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1.
Georgian Med News ; (298): 42-46, 2020 Jan.
Artigo em Russo | MEDLINE | ID: mdl-32141846

RESUMO

The main initiator of the development of PAH is the development of endothelial dysfunction of the pulmonary vessels. The cause of this dysfunction is associated with functional disorders of the serotonin system. This research is devoted to study the role of the serotonin system in the development mechanism of PAH in children with CHD. We examined 30 young children (from 1 month to 2 years) with congenital heart defects (CHD), which were divided into 3 groups: group I - 12 children with CHD complicated by pulmonary arterial hypertension (PAH); Group II - 9 children with CHD, not complicated by PAH; Group III - 9 relatively healthy children (control). The serotonin content of platelets, serum and serotonin transporter (SERT) in platelets was determined. To determine serotonin and its carrier, a quantitative enzyme-linked immunosorbent assay (Elisa kit) was used. The study was performed using the Serotonin ELISA diagnostic kit, IBL Hamburg at the automatic ELISA of the Evolis robotic station (BioRad). The results of our studies showed a pronounced (p <0.001) increase in SERT concentration in platelets in the group of children with CHD complicated by PAH compared with the group of children with CHD and the control group. The amount of serotonin in serum tended to increase in this group compared with the control groups and CHD, and the amount of serotonin in platelets tended to decrease. It is likely that an increase in the serotonin transporter in platelets against the background of an increase in serotonin in the blood plasma and a decrease in serotonin in the platelets indicates the inadequacy of SERT activity as a serotonin carrier. However, by activating the proliferation of smooth muscle cells in the pulmonary artery, SERT leads to the development of PAH in children with congenital heart defects. It is necessary to continue research in this direction, which will reveal the molecular mechanisms by which SERT regulates PASMC proliferation and clarify the role of serotonin and its transporter in the development of PAH in children with CHD.


Assuntos
Plaquetas/metabolismo , Cardiopatias Congênitas/complicações , Hipertensão Pulmonar/sangue , Hipertensão Pulmonar/etiologia , Artéria Pulmonar/metabolismo , Proteínas da Membrana Plasmática de Transporte de Serotonina/sangue , Serotonina/sangue , Biomarcadores/sangue , Criança , Pré-Escolar , Ensaio de Imunoadsorção Enzimática , Cardiopatias Congênitas/sangue , Cardiopatias Congênitas/fisiopatologia , Humanos , Hipertensão Pulmonar/fisiopatologia , Hipertensão Arterial Pulmonar , Artéria Pulmonar/fisiopatologia , Circulação Pulmonar
2.
Am J Physiol Heart Circ Physiol ; 318(2): H470-H483, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31922892

RESUMO

Reactive oxygen species (ROS), mitochondrial dysfunction, and excessive vasoconstriction are important contributors to chronic hypoxia (CH)-induced neonatal pulmonary hypertension. On the basis of evidence that PKCß and mitochondrial oxidative stress are involved in several cardiovascular and metabolic disorders, we hypothesized that PKCß and mitochondrial ROS (mitoROS) signaling contribute to enhanced pulmonary vasoconstriction in neonatal rats exposed to CH. To test this hypothesis, we examined effects of the PKCß inhibitor LY-333,531, the ROS scavenger 1-oxyl-2,2,6,6-tetramethyl-4-hydroxypiperidine (TEMPOL), and the mitochondrial antioxidants mitoquinone mesylate (MitoQ) and (2-(2,2,6,6-tetramethylpiperidin-1-oxyl-4-ylamino)-2-oxoethyl)triphenylphosphonium chloride (MitoTEMPO) on vasoconstrictor responses in saline-perfused lungs (in situ) or pressurized pulmonary arteries from 2-wk-old control and CH (12-day exposure, 0.5 atm) rats. Lungs from CH rats exhibited greater basal tone and vasoconstrictor sensitivity to 9,11-dideoxy-9α,11α-methanoepoxy prostaglandin F2α (U-46619). LY-333,531 and TEMPOL attenuated these effects of CH, while having no effect in lungs from control animals. Basal tone was similarly elevated in isolated pulmonary arteries from neonatal CH rats compared with control rats, which was inhibited by both LY-333,531 and mitochondria-targeted antioxidants. Additional experiments assessing mitoROS generation with the mitochondria-targeted ROS indicator MitoSOX revealed that a PKCß-mitochondrial oxidant signaling pathway can be pharmacologically stimulated by the PKC activator phorbol 12-myristate 13-acetate in primary cultures of pulmonary artery smooth muscle cells (PASMCs) from control neonates. Finally, we found that neonatal CH increased mitochondrially localized PKCß in pulmonary arteries as assessed by Western blotting of subcellular fractions. We conclude that PKCß activation leads to mitoROS production in PASMCs from neonatal rats. Furthermore, this signaling axis may account for enhanced pulmonary vasoconstrictor sensitivity following CH exposure.NEW & NOTEWORTHY This research demonstrates a novel contribution of PKCß and mitochondrial reactive oxygen species signaling to increased pulmonary vasoconstrictor reactivity in chronically hypoxic neonates. The results provide a potential mechanism by which chronic hypoxia increases both basal and agonist-induced pulmonary arterial smooth muscle tone, which may contribute to neonatal pulmonary hypertension.


