven in Group 2, including one patient in each group who had a history of ICU admission. According to the ROC curve, a preoperative PVRi <8.2 WU×m2 can predict postoperative persistent low-risk state, PVRi <5.2 WU×m2 can avoid postoperative death and/or ICU administration. In pediatric patients with PAH and simple congenital heart defects, the treat and repair strategies may provide surgery opportunities, PVRi should be <8 WU×m2, and <5.2 WU×m2 is the best choice.","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"14 2","pages":"e12387"},"PeriodicalIF":2.6,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11095199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Exploratory and confirmatory factor analysis of emPHasis-10: The health-related quality-of-life measure in pulmonary hypertension. emPHasis-10：肺动脉高压患者健康相关生活质量测量的探索性和确认性因子分析。

IF 2.6 4区医学

Pulmonary Circulation Pub Date : 2024-05-12 eCollection Date: 2024-04-01 DOI: 10.1002/pul2.12378

Gregg H Rawlings, Chris Gaskell, Nigel Beail, Andrew Thompson, Iain Armstrong

{"title":"Exploratory and confirmatory factor analysis of emPHasis-10: The health-related quality-of-life measure in pulmonary hypertension.","authors":"Gregg H Rawlings, Chris Gaskell, Nigel Beail, Andrew Thompson, Iain Armstrong","doi":"10.1002/pul2.12378","DOIUrl":"10.1002/pul2.12378","url":null,"abstract":"The emPHasis-10 is a health-related quality of life (HRQoL) unidimensional measure developed specifically for adults with pulmonary hypertension. The tool has excellent psychometric properties and is well used in research and clinical settings. Its factor structure has not been examined, which may help to identity a complimentary approach to using the measure to examine patient functioning. We performed an exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) on a data set collected from 263 adults with PH recruited from a community setting. The EFA suggested the emPHasis-10 consists of three underlying latent variables, which based on the loading of items, were termed \"fatigue\" (Items 3, 4, and 5), \"independence\" (Items 7, 8, 9, and 10), and \"breathlessness\" (Items 1, 2, and 6). All factors were found to have good internal consistency. \"Independence\" accounted for most of the variance (29%), followed by \"breathlessness\" (22%) and \"fatigue\" (19%). The CFA looked to confirm the fit of a three-factor model. A higher-order model was found to be the best fit consisting of HRQoL as a superordinate factor, for which the association between this factor and the 10 items was mediated through the three latent factors. Further analyses were performed testing the validity of the latent variables revealing all were significantly correlated with self-reported measures of depression, anxiety, health-anxiety, and dyspnea. Our analyses support the emPHasis-10 as a measure of HRQoL, while also proposing the clinical utility of examining the three emergent factors, which could be used to glean additional insight into the respondent's functioning and inform care.","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"14 2","pages":"e12378"},"PeriodicalIF":2.6,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11088805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The effects of oxygenation on acute vasodilator challenge in pulmonary arterial hypertension. 吸氧对肺动脉高压急性血管扩张挑战的影响。

IF 2.6 4区医学

Pulmonary Circulation Pub Date : 2024-05-12 eCollection Date: 2024-04-01 DOI: 10.1002/pul2.12375

Matthew D Rockstrom, Ying Jin, Ryan A Peterson, Peter Hountras, David Badesch, Sue Gu, Bryan Park, John Messenger, Lindsay M Forbes, William K Cornwell, Todd M Bull

