Load Adaptability in Patients With Pulmonary Arterial Hypertension

Amsallem, Myriam; Boulate, David; Aymami, Marie; Guihaire, Julien; Selej, Mona; Huo, J.; Denault, André; McConnell, Michael V.; Schnittger, Ingela; Fadel, Élie; Mercier, Olaf; Zamanian, Roham T.; Haddad, François

doi:10.1016/j.amjcard.2017.05.053

Cited by 20 publications

(24 citation statements)

References 26 publications

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“…Some studies showed a significant correlation between PVRi and 5-year mortality rate after surgery - (2,12,13) since PVRi might be a reflection of heart condition, especially for the right side of the heart. Prior study found that an increase in PVRi is associated with right ventricle enlargement (14) that may contribute to the decrease of oxygen saturation in the right ventricle in this study.…”

Section: Discussionsupporting

confidence: 60%

Effects of Pulmonary Vascular Resistance Index on Oxygen Saturation in Patients with Atrial Septal Defect

Supomo

2020

JKB

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<p>Atrial septal defect (ASD) is a congenital lesion in atrium septum. The lesion may cause pulmonary hypertension due to the high pressure in the right ventricle. This condition leads to cyanosis in ASD patient, but the pathophysiology of cyanosis in ASD patient is still unknown. This study aimed to identify the pathophysiology of cyanosis in ASD patients using the Pulmonary Vascular Resistance index (PVRi). The design of this study was retrospective cohort study. The data used in this study were the results of right heart catheterization procedure taken from forty ASD patient medical records at Dr. Sardjito general hospital. The exclusions criteria were the history of previous vasodilator administration and incomplete medical records. The median age of the patients was 30 (18-55) years old. The mean of the Qp/Qs ratio was 1.210 (0.57-6.33). Optimum oxygen saturation was found in vessel leaving the heart. The PVRi median is 61.98 (-15.58-676.64). The PVRi has a significant correlation with oxygen saturation, except in the right atrium. There is a significant correlation between PVRi and oxygen saturation in various heart chambers. Pathophysiology of cyanosis in ASD patients is central cyanosis.</p>

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Section: Discussionsupporting

confidence: 60%

Effects of Pulmonary Vascular Resistance Index on Oxygen Saturation in Patients with Atrial Septal Defect

Supomo

2020

JKB

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“… 15 However, simple ratios may not address the question of disproportionality of adaptation, as the relationship between function and afterload follows a non-linear and often inverse fit. 14 , 27 Dandel et al. proposed an index defined as delta pressure between the RV and the right atrium divided by the end-diastolic volume/length ratio.…”

Section: Discussionmentioning

confidence: 99%

Non‐invasive right ventricular load adaptability indices in patients with scleroderma‐associated pulmonary arterial hypertension

et al. 2018

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Scleroderma-associated pulmonary arterial hypertension (SSc-PAH) is associated with worse outcome than idiopathic pulmonary arterial hypertension (IPAH), potentially due to worse right ventricular adaptation to load as suggested by pressure–volume loop analysis. The value of non-invasive load-adaptability metrics has not been fully explored in SSc-PAH. This study sought to assess whether patients with incident SSc-PAH have worse echocardiographic load-adaptability metrics than patients with IPAH. Twenty-two patients with incident SSc-PAH were matched 1:1 with IPAH based on pulmonary vascular resistance. Echocardiographic load-adaptability indices were divided into: surrogates of ventriculo-arterial coupling (e.g. right ventricular area change/end-systolic area), indices reflecting the proportionality of load adaptation (e.g. tricuspid regurgitation velocity-time integral normalized for average right ventricular radius), and simple ratios (e.g. tricuspid annular plane systolic excursion/right ventricular systolic pressure). The prognostic value of these indices for clinical worsening (i.e. death, transplant, or hospitalization for heart failure) at one year was explored. The two groups were comprised of patients of similar age, with similar cardiac index, pulmonary resistance, capacitance and NT-proBNP levels (p > 0.10). There was no difference in baseline right ventricular dimension, function or load-adaptability indices. At one year, eight (36.4%) SSc-PAH patients had experienced clinical worsening (eight hospitalizations and two deaths) versus one hospitalization in the IPAH group. Load adaptation at one year in survivors was not worse in SSc-PAH (p > 0.33). Patients with IPAH responded better to therapy than SSc-PAH in terms of reduction of right ventricular areas at one year (p < 0.05). Right ventricular load-adaptability echocardiographic indices do not appear to capture the increased risk of negative outcomes at one year associated with SSc-PAH.

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“…2 Translational Lung Research Center Heidelberg (TLRC), Member of the German Center for Lung Research (DZL), Heidelberg, Germany. 3 Department of Rheumatology, University Hospital Heidelberg, Heidelberg, Germany. 4 Institute of Human Genetics, University of Heidelberg, Heidelberg, Germany.…”

Section: Acknowledgementsmentioning

confidence: 99%

“…Pulmonary arterial hypertension (PAH) is a complex cardiopulmonary disorder, characterized by progressive changes affecting both the pulmonary vasculature and the right heart [1,2]. Although the initial pathological changes occur on pulmonary arterioles causing increased pulmonary vascular resistance (PVR), adaptation of right ventricular (RV) pump function is a key determinant of survival [2,3]. Rising attention is drawn to the concept of RV-arterial coupling, a composite measure of RV pump function and ventricular load [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Right heart size and function significantly correlate in patients with pulmonary arterial hypertension – a cross-sectional study

Fischer¹,

Benjamin

Blank

et al. 2019

60. Kongress Der Deutschen Gesellschaft Für Pneumologie Und Beatmungsmedizin E. V.

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Load Adaptability in Patients With Pulmonary Arterial Hypertension

Cited by 20 publications

References 26 publications

Effects of Pulmonary Vascular Resistance Index on Oxygen Saturation in Patients with Atrial Septal Defect

Effects of Pulmonary Vascular Resistance Index on Oxygen Saturation in Patients with Atrial Septal Defect

Non‐invasive right ventricular load adaptability indices in patients with scleroderma‐associated pulmonary arterial hypertension

Right heart size and function significantly correlate in patients with pulmonary arterial hypertension – a cross-sectional study

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