Assuntos
Hipóxia/metabolismo , Proteína Quinase C beta/metabolismo , Animais , Animais Recém-Nascidos , Doença Crônica , Óxidos N-Cíclicos/farmacologia , Inibidores Enzimáticos , Feminino , Depuradores de Radicais Livres , Indóis/farmacologia , Maleimidas/farmacologia , Compostos Organofosforados/farmacologia , Estresse Oxidativo , Gravidez , Proteína Quinase C beta/antagonistas & inibidores , Artéria Pulmonar/efeitos dos fármacos , Circulação Pulmonar , Ratos , Espécies Reativas de Oxigênio , Marcadores de Spin , Ubiquinona/análogos & derivados , Ubiquinona/farmacologia , Vasoconstrição , Vasoconstritores/farmacologia
3.
Arch Dis Child Fetal Neonatal Ed ; 105(1): 18-25, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31123056

RESUMO

OBJECTIVE: Lung hypoplasia associated with congenital diaphragmatic hernia (CDH) results in respiratory insufficiency and pulmonary hypertension after birth. We have investigated whether aerating the lung before removing placental support (physiologically based cord clamping (PBCC)), improves the cardiopulmonary transition in lambs with a CDH. METHODS: At ≈138 days of gestational age, 17 lambs with surgically induced left-sided diaphragmatic hernia (≈d80) were delivered via caesarean section. The umbilical cord was clamped either immediately prior to ventilation onset (immediate cord clamping (ICC); n=6) or after achieving a target tidal volume of 4 mL/kg, with a maximum delay of 10 min (PBCC; n=11). Lambs were ventilated for 120 min and physiological changes recorded. RESULTS: Pulmonary blood flow (PBF) increased following ventilation onset in both groups, but was 19-fold greater in PBCC compared with ICC lambs at cord clamping (19±6.3 vs 1.0±0.5 mL/min/kg, p<0.001). Cerebral tissue oxygenation was higher in PBCC than ICC lambs during the first 10 min after cord clamping (59%±4% vs 30%±5%, p<0.001). PBF was threefold higher (23±4 vs 8±2 mL/min/kg, p=0.01) and pulmonary vascular resistance (PVR) was threefold lower (0.6±0.1 vs 2.2±0.6 mm Hg/(mL/min), p<0.001) in PBCC lambs compared with ICC lambs at 120 min after ventilation onset. CONCLUSIONS: Compared with ICC, PBCC prevented the severe asphyxia immediately after birth and resulted in a higher PBF due to a lower PVR, which persisted for at least 120 min after birth in CDH lambs.


Assuntos
Débito Cardíaco , Constrição , Hérnias Diafragmáticas Congênitas , Respiração com Pressão Positiva , Circulação Pulmonar , Cordão Umbilical , Animais , Animais Recém-Nascidos , Asfixia Neonatal/prevenção & controle , Encéfalo/metabolismo , Modelos Animais de Doenças , Oxigênio/metabolismo , Ovinos , Volume de Ventilação Pulmonar , Resistência Vascular
4.
Radiol Med ; 125(3): 237-246, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31823296