{"title":"The effects of oxygenation on acute vasodilator challenge in pulmonary arterial hypertension.","authors":"Matthew D Rockstrom, Ying Jin, Ryan A Peterson, Peter Hountras, David Badesch, Sue Gu, Bryan Park, John Messenger, Lindsay M Forbes, William K Cornwell, Todd M Bull","doi":"10.1002/pul2.12375","DOIUrl":"10.1002/pul2.12375","url":null,"abstract":"Identification of long-term calcium channel blocker (CCB) responders with acute vasodilator challenge is critical in the evaluation of patients with pulmonary arterial hypertension. Currently there is no standardized approach for use of supplemental oxygen during acute vasodilator challenge. In this retrospective analysis of patients identified as acute vasoresponders, treated with CCBs, all patients had hemodynamic measurements in three steps: (1) at baseline; (2) with 100% fractional inspired oxygen; and (3) with 100% fractional inspired oxygen plus inhaled nitric oxide (iNO). Those meeting the definition of acute vasoresponsiveness only after first normalizing for the effects of oxygen in step 2 were labeled \"iNO Responders.\" Those who met the definition of acute vasoresponsiveness from a combination of the effects of 100% FiO2 and iNO were labeled \"oxygen responders.\" Survival, hospitalization for decompensated right heart failure, duration of CCB monotherapy, and functional data were collected. iNO responders, when compared to oxygen responders, had superior survival (100% vs. 50.1% 5-year survival, respectively), fewer hospitalizations for acute decompensated right heart failure (0% vs. 30.4% at 1 year, respectively), longer duration of CCB monotherapy (80% vs. 52% at 1 year, respectively), and superior 6-min walk distance. Current guidelines for acute vasodilator testing do not standardize oxygen coadministration with iNO. This study demonstrates that adjusting for the effects of supplemental oxygen before assessing for acute vasoresponsiveness identifies a cohort with superior functional status, tolerance of CCB monotherapy, and survival while on long-term CCB therapy.","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"14 2","pages":"e12375"},"PeriodicalIF":2.6,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11088807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nationwide trends of balloon pulmonary angioplasty and pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension (2012-2019). 球囊肺血管成形术和肺血栓内膜切除术治疗慢性血栓栓塞性肺动脉高压的全国趋势（2012-2019 年）。

IF 2.6 4区医学

Pulmonary Circulation Pub Date : 2024-05-09 eCollection Date: 2024-04-01 DOI: 10.1002/pul2.12374

Adam S Vohra, Danielle A Olonoff, Ada Ip, Ajay J Kirtane, Zachary Steinberg, Evelyn Horn, Udhay Krishnan, Mark Reisman, Geoffrey Bergman, Shing-Chiu Wong, Dmitriy N Feldman, Luke K Kim, Harsimran S Singh

{"title":"Nationwide trends of balloon pulmonary angioplasty and pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension (2012-2019).","authors":"Adam S Vohra, Danielle A Olonoff, Ada Ip, Ajay J Kirtane, Zachary Steinberg, Evelyn Horn, Udhay Krishnan, Mark Reisman, Geoffrey Bergman, Shing-Chiu Wong, Dmitriy N Feldman, Luke K Kim, Harsimran S Singh","doi":"10.1002/pul2.12374","DOIUrl":"10.1002/pul2.12374","url":null,"abstract":"Chronic thromboembolic pulmonary hypertension (CTEPH) is a sequela of a pulmonary embolus that occurs in approximately 1%-3% of patients. Pulmonary thromboendoarterectomy (PTE) can be a curative procedure, but balloon pulmonary angioplasty (BPA) has emerged as an option for poor surgical candidates. We used the National Inpatient Sample to query patients who underwent PTE or BPA between 2012 and 2019 with CTEPH. The primary outcome was a composite of in-hospital mortality, myocardial infarction, stroke, tracheostomy, and prolonged mechanical ventilation. Outcomes were compared between low- and high-volume centers, defined as 5 and 10 procedures per year for BPA and PTE, respectively. During our study period, 870 BPA and 2395 PTE were performed. There was a 328% relative increase in the number of PTE performed during the study period. Adverse events for BPA were rare. There was an increase in the primary composite outcome for low-volume centers compared to high-volume centers for PTE (24.4% vs. 12.1%, p = 0.003). Patients with hospitalizations for PTE in low-volume centers were more likely to have prolonged mechanical ventilation (20.0%% vs. 7.2%, p < 0.001) and tracheostomy (7.8% vs. 2.6%, p = 0.017). In summary, PTE rates have been rising over the past 10 years, while BPA rates have remained stable. While adverse outcomes are rare for BPA, patients with hospitalizations at low-volume centers for PTE were more likely to have adverse outcomes. For patients undergoing treatment of CTEPH with BPA or PTE, referral to high-volume centers with multidisciplinary teams should be encouraged for optimal outcomes.","PeriodicalId":20927,"journal":{"name":"Pulmonary Circulation","volume":"14 2","pages":"e12374"},"PeriodicalIF":2.6,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11082429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0