Isolated diastolic dysfunction of right ventricle: stress-induced pulmonary hypertension: Table 1—

Faludi, Réka; Komócsi, András; Bozό, J.; Kumánovics, Gabór; Czirják, László; Papp, Lajos; Símor, Tamás

doi:10.1183/09031936.00124207

Cited by 13 publications

(10 citation statements)

References 5 publications

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“…Elevated pulmonary artery pressures, even at borderline high levels, can impair right ventricular diastolic function. 32,33 That impairment could induce chronic sympathetic nervous system hyperactivity, resulting in chronotropic incompetence—elevated resting heart rate, decreased maximal heart rate, decreased heart rate variability and (as relates to this study) impaired HRR. Sympathetic activation is known to participate in the cardiovascular perturbations in idiopathic pulmonary arterial hypertension 34 and could certainly do so here.…”

Section: Discussionmentioning

confidence: 54%

Heart rate recovery after six‐minute walk test predicts pulmonary hypertension in patients with idiopathic pulmonary fibrosis

et al. 2011

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Background and objective In patients with IPF, we sought to validate that abnormal heart rate recovery at 1 min (HRR1) after six-minute walk test (6MWT) predicts mortality and to explore the relationship between abnormal HRR1 and pulmonary hypertension (PH). Methods We identified IPF patients who performed a 6MWT as part of their clinical evaluation between 2006 and 2009 and were followed to lung transplantation or death. Right heart catheterization (RHC) data were collated and analysed for the subgroup who had this procedure. Results There were 160 subjects who qualified for the survival analysis, and those with an abnormal HRR1 had worse survival than subjects with normal HRR1 (log-rank P = 0.01). Eighty-two subjects had a right heart catheter (RHC); among them, abnormal HRR1 was associated with RHC-confirmed PH (χ2 = 4.83, P = 0.03) and had a sensitivity, specificity, positive predictive value and negative predictive value of 52%, 74%, 41% and 82%, respectively, for PH. In bivariate and multivariable analyses, abnormal HRR1 appeared to be the strongest predictor of RHC-confirmed PH (odds ratio (OR) = 4.0, 95% CI: 1.17–13.69, P = 0.02 in the multivariable analysis). Conclusions This study adds to data that support the validity of abnormal HRR1 as a predictor of mortality and of RHC-confirmed PH in IPF. Research is needed to further investigate the link between abnormal HRR1 and PH and to elucidate heart–lung interactions at work during exercise and recovery in patients with IPF.

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Section: Discussionmentioning

confidence: 54%

Heart rate recovery after six‐minute walk test predicts pulmonary hypertension in patients with idiopathic pulmonary fibrosis

et al. 2011

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“…First, it may result from a decrease in LV filling resulting from reduction in pulmonary blood flow. Second, RV enlargement may lead to reduced LV filling because of direct RV impingement on LV filling mediated by septal wall motion displacement by a pressure-and volume-overloaded RV (15,20,(38)(39)(40)(41). In both acute and chronic pulmonary hypertension, this adverse effect on left ventricular filling has been shown to be augmented by an increase in pericardial pressure caused by an enlarged RV (42).…”

mentioning

confidence: 99%

Intensive Care Unit Management of Patients with Severe Pulmonary Hypertension and Right Heart Failure

Hoeper

Granton

2011

Am J Respir Crit Care Med

272

249

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Despite advances in medical therapies, pulmonary arterial hypertension (PAH) continues to cause significant morbidity and mortality. Although the right ventricle (RV) can adapt to an increase in afterload, progression of the pulmonary vasculopathy that characterizes PAH causes many patients to develop progressive right ventricular failure. Furthermore, acute right ventricular decompensation may develop from disorders that lead to either an acute increase in cardiac demand, such as sepsis, or to an increase in ventricular afterload, including interruptions in medical therapy, arrhythmia, or pulmonary embolism. The poor reserve of the right ventricle, RV ischemia, and adverse right ventricular influence on left ventricular filling may lead to a global reduction in oxygen delivery and multiorgan failure. There is a paucity of data to guide clinicians caring for acute right heart failure in PAH. Treatment recommendations are frequently based on animal models of acute right heart failure or case series in humans with other causes of pulmonary hypertension. Successful treatment often requires that invasive hemodynamics be used to monitor the effect of strategies that are based primarily on biological plausibility. Herein we have developed an approach based on the current understanding of RV failure in PAH and have attempted to develop a treatment paradigm based on physiological principles and available evidence.

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“…These measures, including RV dP/dt, RV index of myocardial performance (RV-IMP), and those obtained by Doppler tissue imaging, can identify subclinical RV systolic and diastolic abnormalities that have been shown to correlate with cardiopulmonary abnormalities affecting functional status [17][18][19]. The RV-IMP, also called the Tei index, is derived from measurements obtained from the tricuspid infl ow and pulmonary systolic ejection envelope and can be used to assess RV diastolic and systolic function [ 20 ].…”

Section: Diagnosis Of Rv Dysfunctionmentioning

confidence: 99%

“…pulmonary hypertension [ 17 ] and OSA [ 25 ]. The presence of abnormal RV function with an annular Sa ≤ 10.8 and Ea ≤ 8.9 cm/s in patients with concomitant LV dysfunction has been shown to independently predict death (RR, 2.5-2.8) [ 21 , 26 ].…”

Section: Endothelin Receptor Antagonistsmentioning

confidence: 99%

Right-sided heart failure: Diagnosis and treatment strategies

Cowger

Dardas²,

Dorsch³

et al. 2008

Curr Treat Options Cardiovasc Med

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Right ventricular (RV) dysfunction in the setting of cardiomyopathy, ischemia, and pulmonary hypertension is associated with high morbidity and mortality, but therapeutic clinical trials examining RV failure as a primary outcome are lacking. This review focuses on the ontologic, morphologic, and microscopic differences between the right and left ventricles. It also discusses the rationale and potential risks associated with the extrapolation of medical therapies used in left ventricular failure and pulmonary arterial hypertension management to the treatment of RV failure. Finally, it introduces the reader to new echocardiographic techniques that may be used to diagnose clinical and subclinical RV systolic and diastolic dysfunction. Given the anticipated rise in the prevalence of RV dysfunction, more studies are needed to gain a better understanding of RV cellular and subcellular function and its response to pathologic stressors and disease so that therapeutic targets can be devised to improve RV failure morbidity and mortality.

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Isolated diastolic dysfunction of right ventricle: stress-induced pulmonary hypertension: Table 1—

Abstract: In summary, the results suggest that environmental temperature and relative humidity contribute to the variability of condensate pH.

Cited by 13 publications

References 5 publications

Heart rate recovery after six‐minute walk test predicts pulmonary hypertension in patients with idiopathic pulmonary fibrosis

Heart rate recovery after six‐minute walk test predicts pulmonary hypertension in patients with idiopathic pulmonary fibrosis

Intensive Care Unit Management of Patients with Severe Pulmonary Hypertension and Right Heart Failure

Right-sided heart failure: Diagnosis and treatment strategies

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