RESUMO

Persistent left-sided superior vena cava (PLSVC) is the commonest systemic venous anomaly in the thorax with a reported prevalence of up to 0.5% in otherwise normal population and up to 10% in patients with congenital heart disease (CHD). In the absence of associated CHD, it is usually asymptomatic, discovered incidentally. It may complicate catheter or pacemaker lead placement. PLSVC typically drains into the right atrium through the coronary sinus. In children with CHD, the presence of a PLSVC may affect the choice of certain surgical procedures. PLSVC is significantly more common in association with situs ambiguous than with situs solitus or inversus, up to 60-70%. In patients with situs ambiguous, the drainage of LSVC is variable, more commonly directly into the atria rather than through the coronary sinus (CS). Rarely, there is a PLSVC draining into the CS with absent right SVC. PLSVC draining into the right atrium via the CS will not usually cause blood shunting between the right and the left sides. However, shunting occurs when PLSVC is associated with unroofed CS, or when it directly drains into the left atrium. With an increased use of CT and MRI for chest and cardiac imaging, PLSVC is being more encountered by radiologists than before. In this article, we will discuss the embryology of PLSVC, its anatomic course and drainage pathways, as well as its clinical relevance and relation to congenital heart disease and viscero-atrial situs.


Assuntos
Cardiopatias Congênitas/complicações , Veia Cava Superior/anormalidades , Adolescente , Doenças Assintomáticas , Veias Braquiocefálicas/embriologia , Criança , Pré-Escolar , Seio Coronário/anormalidades , Seio Coronário/diagnóstico por imagem , Feminino , Síndrome de Heterotaxia/complicações , Humanos , Achados Incidentais , Lactente , Imagem por Ressonância Magnética , Masculino , Circulação Pulmonar , Fluxo Sanguíneo Regional , Situs Inversus/complicações , Tomografia Computadorizada por Raios X , Veia Cava Inferior/anormalidades , Veia Cava Superior/diagnóstico por imagem , Veia Cava Superior/embriologia
5.
Zhonghua Wai Ke Za Zhi ; 57(12): 939-943, 2019 Dec 01.
Artigo em Chinês | MEDLINE | ID: mdl-31826600

RESUMO

Objective: To examine the early- and midterm outcomes of pulmonary artery banding as an initial palliation in patients with single ventricle associated with unrestricted pulmonary blood flow. Methods: Between January 2008 and December 2017, 49 patients with single ventricle and unrestricted pulmonary blood flow underwent pulmonary artery banding at Department of Cardiac Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University. There were 29 males and 20 females. The age at the time of surgery was 5.6 (11.5) months (M(Q(R))), and the weight was 5.2 (3.9) kg. The medical records and results after pulmonary artery banding (death/reoperation, transition to the Glenn procedure) and subsequently after the Glenn procedure (death, transition to the Fontan procedure) were reviewed retrospectively. Actuarial survivals were estimated by the Kaplan-Meier curve. Relative factors for affecting outcomes were analyzed using the Cox regression hazard model. Results: There were 8 early deaths, with a mortality of 16.3%, including 4 cases who received simultaneous arch repair. There were 5 late deaths. During the follow-up of 47(62) (M(Q(R))) months, 11 patients (22.4%) underwent pulmonary artery banding adjustment, 29 patients (59.2%) underwent the Glenn procedure, 21 patients (42.8%) underwent the Fontan procedure. The survival of patients after the initial pulmonary artery banding were 77.4% (95%CI: 65.6% to 89.2%) and 72.6% (95%CI: 59.9% to 85.3%) at 1 year and 5 years, respectively. Multivariate Cox regression analysis revealed that systemic ventricular outflow tract obstruction (HR=4.25, 95%CI: 1.50 to 12.03, P=0.006) and total anomalous pulmonary venous connection (HR=6.49, 95%CI: 3.24 to 12.98, P=0.000) were relative factors for death. Conclusions: The early and midterm outcomes of pulmonary artery banding as an initial palliative strategy is not satisfactory. Systemic ventricular outflow tract obstruction and total anomalous pulmonary venous connection are associated with high mortality.


