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Pulmonary Arterial Hypertension - Crossref

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Last Updated: 08 August 2022

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A Review of Sildenafil in the Treatment of Pediatric Pulmonary Arterial Hypertension

This is a review article that explores the role of sildenafil in pediatric pulmonary hypertension. Pediatric pulmonary hypertension causes etiopathogenesis and prognosis for pediatric pulmonary hypertension. The basic tenets of targeted PH management are also similar. Large double blinded and controlled trials looking at sildenafil's effects in pediatric PH are not available.

Source link: https://doi.org/10.4137/cmt.s1959


Wave Intensity Analysis Provides Novel Insights Into Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension

We hypothesized that arterial wave energy and wave reflection are boosted in PH, and that wave activity in PH and chronic thromboembolic hypertension differs between patients with pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. In PAH patients than CTEPH patients and controls, the ratio of wave power to mean right ventricular power was lower than in CTEPH patients and controls. Although wave speed was strongly related to disease progression, wave reflection indexes of patients with mildly and significantly elevated pulmonary pressures were similar. Conclusions: The pulmonary artery artery's rise in PH and was unrelated to severity, suggesting that vascular impedance mismatch occurs early in the development of pulmonary vascular disease. In comparison to CTEPH, the lower wave power fraction in PAH compared to CTEPH reveals differences in the intrinsic and/or extrinsic ventricular load between the two diseases.

Source link: https://doi.org/10.1161/jaha.117.006679


Prognostic Value of Follow-Up Hemodynamic Variables After Initial Management in Pulmonary Arterial Hypertension

Background: Hemodynamic factors such as cardiac index and right atrial pressure have been consistently linked to pulmonary arterial hypertension at the time of diagnosis. Recent research has shown that pulmonary arterial hygiene may also predict prognosis in PAH. We reviewed incident patients with idiopathic, drug- and toxin-induced, or heritable PAH who were enrolled in the French pulmonary hypertension registry between 2006 and 2016, which included a follow-up right-sided heart catheterization. Results: A primary outcome in 981 patients over a median follow-up duration of 2. 8 years was observed in 331 patients. Patients at baseline or during follow-up did not correctly predict outcomes at baseline or during follow-up. SVI's adjusted hazard ratio was 1. 28 per 10-mL/m2 decrease and right atrial pressure was 1. 05 per 1 million Hg increase. Patients with reduced incidence of death or lung transplantation were still associated with increased risks of death or lung transplantation among patients with 2 or three low-risk prognostic measures at a follow-up, including a heart index u2252121, 6-minute walk distance > 440 meters, and the New York Heart Association class I or II functional class. Conclusions: SVI and right atrial pressure were the hemodynamic variables that were not directly related to death or lung transplantation at the first follow-up RHC after initial PAH treatment. These results show that the SVI may be a more suitable treatment target than the cardiac index in PAH.

Source link: https://doi.org/10.1161/circulationaha.117.029254


The Paradox of Pulmonary Vascular Resistance: Restoration of Pulmonary Capillary Recruitment as a Sine Qua Non for True Therapeutic Success in Pulmonary Arterial Hypertension

Exercise-induced rises in pulmonary blood flow are expected to raise pulmonary arterial pressure only modestly, mainly due to a reserve of pulmonary capillaries that are only available for recruitment to carry the flow. In treating pulmonary arterial hypertension patients, pulmonary arterial pressure remains elevated and may even rise more. Current pulmonary arterial hypertension drugs, which act primarily as vasodilators, reduce estimated pulmonary risk by increasing pulmonary blood flow, but have no effect in lowering pulmonary arterial pressure and do not restore significant capillary recruitment.

