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Start Over Descriptor "RAP, right atrial pressure" Publisher elsevier
3 results on '"RAP, right atrial pressure"'

1. Beneficial effects of riociguat on hemodynamic responses to exercise in CTEPH patients after balloon pulmonary angioplasty – A randomized controlled study

Author

Hideaki Suzuki, Haruka Sato, Kotaro Nochioka, Masanobu Miura, Tatsuo Aoki, Satoshi Miyata, Hiroaki Shimokawa, Shigefumi Fukui, Saori Yamamoto, Yosuke Terui, Ryo Konno, Katsuya Kozu, Shunsuke Tatebe, Koichiro Sugimura, Nobuhiro Yaoita, and Kimio Satoh

Subjects
medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, PEA, pulmonary endarterectomy, Haemodynamic response, mPAP, mean pulmonary arterial pressure, medicine.medical_treatment, CO, cardiac output, Chronic thromboembolic pulmonary hypertension, Hemodynamics, 030204 cardiovascular system & hematology, PVR, pulmonary vascular resistance, Balloon, Riociguat, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Angioplasty, medicine, Balloon pulmonary angioplasty, 030212 general & internal medicine, CI, Cardiac index, PAWP, pulmonary arterial wedge pressure, Beneficial effects, Original Paper, HR, heart rate, business.industry, BP, Arterial blood pressure, BPA, Balloon pulmonary angioplasty, Riociguat, exercise response, lcsh:RC666-701, 6MWD, 6-min walk distance, Cardiology, CTEPH, Chronic thromboembolic pulmonary hypertension, RAP, right atrial pressure, PAH, pulmonary arterial hypertension, Cardiology and Cardiovascular Medicine, business, RVEF, right ventricular ejection fraction, medicine.drug
Abstract

Background: Although balloon pulmonary angioplasty (BPA) improves symptoms and pulmonary hemodynamics in patients with chronic thromboembolic pulmonary hypertension (CTEPH), the effects of riociguat on hemodynamics and exercise capacity in patients after BPA remain to be elucidated. Methods and Results: This study was a single-center, prospective, randomized, open-label trial. From November 2015 to November 2018, we prospectively examined 21 patients with CTEPH (65 ± 9 years old, M/F 2/19) who showed hemodynamic improvement with mean pulmonary arterial pressure (mPAP)

Published
2020

2. Does combination therapy work in chronic thromboembolic pulmonary hypertension?

Author

J. C. Kelder, R.J. Snijder, Johannes J. Mager, M.C.J. van Thor, and M.C. Post

Subjects
lcsh:Diseases of the circulatory (Cardiovascular) system, Survival, HR, hazards regression, mPAP, mean pulmonary arterial pressure, Cardiac index, Chronic thromboembolic pulmonary hypertension, Hemodynamics, 030204 cardiovascular system & hematology, Gastroenterology, NT-proBNP, N-terminal pro brain natriuretic peptide, 0302 clinical medicine, Combination strategy, 030212 general & internal medicine, CTEPH, chronic thromboembolic pulmonary hypertension, CT, computed tomography, medicine.anatomical_structure, COPD, chronic obstructive lung disease, Baseline characteristics, FC, functional class, RAP, right atrial pressure, Erratum, PAH, pulmonary arterial hypertension, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Combination therapy, BPA, balloon pulmonary angioplasty, PEA, pulmonary endarterectomy, CO, cardiac output, PH, pulmonary hypertension, PVR, pulmonary vascular resistance, WHO, World Health Organization, 03 medical and health sciences, medicine.artery, Internal medicine, medicine, CI, cardiac index, ERA(s), endothelin receptor antagonist(s), IQR, interquartile range, Original Paper, 6MWD, 6-minute walking distance, business.industry, Monotherapy, lcsh:RC666-701, Pulmonary artery, Vascular resistance, business, SD, standard deviation, RHC, right heart catheterisation
Abstract