Assuntos
Cardiopatias Congênitas/mortalidade , Cardiopatias Congênitas/cirurgia , Cuidados Paliativos/métodos , Artéria Pulmonar/cirurgia , Procedimentos Cirúrgicos Vasculares/mortalidade , Feminino , Seguimentos , Ventrículos do Coração/anormalidades , Humanos , Lactente , Recém-Nascido , Masculino , Circulação Pulmonar , Estudos Retrospectivos , Resultado do Tratamento , Procedimentos Cirúrgicos Vasculares/métodos
6.
Medicine (Baltimore) ; 98(42): e17615, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31626139

RESUMO

BACKGROUND: The Fontan circulation is fragile, which is easily broken down. For now, there is no consensus on the drug treatment for the prevention of failure of the Fontan circulation. METHODS: Studies comparing pulmonary vasodilator and control in Fontan patients were identified by searching the PubMed, EMBASE, Clinical Trials, and the Cochrane Library databases until March 20, 2019. The assessed variables included the change of pulmonary resistance, heart function, exercise capacity, life of quality, mortality, and serials of adverse events before and after drug administration. A random-effect/fixed-effect model was used to summarize the estimates of the mean difference (MD)/risk ratio (RR) with 95% confidence interval (CI). Subgroup analysis stratified by drug was performed. RESULTS: This study will be submitted to a peer-reviewed journal for publication. CONCLUSION: This study will assess the efficacy and safety of pulmonary vasodilators for patients after Fontan procedure, and provide more evidence-based guidance in clinical practice. PROSPERO REGISTRATION NUMBER: CRD42019132135.


Assuntos
Técnica de Fontan/métodos , Cardiopatias Congênitas/cirurgia , Hipertensão Pulmonar/tratamento farmacológico , Circulação Pulmonar/efeitos dos fármacos , Pressão Propulsora Pulmonar/efeitos dos fármacos , Vasodilatadores/uso terapêutico , Cardiopatias Congênitas/fisiopatologia , Humanos , Hipertensão Pulmonar/fisiopatologia
8.
Int Heart J ; 60(5): 1137-1141, 2019 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-31484878

RESUMO

Current therapeutic methods for chronic thromboembolic pulmonary hypertension (CTEPH) can improve hemodynamic status and are expected to improve prognoses. However, some patients experience dyspnea during effort and continue supplemental oxygenation despite their hemodynamic status being fully improved. Considering the pathogenesis of CTEPH, the dead space and intrapulmonary shunt are assumed to be responsible for hypoxia in CTEPH, but their contributions are unclear. It is also unclear whether they are improved after treatment. The aim of this study was to investigate the implications of the dead space ratio (DSR) and the intrapulmonary shunt ratio (ISR) for hypoxia in CTEPH and treatment for CTEPH.We retrospectively measured the DSR and ISR of 23 consecutive patients with CTEPH. For 11 of these 23 (10 were treated by balloon pulmonary angioplasty, one with riociguat), we also measured these parameters before and after CTEPH treatments. Overall, the DSR and ISR were abnormally elevated (DSR: 0.63 ± 0.06; ISR: 0.20 ± 0.05). After treatment, mean pulmonary artery pressure was improved (from 40.3 ± 8.1 to 25.5 ± 2.7 mmHg). Although atrial oxygen saturation (SaO2), DSR and ISR were improved (SaO2: from 90.2 ± 3.2 to 93.7 ± 1.8%; DSR: from 0.64 ± 0.06 to 0.58 ± 0.05; ISR: from 0.20 ± 0.04 to 0.18 ± 0.02), these improvements were slight compared with that of mean pulmonary artery pressure.The DSR and ISR were abnormally elevated in patients with CTEPH and their improvement by treatment was limited. Only DSR can be a useful marker for normalization of hypoxia in CTEPH.


Assuntos
Angioplastia com Balão/métodos , Hipertensão Pulmonar/terapia , Embolia Pulmonar/terapia , Pirazóis/uso terapêutico , Pirimidinas/uso terapêutico , Espaço Morto Respiratório/efeitos dos fármacos , Adulto , Idoso , Doença Crônica , Feminino , Hemodinâmica/fisiologia , Hospitais Universitários , Humanos , Hipertensão Pulmonar/complicações , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/mortalidade , Japão , Masculino , Pessoa de Meia-Idade , Oxigenoterapia/métodos , Prognóstico , Circulação Pulmonar/fisiologia , Embolia Pulmonar/complicações , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/mortalidade , Espaço Morto Respiratório/fisiologia , Testes de Função Respiratória , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Estatísticas não Paramétricas , Taxa de Sobrevida , Resultado do Tratamento
9.
Nucl Med Rev Cent East Eur ; 22(2): 81-84, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31482561

