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Right ventricular mass/volume in PAH: A double edged sword? PAH的右心室质量/容积:双刃剑?

Right ventricle Pub Date : 2018-09-15 DOI: 10.1183/13993003.CONGRESS-2018.OA1633

R. Vanderpool, K. Wickstrom, A. Desai, S. Airhart, R. Avery, R. Naeije, F. Rischard

{"title":"Right ventricular mass/volume in PAH: A double edged sword?","authors":"R. Vanderpool, K. Wickstrom, A. Desai, S. Airhart, R. Avery, R. Naeije, F. Rischard","doi":"10.1183/13993003.CONGRESS-2018.OA1633","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.OA1633","url":null,"abstract":"A high right ventricular (RV) mass-to-volume (M/V) ratio is used as a measure of the structural adaptation in pulmonary arterial hypertension. However, low M/V ratio can indicate either a normal or dilated RV. The aim of the study was to investigate the association between RV structure (M/V) and RV function (RVCR) in PAH patients utilizing serial measurements on PAH therapy. Prospectively followed Group I PAH patients (N = 38) underwent catheterization and cardiac MRI after 3 months (3mo) of parenteral treprostinil and again on combination therapy (COMB). A subset of patients underwent exercise catheterization (3mo: n = 27 and COMB: n = 24). RVCR was defined as the difference between exercise peak cardiac index (CI) and resting CI. Analysis were stratified by median M/V and resting systolic PAP (sPAP) at 3 mo. On 3mo of therapy, RV mass, end-diastolic volume, and M/V did not significantly associate with sPAP(Figure 1A). RVCR was higher in the low M/V (1.0±0.2) versus high M/V groups (0.6±0.2, p=0.03). After 332 (98-1260) days of follow-up on COMB, M/V did not change (p = 0.9) but RVCR increased from 0.8±0.6 to 1.2±0.6 (p=0.05) and sPAP dropped (74±16 to 66±15, p The heterogenous association between M/V and afterload in this PAH population suggests that the improvement in RVCR with combination therapy is not due to high M/V of the RV.","PeriodicalId":21522,"journal":{"name":"Right ventricle","volume":"151 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77764549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Allopurinol reduces RV mass in patients with severe COPD 别嘌呤醇可减少严重COPD患者的右心室质量

Right ventricle Pub Date : 2018-09-15 DOI: 10.1183/13993003.CONGRESS-2018.OA1635

P. L. Cheong, B. Lipworth, J. Weir-McCall, A. Struthers

{"title":"Allopurinol reduces RV mass in patients with severe COPD","authors":"P. L. Cheong, B. Lipworth, J. Weir-McCall, A. Struthers","doi":"10.1183/13993003.CONGRESS-2018.OA1635","DOIUrl":"https://doi.org/10.1183/13993003.CONGRESS-2018.OA1635","url":null,"abstract":"Background: Oxidative stress has been implicated in the development of pulmonary hypertension (PH) and right ventricular (RV) hypertrophy. It is well established that xanthine oxidoreductase can act as source of reactive oxygen species, which lead to oxidative stress. Aim: The aim of this proof of concept study was to assess whether allopurinol (xanthine oxidase inhibitor) regressed right ventricular mass (RVM) in patients with PH associated with chronic lung disease (PH-CLD). Methods: We conducted a randomised, double-blind, parallel-group, placebo-controlled trial. Patients with PH-CLD (93% COPD, 7% IPF) were randomly assigned to receive allopurinol or placebo for 12 months. The primary outcome measure was the mean change in RVM, as assessed by cardiac MRI. We also measured change in SGRQ, SF-36 and 6MWT. Results: 71 patients were recruited: mean age 71 years, mean PAP 30 mm Hg, FEV1 60% and resting SpO2 96%. After 12 months, we recorded no change in RVM (allopurinol 1.85 g vs placebo 0.97 g; mean diff 0.88, CI -4.77 to 3.01, p = 0.7). There were also no significant changes in other parameters measured on MRI for RV or LV, in QOL, spirometry and 6MWT. Subgroup analysis showed that allopurinol reduced RV mass (allopurinol -6.16 g vs placebo 0.75 g; mean diff 6.92, CI 1.14 to 12.69, p = 0.02) in 20 COPD patients with more severe airflow limitation. Patients (n= 31) with higher NTProBNP (> 489 pg/ml) had a greater improvement in LVEF with allopurinol 5.12 vs placebo -1.62 (mean diff 7.33, CI 1.88 to 12.78, p = 0.02). Conclusions: Allopurinol had no overall impact but reduced RV mass in COPD patients with more severe airflow limitation. Further studies are warranted to assess the longer term impact of allopurinol in more severe COPD.","PeriodicalId":21522,"journal":{"name":"Right ventricle","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83938345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

The right ventricle function in highlanders with sleep-related respiratory disturbances 高原人与睡眠有关的呼吸障碍的右心室功能

Right ventricle Pub Date : 2018-09-15 DOI: 10.1183/13993003.CONGRESS-2018.OA1636

Kubatbek Muratali Uulu, M. Cholponbaeva, Samat A Satybaldiev, Nursultan Baktybek, Aidana Toktosunova, A. Maripov, A. Sarybaev

引用次数: 1

Effects of urocortin-2 on cellular Ca2+ homeostasis in right heart failure induced by pulmonary artery hypertension 尿皮质素-2对肺动脉高压右心衰患者细胞Ca2+稳态的影响

Right ventricle Pub Date : 2018-09-15 DOI: 10.1183/13993003.CONGRESS-2018.OA1634

R. Adão, S. Kraler, S. Holzer, A. Leite-Moreira, S. Sedej, C. Brás-Silva

引用次数: 1