Source link: https://doi.org/10.3390/jcm11154568


The association between non-clinically apparent liver fibrosis and pulmonary arterial hypertension in Hispanic patients

It is also unknown about the medical consequences of NAFLD in Hispanic PAH patients. The goal of this research was to investigate the effect of a validated scoring system, non-alcoholic fatty liver disease fibrosis score, on liver fibrosis in a Hispanic PAH population and its correlation to hemodynamics, functional class, and outcomes. Methods: All therapy nau00efve Hispanic patients with group I WHO pulmonary hypertension at a joint academic center between February 2016 and March 2021 was administered at a single academic center between February 2016 and March 2021. The median age of patients in our study was 49 and 69% of our cohort, with 49 and 69% being females. NFS scores in Hispanic patients with PAH correlate with the degree of right-sided pressure overload. In addition, advanced fibrosis scores were independently associated with lower 5-year survival rates and added prognostic data to other commonly used risk factors in PAH.

Source link: https://doi.org/10.21203/rs.3.rs-1842484/v1


Compromised Cerebrovascular Regulation and Cerebral Oxygenation in Pulmonary Arterial Hypertension

We'll investigate whether pulmonary arterial hypertension is related to abnormal cerebrovascular control and lower cerebral oxygen saturation, as well as their physiological and clinical implications. Patients were characterized by a significant decrease in resting MCA vs mean P 0. 1 and greater transfer function gain at rest and during squat u2010stand maneuvers both P 0. 05. P = 0. 05 and the exercise ventilation/CO 2 slope V 0. 05; P 0. 05 during exercise for patients; P 0. 05; P 0. 05; P 0. 05; P 0. 05; P 0. 05; and the exercise ventilation/CO 2 slope V / V / V t02de d 9 slope V / 0. 06; P 0. 05; P 0. 05; P 0. 05; P & a /P /CO 2 slope V /V / V /V a d9 /P 0. 05; 0. 05 Both P 0. 05 vs. 0. 05, the former related to decreased cerebral oxygen delivery and oxygenation in patients with PAH R 2 =0. 52; P =0. 01.

Source link: https://doi.org/10.1161/jaha.117.006126


Pulmonary Arterial Hypertension

Long-term pulmonary hypertension in patients with obstructive sleep apnea and putative pathophysiologic links has been extensively documented. Chronic hypoxia, repetitive hypoxia, and left-sided heart disease, among other comorbidities, include chronic obstructive pulmonary disease and left-sided heart dysfunction, all play a role in contributing to pulmonary hypertension in patients with OSA. Patients with established pulmonary hypertension are highly affected by sleep disordered breathing, including OSA.

Source link: https://doi.org/10.1093/med/9780190671099.003.0052


Risk assessment and treatment goals in patients presenting with pulmonary arterial hypertension

A multidimensional strategy for patients with pulmonary arterial hypertension is based on a multidimensional model that incorporates clinical characteristics, World Health Organization functional class, endurance, biomarkers, and analysis of right ventricular function by imaging and/or invasive measurements. The initial treatment plan is based on risk assessment at the time of diagnosis, while risk assessment during follow-up is conducted to determine disease progression and the need for treatment reforms. Patients with pulmonary arterial hypertension are undergoing treatment with a big goal in their care. Obtaining and retaining a low-risk status is a key aim in the treatment of patients with pulmonary arterial hypertension.

Source link: https://doi.org/10.1093/med/9780198784906.003.0603_update_001


Pulmonary arterial hypertension associated with congenital heart diseases

If pulmonary vascular resistance is normal or near-normal, patients with PAH-CHD and left-to-right shunting may benefit from late defect closure. Patients with PAH-CHD and coincidental anomaly, as well as patients with CHD with previous CHD repair should be treated as patients with idiopathic PAH. All patients with PAH-CHD should be treated at medical centers, and those with Eisenmenger syndrome may benefit from a proactive disease-targeting therapy approach.

Source link: https://doi.org/10.1093/med/9780198784906.003.0594_update_001


Heritable pulmonary arterial hypertension

Patients with PAH who have a family history of the disease or have a mutation in a gene that has been known to be associated with PAH are diagnosed with hereditable pulmonary arterial hypertension (HERITable pulmonary arterial hypertension). The most common genetic abnormalities seen in heritable PAH are Heterozygous mutations in the gene encoding the bone morphogenetic protein receptor type 2 protein.

Source link: https://doi.org/10.1093/med/9780198784906.003.0590

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions