Hemodynamic indices in pulmonary hypertension: a narrative review

Manek, Gaurav; Gupta, Manasvi; Chhabria, Mamta; Bajaj, Divyansh; Agrawal, Ankit; Tonelli, Adriano R.

doi:10.21037/cdt-22-244

Cited by 4 publications

(4 citation statements)

References 130 publications

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“…Cardiac catheterization and hemodynamics were obtained under resting conditions with normal gas exchange (pH 7.35–7.45 and paCO 2 35–45 mmHg). Where possible, the following measurements were obtained: systolic, mean, and diastolic systemic arterial pressures; right-arterial pressure; right-ventricular systolic end-diastolic pressure; systolic, mean, and diastolic mean pulmonary arterial pressure (mPAP); pulmonary arterial wedge pressure (PAWP); left-atrial and left-ventricular end-diastolic pressure; transpulmonary gradients, simultaneous PAWP, and end-diastolic pressure; and cardiac index and pulmonary vascular resistance index via standardized formulas based on hemodynamic measurements ( 2 , 13 ). All patients, even those for whom devices were not successfully deployed, were included.…”

Section: Methodsmentioning

confidence: 99%

“…cardiac index and pulmonary vascular resistance index via standardized formulas based on hemodynamic measurements ( 2 , 13 ).…”

Section: Methodsmentioning

confidence: 99%

“…• transpulmonary gradients, simultaneous PAWP, and end-diastolic pressure; and • cardiac index and pulmonary vascular resistance index via standardized formulas based on hemodynamic measurements (2,13).…”

Section: Technical Details and Follow-upmentioning

confidence: 99%

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A North American, single-center experience implanting fenestrated atrial devices and atrial flow regulators into a heterogeneous group of pediatric pulmonary hypertension patients

et al. 2023

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IntroductionThe clinical deterioration commonly experienced by pediatric patients with pulmonary arterial hypertension (PAH) has motivated a shift in the treatment of pulmonary hypertension (PH) through innovations in surgical salvage interventions. The Occlutech fenestrated atrial septal defect (FASD) Occluder and the atrial flow regulator (AFR), which provides a protective, atrial-level shunt during hypertensive crises, have found an important role in treating pediatric patients with PAH. Other groups of pediatric patients with PH may also benefit from a similar protective physiology. The primary aim of this work is to present a single center's experience with AFR and FASD devices for managing a heterogeneous group of pediatric PH patients. A secondary goal is to identify hemodynamic changes and complications following device implantation.Materials and MethodsWe performed a retrospective review of all pediatric PH patients who, after being found suitable, either successfully or unsuccessfully received an FASD or AFR device between January 2015 and December 2021 at the Stollery Children's Hospital in Edmonton, Canada.ResultsFourteen patients (eight female) with a median age of 4.6 (range 0.3–17.9) years and a median body mass index of 15.1 (Q1 = 13.8, Q3 = 16.8) kg/m2 underwent device implantation: five received FASDs, eight received AFRs, and one was ultimately unable to receive an implant due to thrombosed iliac vessels and required surgical intervention. Of the fourteen patients, seven were in group 1 (PAH), one was in group 3 (lung disease), and six were in group 5 (primarily pulmonary hypertension vascular disease) under the World Symposium PH classification. All patients were on mono-, dual-, or triple-drug PH therapy. Device stabilization was not possible for two patients, who then required a repeat catheterization. Of the group 1 patients, three AFR and three FASD implants were successful, while one FASD implant was unsuccessful due to thrombosed vessels. At a six-month clinical assessment, all group 1 patients had patent devices and improved WHO FCs.ConclusionThis work presents a single center's experience with AFR and FASD implants in a heterogeneous group of fourteen pediatric patients with severe PH. This treatment strategy is novel in the pediatric population and so this work provides momentum for future studies of interventional cardiac catheterization procedures for pediatric patients with PH. Further collaborations are required to develop criteria to identify ideal pediatric candidates and optimally time interventions in order to maximize the benefits of this treatment.

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Section: Methodsmentioning

confidence: 99%

“…cardiac index and pulmonary vascular resistance index via standardized formulas based on hemodynamic measurements ( 2 , 13 ).…”

Section: Methodsmentioning

confidence: 99%

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A North American, single-center experience implanting fenestrated atrial devices and atrial flow regulators into a heterogeneous group of pediatric pulmonary hypertension patients

et al. 2023

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“…However, few studies have utilized clinical samples with definite diagnosis of PH, and researches for PH in COPD are even fewer. To the best of our knowledge, the present study is the first to profile circRNA expression of lung tissues from COPD patients with mean pulmonary artery pressure(mPAP)≥20 mmHg measured by right heart catheterization(RHC) [27] . 136 differentially expressed circRNAs were identified between the COPD-PH and control groups.…”

Section: W I T H D R a W N S E E M A N U S C R I P T D O I F O R D E ...mentioning

confidence: 99%

Expression profiles of circRNAs and identification of hsa_circ_0007608 and hsa_circ_0064656 as potential biomarkers for COPD-PH patients

HUANG

Shen

et al. 2023

Preprint

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Pulmonary hypertension(PH) is a common complication of chronic obstructive pulmonary disease(COPD) which can worsen the prognosis and increase the mortality of COPD patients. However, the underlying mechanisms of PH in COPD(COPD-PH) remain to be elucidated. This study is the first to explore the expression profile of circRNAs in human lung tissues with definite diagnosis of COPD-PH and validate the differentially expressed circRNAs(DECs) utilizing human serum, pulmonary arterial endothelial cells(HPAECs) and pulmonary arterial smooth muscle cells(HPASMCs). A total of 136 circRNAs(39 up-regulated and 97 down-regulated) were differentially expressed between the COPD-PH group and the control group. Following quantitative real-time polymerase chain reaction(qRT-PCR) validation, two circRNAs (hsa_circ_0007608 and hsa_circ_0064656) were believed to be involved in the pathogenesis. GO and KEGG pathway analysis suggested these two DECs were mainly related to the celluar proliferation, migration and EndoMT. PPI network revealed 11 pairs of key mRNAs. VCAM1, VCAN and THBS1, three hub mRNAs with the highest reliability among all, were validated and proven to be up-regulated in COPD-PH. We innovatively found that VCAN may be involved in COPD-PH. These identified genes show high potential to be diagnostic markers and therapeutic targets of COPD-PH, and may provide new insights into the underlying mechanisms of COPD-PH patients.

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Can Inhaled Nitric Oxide Response Predict Tolerance to Therapies and Survival in Patients With Combined Precapillary and Postcapillary Pulmonary Hypertension?

Krishtopaytis,

Ampnti,

Obeidat

et al. 2023

The American Journal of Cardiology

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Hemodynamic indices in pulmonary hypertension: a narrative review

Cited by 4 publications

References 130 publications

A North American, single-center experience implanting fenestrated atrial devices and atrial flow regulators into a heterogeneous group of pediatric pulmonary hypertension patients

A North American, single-center experience implanting fenestrated atrial devices and atrial flow regulators into a heterogeneous group of pediatric pulmonary hypertension patients

Expression profiles of circRNAs and identification of hsa_circ_0007608 and hsa_circ_0064656 as potential biomarkers for COPD-PH patients

Can Inhaled Nitric Oxide Response Predict Tolerance to Therapies and Survival in Patients With Combined Precapillary and Postcapillary Pulmonary Hypertension?

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