Right ventricular outflow tract fractional shortening: a novel diagnostic parameter for pulmonary hypertension.

Pulmonary hypertension (PH) is a progressive vascular disease characterized by elevated pulmonary arterial pressure and resistance in the pulmonary vascular bed. It is associated with high morbidity and mortality. Although right heart catheterization (RHC) is the gold standard for diagnosis, noninvasive methods, such as echocardiography, are essential for early detection and management.

Which Diastolic Pressure Should Be Used to Assess Diastolic Function?

Background: Although high left ventricular filling pressures [left ventricular (LV) end-diastolic pressure or pulmonary capillary wedge pressure (PCWP)] are widely taken as surrogates for LV diastolic dysfunction, the actual distending pressure that governs LV diastolic stretch is transmural pressure difference (∆PTM). Clinically, preferring ∆PTM over PCWP may improve diagnostic and therapeutic decision-making. We aimed to compare the clinical implications of diastolic function characterization based on PCWP or ∆PTM.

Is Pulmonary Capillary Wedge Pressure a Reliable Indicator of Postcapillary Pulmonary Hypertension?

Although current pulmonary hypertension (PH) guidelines recommend a pulmonary capillary wedge pressure (PCWP) >15 mm Hg for the detection of a postcapillary component, the rationale of this recommendation may not be quite compatible with the peculiar hemodynamics of PH. We hypothesize that a high PCWP alone does not necessarily indicate left-sided disease, and this diagnosis can be improved using left ventricle transmural pressure difference (∆ P). In this 2-center, retrospective, observational study, we enrolled 1,070 patients with PH who underwent heart catheterization, with the final study population comprising 961 cases.

Are Guideline-recommended Risk Classification Schemes in Pulmonary Hypertension Adequately Robust to Guide the Real-world Setting?

Background: Pulmonary hypertension is a complex syndrome that encompasses a diverse group of pathophysiologies predisposed by different environmental and genetic factors. It is not clear to which extent the universal risk classification schemes can be applied to cohorts in individual pulmonary hypertension centers with differing environmental backgrounds, genetic pools, referral networks.

Aims: To explore whether the recommended risk classification schemes could reliably be used for mortality prediction in an unselected pulmonary hypertension population of a tertiary pulmonary hypertension center.

Right Ventricular Energy Failure Predicts Mortality in Patients With Pulmonary Hypertension.

Right ventricular (RV) failure has a significant adverse impact on pulmonary hypertension (PH) prognosis. None of the currently used parameters directly assess whether RV fails to provide enough energy output to propel the blood through diseased pulmonary vascular system. Furthermore, most of the current parameters are affected by the volume status of the patient.

Effects of balloon pulmonary angioplasty procedure on electrocardiographic parameters in patients with chronic thromboembolic pulmonary hypertension.

Aim: The aim of the present study was to evaluate the value of electrocardiography (ECG) in predicting postoperative hemodynamic improvement in patients with chronic thromboembolic pulmonary hypertension (CTEPH) undergoing balloon pulmonary angioplasty (BPA).

Material And Methods: A total of 32 patients were included in the study. During ECG analysis, parameters that have been suggested to be related to right ventricular hypertrophy and/or dilatation were evaluated.

Intra-aortic Balloon Occlusion for Refractory Cardiac Arrest in a Patient with Anterior Myocardial Infarction.

Despite recent advances in its management, the outcome of cardiac arrest is often poor despite appropriate cardiopulmonary resuscitation. The arteriovenous perfusion gradient achieved dur ing cardiopulmonary resuscitation is associated with the successful return of spontaneous cir culation. Continuous balloon occlusion of the descending aorta is an experimental method that can occlude the "unnecessary" part of the circulation, thus diverting generated pressure and blood flow to the heart and brain.

The Effects of Iron Replacement on Functional Capacity in Patients with Group 1 and Group 4 Pulmonary Hypertension.

Objective: Abnormal iron handling complicates pulmonary hypertension (PH), causes functional limitation and poor outcomes. Although preliminary results in group 1 PH patients support the use of iron replacement, whether this applies to other PH subgroups is not known.

Methods: A total of 58 patients with an established diagnosis of group 1 or 4 PH, who had a serum ferritin of <100 ng/mL or 100 to 300 ng/mL in combination with a transferrin saturation (TSAT) <20% and received 500 to 1000 mg of ferric carboxymaltose (FCM) were included in the study.

Prediction of subclinical left ventricular dysfunction by speckle-tracking echocardiography in patients with anti-neutrophil cytoplasmic antibody--associated vasculitis.

Objectives: This study aims to evaluate left ventricular functions using speckle-tracking echocardiography (STE) in patients with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).

Patients And Methods: Between June 2018 and July 2019, a total of 31 AAV patients (17 males, 14 females; median age: 53 years; range, 47 to 62 years) and 21 healthy controls (11 males, 10 females; median age: 56 years; range, 46 to 60 years) were included in the study. Clinical and biochemical characteristics of all participants were recorded.

Change in pulmonary arterial compliance and pulmonary pulsatile stress after balloon pulmonary angioplasty.

Objective: Although the underlying pathology of chronic thromboembolic pulmonary hypertension (CTEPH) is mechanical obliteration of the major pulmonary vessels, high pulsatile stress penetrating into the normal distal pulmonary microvasculature resulting from reduced pulmonary arterial compliance (CPA) may cause progressive deterioration in pulmonary hemodynamics. Hypothetically, balloon pulmonary angioplasty (BPA) may be beneficial in reducing CPA and pulsatile stress in patients with CTEPH.

Methods: In total, 26 patients with available pre- and post-BPA right heart catheterization results were included in the study.

Balloon Pulmonary Angioplasty in Patients With Inoperable or Recurrent/Residual Chronic Thromboembolic Pulmonary Hypertension: A Single-Centre Initial Experience.

Background: Patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) are often treated with pulmonary arterial hypertension-specific drugs. However, most of these patients remain symptomatic, despite medical treatment. Balloon pulmonary angioplasty (BPA) is an emerging therapeutic intervention for patients with inoperable CTEPH.

Multimodal Approach of Isolated Pulmonary Vasculitis: A Single-Institution Experience.

Background: Isolated pulmonary vasculitis (IPV) is a single-organ vasculitis of unknown etiology and may mimic chronic thromboembolic pulmonary hypertension (CTEPH). The aim of this study was to review our clinical experience with pulmonary endarterectomy in patients with CTEPH secondary to IPV.

Methods: Data were collected prospectively for consecutive patients who underwent pulmonary endarterectomy and had a diagnosis of IPV at or after surgery.

The prevalence of metabolic syndrome is increased in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis.

Purpose: Cardiovascular disease is one of the major causes of mortality in anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV). Metabolic syndrome (MetS) is associated with increased cardiovascular risk in the normal population. However, MetS in AAV has not been adequately investigated.

A case of heart failure mimicking COVID-19 pneumonia: The role of clinical and chest computed tomography findings in the differential diagnosis.

Acute heart failure (HF) is one of the most common cardiac emergencies. Pulmonary edema caused by HF may mimic an exudative disease on chest computed tomography scans. Coronavirus disease 2019 (COVID-19) emerged in China in December 2019 and quickly spread around the world.

Improvements of right ventricular function and hemodynamics after balloon pulmonary angioplasty in patients with chronic thromboembolic pulmonary hypertension.

Purpose: Right ventricular (RV) function is an important factor in the prognosis of chronic thromboembolic pulmonary hypertension (CTEPH) in patients. In our study, we aimed to evaluate the timing and magnitude of regional RV function before and after balloon pulmonary angioplasty (BPA) using speckle tracking echocardiography (STE) and their relation to clinical and hemodynamic parameters in patients with CTEPH.

Material And Method: We enrolled 20 CTEPH patients and 19 healthy subjects in our study.

Timing and magnitude of regional right ventricular function and their relationship with early hospital mortality in patients with acute pulmonary embolism.

Objective: Right ventricular (RV) dysfunction in acute pulmonary embolism (APE) has been associated with increased mortality and morbidity. The aim of the present study was to assess the timing and magnitude of regional RV functions using speckle-tracking echocardiography (STE) and their relationship to early hospital mortality in patients with APE.

Methods: One hundred forty-two patients were prospectively studied at the onset of an acute episode and after a median follow-up period of 30 days.

Assessment of right ventricular function and relation to mortality after acute pulmonary embolism: A speckle tracking echocardiography-based study.

Purpose: Right ventricular (RV) dysfunction is a common condition that is related to increased adverse outcomes in patients with acute pulmonary embolism (APE). Our aim was to assess timing and magnitude of regional RV function using speckle tracking echocardiography (STE) and to evaluate their relationship to long-term mortality in patients after APE.

Methods: In total, 147 patients were enrolled at the onset of an APE episode and followed for 12 ± 1.

Subacute aortic prosthetic mechanical valve thrombosis complicated with acute coronary syndrome.

A prosthetic valve thrombosis (PVT), which is a potentially fatal complication, refers to the presence of non-infective thrombotic material on a prosthetic valve apparatus, interfering with its function. Possible complications of a PVT include transient neurologic embolic events, cardiac arrest due to a stuck valve prosthesis, and cardio-embolic myocardial infarction (MI). The choice of treatments, including a redo surgery, a percutaneous coronary intervention (PCI), and a fibrinolysis with PVT or MI dosages, depends on the patient's clinical and hemodynamic status and thrombotic burden involving the prosthetic valve and surrounding tissues.

Short and Long Term Mortality Predictors in Octogenarians with Acute Coronary Syndromes.

Purpose: Octogenarians with acute coronary syndromes have higher mortality and morbidity due to higher prevalence of comorbidities and frailty. The aim of this study was to explore the predictors of short and long term mortality in octogenarians with ACS.

Methods: Ninety-eight consecutive octogenarians presenting with acute coronary syndrome (mean age:84±3 years, 56 male) were included.

Influence of collaterals on the left ventricular end-diastolic pressure and serum NT-proBNP levels in patients with coronary chronic total occlusion.

Objective: Although numerous studies have shown the protective effects of the well-developed coronary collaterals on left ventricular functions, the relationship between collateral grade and left ventricular end diastolic pressure has not been studied in chronic total occlusion patients. Also, there are conflicting data on the effect of collaterals on NT-proBNP levels. The aim of our study was to evaluate the relationship between coronary collateral circulation and left ventricular end diastolic pressure and NT-proBNP levels in chronic total occlusion patients.