RESUMO

INTRODUCTION: Hypoplastic left heart syndrome (HLHS) is an inborn complex heart malformation. A multi-stage treatment is initiated in a neonatal period with a Norwood surgery. The next step is Glenn surgery - a bidirectional superior cavo-pulmonary anastomosis. At the last stage anastomosis of inferior vena cava (IVC) with the right pulmonary artery (RPA) is formed as a result of a Fontan surgery. The aim of this study was to assess lung perfusion in patients with HLHS after completion of a surgical therapy, using a scintigraphic method. MATERIAL AND METHODS: In 92 patients with HLHS a planar lung scintigraphy in anterior and posterior projections after administration of 99mTc-macroaggregates in activity 18-111MBq was carried out twice (in several day intervals). At first, a radiopharmaceutical was administered to the right extremity in order to assess the lung distribution of blood flowing through the anastomosis of superior vena cava (SVC) with RPA. In the next study, after administration of the tracer to the right lower extremity, the distribution of blood flowing through the anastomosis of IVC with RPA was assessed. The relative percentage of each lung in the total lung perfusion was calculated on a Xeleris workstation using the "Lung perfusion analysis" program. Lung perfusion was considered close to symmetrical when the proportion was in the range of 40-60%. RESULTS: In spite of the fact that mean relative values of distribution of blood flowing through the anastomosis of SVC with RPA to the left lung (LL) and right lung (RL) in the entire study group did not differ significantly: LLmean = 47%; RLmean = 53%, p = 0.14, relative values of perfusion of both lungs were differentiated - in 26% of patients LL was better perfused, in 38% RL was better perfused and in 36% a perfusion of both lungs was similar. The analysis of blood distribution by anastomosis of IVC with RPA showed that the mean relative perfusion of RL was significantly higher than that of LL (70% vs. 30%, p < 0.0000001). No signs of pulmonary emboli were detected. In 13% of studied patients, uptake of the radiopharmaceutical in kidneys was shown indicating the presence of shunt "from right to left". CONCLUSIONS: After completion of surgical treatment of patients with HLHS, differentiated blood supply of the lungs was observed through SVC with RPA anastomosis and a tendency to higher blood supply of RL than LL by anastomosis of IVC with RPA. No signs of pulmonary embolism were detected. The study revealed a "right to left" shunt in some patients.


Assuntos
Síndrome do Coração Esquerdo Hipoplásico/fisiopatologia , Síndrome do Coração Esquerdo Hipoplásico/cirurgia , Pulmão/irrigação sanguínea , Pulmão/diagnóstico por imagem , Imagem de Perfusão , Circulação Pulmonar , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Síndrome do Coração Esquerdo Hipoplásico/diagnóstico por imagem , Pulmão/cirurgia , Masculino , Resultado do Tratamento , Adulto Jovem
14.
Aerosp Med Hum Perform ; 90(8): 688-695, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31331418

RESUMO

INTRODUCTION: Changes in gravity or body position provoke changes in hydrostatic pressure in the arterial system and in venous return. Potential asymmetries between left (QLV) and right ventricular (QRV) cardiac output during transient gravity changes were investigated. It was hypothesized that blood volume is temporarily stored in the pulmonary vessels, with amount and duration depending on the level and directions of gravity.METHODS: Eight healthy, male subjects (32 ± 3 yr, 182 ± 7 cm, 82 ± 6 kg) were tested on a tilt seat (TS), in a long arm human centrifuge (laHC), and during parabolic flights (PF). The gravitational changes during PF were reconstructed by changing gravity in a laHC and different body positions on a TS. All participants were tested in the seated, resting position. Heart rate and blood pressure were recorded continuously and QLV was calculated, applying the Modelflow Algorithm. Gas exchange was measured breath-by-breath. QRV was calculated from these data according to the Fick Principle. Four sequences were superimposed and analyzed by ANOVA with the factors Time, Ventricle (QRV, QLV), and Mode (TS, PF, laHC).RESULTS: After reductions in gravity QRV and QLV were transiently desynchronized. ANOVA showed no main effect for Mode, but significant changes were found for Time and Ventricle and all interactions.DISCUSSION: Phases of reduced gravity seem to lead to transiently increased storage of blood volume inside the pulmonary vascular system. A more detailed understanding of these mechanisms might help to describe the compliance of the pulmonary vascular system in diseases of the pulmonary circulation.Hoffmann U, Koschate J, Appell Coriolano H-J, Drescher U, Thieschäfer L, Dumitrescu D, Werner A. Adaptation of systemic and pulmonary circulation to acute changes in gravity and body position. Aerosp Med Hum Perform. 2019; 90(8):688-695.