Highlights • Long-term overall survival of CTEPH patients receiving PH-specific medial therapy is very reasonable. • Despite worse baseline characteristics at baseline, combination therapy showed similar survival as monotherapy. • Combination therapy strategy showed no difference in survival outcome., Objective The current experience with combination therapy in chronic thromboembolic pulmonary hypertension (CTEPH) is limited. We present the first survival results up to 5 years for dual combination therapy versus monotherapy in CTEPH. Methods All consecutive, non-operated CTEPH or residual PH after pulmonary endarterectomy patients treated with PH-specific medical therapy between January 2002 and November 2019 were included. We report and compare survival between monotherapy and (upfront or sequential) dual combination therapy until five years after medication initiation. Results In total, 183 patients (mean age 65 ± 14 years, 60% female, 66% WHO FC III/IV, 86% non-operated) were included, of which 83 patients received monotherapy and 100 patients received dual combination therapy. At baseline, patients receiving combination therapy had a higher NT-proBNP (p = 0.02) mean pulmonary artery pressure (p = 0.0001) and pulmonary vascular resistance (p = 0.02), while cardiac index was lower (p = 0.03). Total follow-up duration was 3.3 ± 1.8 years, during which 31 (17%) patients died. Estimated 1-, 3- and 5-year survival for monotherapy were 99%, 92% and 79%, respectively. For combination therapy percentages were 98%, 89% and 70%, respectively. Survival did not significantly differ between both groups (p = 0.22). Conclusion Survival up to 5 years for patients treated with combination therapy, regardless of the combination strategy, was similar as patients with monotherapy, despite worse clinical and haemodynamic baseline characteristics.

Published
2020

3. Left Ventricular Diastolic Dysfunction is Associated with Renal Dysfunction, Poor Survival and Low Health Related Quality of Life in Cirrhosis.

Author

Premkumar M, Devurgowda D, Vyas T, Shasthry SM, Khumuckham JS, Goyal R, Thomas SS, and Kumar G

Abstract

Background: The presence of left ventricular diastolic dysfunction (LVDD) in patients with cirrhosis leads to a restriction of activities and a poor health related quality of life (HRQoL), which should be taken into consideration when treating them for liver and cardiac complications., Aims: The prevalence, complications, predictors of HRQoL and survival in cirrhotic patients with LVDD were studied., Methods: We report a prospective cohort study of 145 consecutive cirrhotic patients with LVDD who were evaluated for cardiac functional status at enrollment and followed up for hepatic complications, cardiac events, outcome and HRQoL using the Minnesota Living With Heart Failure Questionnaire (MLHFQ) over a period of 2 years., Results: In total, 145 (mean age 61 years, 59% male) patients were included. Seventeen patients died with 10.5%, 22.5% and 40% mortality rates in patients with Grades 1, 2 and 3 LVDD respectively over 24 months. The parameters that were significant for predicting mortality on bivariate analysis were MELD, MELDNa, hepatic venous pressure gradient, MLHFQ, and left ventricular (LV) diastolic function (e' and E/e' ratio), but only MELD, MELDNa and E/e' remained significant on multivariate analysis. The E/e' ratio (8.7 ± 3.3 in survivors vs. 9.1 ± 2.3 in non-survivors) predicted outcome. On univariate analysis, the predictors of poor HRQoL were the Child-Pugh score ≥9.8 (OR 2.6; 95% confidence intervals (CI) 2.3-9.1, P  = 0.041), MELD score ≥ 15.7 (OR 2.48; 95% CI 1.4-3.9, P  = 0.029), refractory ascites (OR 1.9; 95% CI 1.1-6.1, P  = 0.050), and E/e' ratio ≥7.6 (OR 1.9; 95% CI 1.8-7.1, P  = 0.036) The presence of Class II/III ( P  = 0.046) symptoms of heart failure and MLHFQ≥ 45 ( P  = 0.042) were predictors of mortality at 24 months., Conclusion: The grade of LVDD correlates with liver function, clinical events, risk of renal dysfunction and HRQoL. Evaluation of novel therapies which target symptomatic improvement in LVDD, should be done with suitable outcome measures, including HRQoL assessment.

Published
2019
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