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1.
ESC Heart Fail ; 11(2): 1263-1268, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38158705

RESUMEN

AIMS: Our aim was to investigate haemodynamics at rest and during exercise in patients with transthyretin cardiomyopathy (ATTR-CM) in light of the 2022 European Society of Cardiology (ESC) and European Respiratory Society (ERS) guidelines on pulmonary hypertension (PH). METHODS AND RESULTS: We performed right heart catheterization (RHC) in 57 subjects with ATTR-CM. The proportion of patients with PH was 77% according to the 2022 guidelines versus 47% when applying the 2015 guidelines. Isolated post-capillary PH and combined pre- and post-capillary PH were most prevalent. Thirty-six patients underwent a supine bicycle cardiopulmonary exercise test during RHC. Exercise-induced PH was defined as an increase in mean pulmonary arterial pressure from rest to exercise per increase in cardiac output (ΔmPAP/ΔCO) of > 3 mmHg/L/min. An increase in pulmonary arterial wedge pressure per change in cardiac output (ΔPAWP/ΔCO) from rest to exercise >2 mmHg/L/min was considered suggestive of post-capillary exercise-induced PH. All but two patients who exercised during RHC developed exercise-induced PH. The median ΔmPAP/ΔCO was 7.2 mmHg/L/min and ΔPAWP/ΔCO was 5.1 mmHg/L/min. The median ΔRAP/ΔCO was 3.6 mmHg/L/min and ΔRAP/ΔPAWP was 0.6 mmHg/L/min. CONCLUSIONS: Most patients with ATTR-CM have isolated post-capillary or combined pre- and post-capillary PH at rest, and almost all patients develop exercise-induced PH with a large post-capillary component. There was a pronounced, but balanced increase in atrial pressures on exercise.


Asunto(s)
Amiloidosis , Hipertensión Pulmonar , Humanos , Hemodinámica , Gasto Cardíaco , Presión Esfenoidal Pulmonar
2.
Tidsskr Nor Laegeforen ; 143(9)2023 06 13.
Artículo en Inglés, Noruego | MEDLINE | ID: mdl-37341412

RESUMEN

A man in his seventies underwent routine heart examinations as part of workup for kidney transplantation. Unexpected findings led to more extensive investigations and revealed two rare systemic diseases as causes of his heart failure.


Asunto(s)
Fatiga , Insuficiencia Cardíaca , Insuficiencia Renal , Humanos , Masculino , Fatiga/etiología , Insuficiencia Cardíaca/etiología , Trasplante de Riñón , Insuficiencia Renal/diagnóstico , Insuficiencia Renal/etiología , Anciano
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