Assuntos
Adaptação Fisiológica , Hipergravidade/efeitos adversos , Postura/fisiologia , Voo Espacial , Adulto , Pressão Sanguínea/fisiologia , Débito Cardíaco/fisiologia , Centrifugação , Voluntários Saudáveis , Frequência Cardíaca/fisiologia , Humanos , Masculino , Circulação Pulmonar/fisiologia
17.
Cardiol Young ; 29(6): 835-836, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31198122

RESUMO

Aneurysms of the pulmonary arteries and trunk are rare entities. The Waterston shunt is a palliative procedure for children with cyanotic CHD due to obstruction of the pulmonary outflow. Described complications are distortion of the pulmonary artery and pulmonary arterial hypertension. We report a patient with a giant right pulmonary artery aneurysm in relation to a Waterston shunt.


Assuntos
Aneurisma/diagnóstico , Artéria Pulmonar , Circulação Pulmonar/fisiologia , Malformações Vasculares/diagnóstico , Adulto , Aneurisma/complicações , Aneurisma/fisiopatologia , Angiografia , Humanos , Masculino , Pressão Propulsora Pulmonar/fisiologia , Malformações Vasculares/complicações , Malformações Vasculares/fisiopatologia
19.
Am J Cardiol ; 124(4): 567-572, 2019 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-31204033

RESUMO

In recent years, the study of right ventricular (RV) to pulmonary circulation (PC) coupling in heart failure with preserved ejection fraction (HFpEF) has been a matter of special interest. Tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (PASP) ratio has emerged as a reliable noninvasive index of RV to PC coupling. Thus, we hypothesized that TAPSE/PASP would be a predictor of readmission burden in HFpEF. One thousand one hundred and twenty seven consecutive HFpEF patients discharged for acute HF were included. In 367 patients (32.6%), PASP could not be accurately measured by echocardiography, leaving the final sample size to be 760 patients. Negative binomial regression method was used to evaluate the association between TAPSE/PASP ratio and recurrent admissions. Mean age of the cohort was 75.6 ± 9.7 years and 68.3% were women. At a median (interquartile range) follow-up of 2.0 (2.9) years, 352 (46.3%) patients died and 1,214 readmissions were registered in 482 patients (63.4%), being 506 of them HF-related. There was a stepwise increase in the rates of all-cause and HF readmissions by decreasing TAPSE/PASP ratio. After multivariable adjustment, TAPSE/PASP <0.36 was associated with a higher risk of HF-related recurrent admissions (incidence rate ratio [IRR] 1.51, 95% confidence interval [CI], 1.01 to 2.24; p = 0.040), whereas patients in the lowest quintile (TAPSE/PASP <0.28) exhibited the highest risk of both all-cause and HF-related recurrent admissions (IRR 1.40, 95% CI 1.04 to 1.87, p = 0.025; and IRR 1.85, 95% CI 1.22 to 2.80, p = 0.004, respectively). In conclusion, TAPSE/PASP ratio, as a noninvasive index of RV-PC coupling, emerges as a strong predictor of recurrent hospitalizations in HFpEF.


Assuntos
Insuficiência Cardíaca/diagnóstico por imagem , Hospitalização/estatística & dados numéricos , Circulação Pulmonar/fisiologia , Volume Sistólico , Disfunção Ventricular Direita/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Pressão Arterial/fisiologia , Estudos de Coortes , Ecocardiografia Doppler , Feminino , Insuficiência Cardíaca/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Artéria Pulmonar/diagnóstico por imagem , Risco , Valva Tricúspide/diagnóstico por imagem , Disfunção Ventricular Direita/fisiopatologia
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