Pulmonary Hypertension - Wiley Online Library

Transgelin exacerbates pulmonary artery smooth muscle cell dysfunction in shunt‐related pulmonary arterial hypertension

Aims Orchestrating The change from reversible medial hypertrophy to irreversible plexiform lesions is vital for pulmonary arterial hypertension related to congenital heart disease. Transgelin is an actinu2010binding protein that modulates pulmonary arterial smooth muscle cell dysfunction. Methods and findings Transgelin expression was detected in lung tissues from both CHD and monocrotaline u2010induced PAH rats by immunohistochemistry, as well as immunohistochemistry in u2010+ PAH rats. TGFu2010/u203b21 and transgelin was discovered in CHDu2010PAH patients and MCTu2010AVu2010induced PAH rats, which was later reported at sub-u2010cellular levels. Conclusions These results show that transgelin may be an early warning of CHDu2010PAH progression by improving HPASMC dysfunction by positive regulation of the TGFu2021 signaling pathway, as well as a potential therapeutic target for CHDu2010PAH therapy.

Source link: https://onlinelibrary.wiley.com/doi/10.1002/ehf2.14080

Utility of Cardiac MRI Feature Tracking Strain Assessment in Chronic Thromboembolic Pulmonary Hypertension for Prediction of REVEAL 2.0 High Risk Status

Chronic thromboembolic pulmonary hypertension can be alleviated by pulmonary endarterectomy. The primary Thromboembolic disease pathology/PEA achievement largely determines prognosis, but risk scoring criteria may be flexible, as shown by Thromboembolic disease epidemiology/PEA results. Hearterial and ventriculo-u2010atrial coupling can be assessed by cardiac MRI data deformation/strain analysis. Following PEA, we characterized biventricular and biventricular CMR stress strain parameters, as well as tested the ability of CMR FT to determine REVEAL 2. 0 high risk status. Risk scores were established based on Pulmonary arterial hypertension. With LVEDVi and LAVi increments, PEA augmented left heart filling with LVEDVi and LAVi increments. LVEF was unchanged post-u201 medically, but LV GLS rose. With the reduction of RV mass, RV geometry and functionality were also improved. Post-u2010-operatively, there were 6 REVEAL 2. 0 high risk patients, mainly due to an impaired RA strain that was superior to traditional volumetric parameters. The more difficult REVEAL 2. 0 score's more laborious; a CMR deformation/strain analysis can provide insight into coupling recovery; a RA strain can be a quick substitute for the more laborious REVEAL 2. 0 score.

Source link: https://onlinelibrary.wiley.com/doi/10.1002/pul2.12116

Prevalence of potential drug‐drug interactions with disease specific treatments in patients with pulmonary arterial hypertension or chronic thromboembolic pulmonary hypertension – a registry study

Polypharmacy raises the risk of drug-u2010drug interactions that may cause treatment effects to be offended. In the Swedish pulmonary arterial hypertension and chronic thromboembolic hypertension population, the aim of this research was to determine the prevalence of co-u2010dispensing of potentially interfering or contraindicated drugs related to PH-specific therapy. The Drug Interaction tool in IBM's Micromedexu00ae database was used to investigate potential drugu2010drug interactions. Bosentan had the most potential drug-u2010drug interactions, according to a u2010dispensed, potentially interacting drug combination, sildenafil/furosemide was the most common pharmacokinetic drug mixture.

Source link: https://onlinelibrary.wiley.com/doi/10.1002/pul2.12114

Direct oral anticoagulants in patients with chronic thromboembolic pulmonary hypertension and the presence of recent thrombus during pulmonary endarterectomy

Of 405 PEA patients, 166 patients were anticoagulated with one of three known DOACs, two investigators blinded to patient data; 239 were treated with either oral vitamin u2010K antagonist or chronic injectable therapy. Patients on traditional, non-u2010DOAC anticoagulant therapies were twice as likely to have acute or subacute thrombus as well as evidence of recent thrombus after adjusting for age, gender, race, BMI, and history of antiphospholipid antibody syndrome.

Source link: https://onlinelibrary.wiley.com/doi/10.1002/pul2.12110

Social Determinants of Health in Pulmonary Arterial Hypertension Patients in the United States: Clinician Perspective and Health Policy Implications

Particularly during the COVID pandemic, the vulnerable pulmonary arterial hypertension population can be affected by socioeconomic determinants of health. At 17 pulmonary hypertension centers and one patient advocate for the Pulmonary Hypertension Association, we conducted semi-structured virtual interviews with U. S. physicians at 17 pulmonary hypertension centers and one patient advocate for the Pulmonary Hypertension Association. Participants from a large PAH population with a high incidence of SDoH and its effects on treatment and outcomes. Although telemedicine assisted physicians in monitoring patients remotely during the pandemic, there was a fear among patients with poor access to this drug. Participants found that with the recognition and the eagerness to act on health inequities associated with SDoH, they felt that it was vital for their centers to have a dedicated PH social worker and support staff to ensure optimal care and results. An approach that integrates SDoH in PAH care administration, which has been simplified through institutional policy, may help eliminate health inequalities that result in improved healthcare access, care quality, and care quality.

Source link: https://onlinelibrary.wiley.com/doi/10.1002/pul2.12111

Synemin promotes pulmonary artery smooth muscle cell phenotypic switch in shunt‐induced pulmonary arterial hypertension

Although significant strides have been made in the diagnosis and treatment of congenital heart disease and pulmonary hypertension in U2010, the patient's CHD -U20PAH patients' physical deterioration remain poor, according to the clinical prognosis and overall survival of patients with CHDu2010PAH. Using immunohistochemistry and western blot, we investigated SYN expression in the pulmonary arterioles of CHD 2010PAH patients and shunt induced PAH rat models. Cell counts and Transwell migration assays were used to determine the effect of SYN on human pulmonary smooth muscle cells' proliferation and migration capability. Such rats were then used to develop a shunt-induced PAH animal model to see how SYN plays a role in PAH and pulmonary vascular remodelling. SYN expression was found to be highly up—u2010 controlled in the newly developed pulmonary arterioles of CHDu2010PAH and shuntu2010induced PAH rats models, in contrast to the normal control group.

Source link: https://onlinelibrary.wiley.com/doi/10.1002/ehf2.14048

Pulmonary Hypertension in Remote and Disadvantaged Population: Overcoming Unique Challenges for Improved Outcomes

Pulmonary Hypertension is a common and debilitating medical disorder with elevated mortality. Pulmonary Arterial Hypertension and its administration in expert PH centers has traditionally concentrated on Pulmonary Arterial Hypertension and its management. Other forms of PH, such as heart or respiratory disease, are more common, less well-known, and correlated with higher mortality. PH in impoverished, rural, and rural areas remains largely undocumented. Using the Top End region of Australia's Northern Territory of Australia as an example in this report, we explore the particulars of identifying PH in rural and homeless populations.

Source link: https://onlinelibrary.wiley.com/doi/10.1111/imj.15860

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