Phenotype and outcomes according to loop diuretic use in pulmonary arterial hypertension.

Aims: The use of loop diuretics in pulmonary arterial hypertension (PAH) is less frequent compared with heart failure. The clinical and prognostic characteristics of PAH patients according to loop diuretic use remain unexplored. In this study, we retrospectively analysed the characteristics and survival of PAH patients requiring different doses of loop diuretics.

Performance of risk stratification scores and role of comorbidities in older vs younger patients with pulmonary arterial hypertension.

Background: Risk scores are important tools for the prognostic stratification of pulmonary arterial hypertension (PAH). Their performance and the additional impact of comorbidities across age groups is unknown.

Methods: Patients with PAH enrolled from 2001 to 2021 were divided in ≥65 years old vs <65 years old patients.

[Pulmonary hypertension clinical pathway: ANMCO Tuscany Board model].

Pulmonary hypertension (PH) is defined by a mean pulmonary artery pressure >20 mmHg at rest during right heart catheterization. PH prevalence is about 1% of the global population. The PH clinical classification includes five groups: pulmonary arterial hypertension, PH associated with left heart disease, PH associated with lung disease, PH associated with pulmonary artery obstructions, PH with unclear and/or multifactorial mechanisms.

Echocardiographic Biventricular Coupling Index to Predict Precapillary Pulmonary Hypertension.

Background: Pulmonary hypertension (PH) is a frequent and detrimental condition. Right heart catheterization (RHC) is the gold standard to identify PH subtype (precapillary from postcapillary PH) and is key for treatment allocation. In this study, the novel echocardiographic biventricular coupling index (BCI), based on the ratio between right ventricular stroke work index and left ventricular E/E' ratio, was tested for the discrimination of PH subtype using RHC as the comparator.

A novel echocardiographic method for estimation of pulmonary artery wedge pressure and pulmonary vascular resistance.

Aims: This study aimed to evaluate a novel echocardiographic algorithm for quantitative estimation of pulmonary artery wedge pressure (PAWP) and pulmonary vascular resistance (PVR) in patients with heart failure and pulmonary hypertension (PH) scheduled to right heart catheterization (RHC).

Methods And Results: In this monocentric study, 795 consecutive patients (427 men; age 68.4 ± 12.

Global Right Heart Assessment with Speckle-Tracking Imaging Improves the Risk Prediction of a Validated Scoring System in Pulmonary Arterial Hypertension.

Background: Right ventricular (RV) function and right atrial (RA) remodeling are major determinants of outcome in pulmonary arterial hypertension (PAH). Strain echocardiography is emerging as a valuable approach for the study of RV and RA function. We sought to assess the incremental prognostic value of serial combined speckle-tracking examination of right chambers in newly diagnosed therapy-naïve PAH patients.

Cardio-pulmonary involvement in pulmonary arterial hypertension: A perfusion and innervation scintigraphic evaluation.

Background: Pulmonary arterial hypertension (PAH) is characterized by the right ventricle (RV) remodeling and pulmonary endothelial dysfunction. We studied cardiac perfusion and innervation in PAH with a cadmium-zinc-telluride (CZT) scanner and lung uptake impairment of I-metaiodobenzylguanidine (I-MIBG).

Methods: In 13 patients with newly diagnosed PAH and 11 dilated cardiomyopathies (DCM, for comparative purposes), we assessed early and delayed I-MIBG uptake ratios of lung-to-mediastinum (L/M) and heart-to-mediastinum (H/M) on anterior planar images.

Survival protection by bodyweight in isolated scleroderma-related pulmonary artery hypertension.

In chronic heart failure (CHF) due to systemic cardiovascular disease, obese patients have better survival. Bodyweight versus survival was analyzed post hoc in subjects with limited scleroderma (SSc) and isolated pulmonary artery hypertension (PAH), i.e.

Accuracy of chest radiography in predicting pulmonary hypertension: a case-control study.

Objective: To assess the accuracy of chest radiography (CXR) in predicting pulmonary hypertension (PH).

Methods: We studied 108 consecutive patients with suspected PH who underwent right heart catheterization (RHC). All were PH treatment naives.

Improved survival in limited scleroderma-related pulmonary artery hypertension.

Reportedly, patients with scleroderma-related pulmonary hypertension (SSc-PAH) respond poorly to new vasoactive drugs (NVD). Forty-nine SSc-PAH patients underwent right heart catheterization (RHC) and, according to NVD availability, divided as follows: Group 1 (n = 23, from 1999 to 2004, poor availability), and Group 2 (n = 26, from 2005 to 2010, good availability). Before diagnostic RHC, NVD had been given to 30 % of the patients in Group 1, and 58 % of those in Group 2 (p = 0.

Improved survival in patients with inoperable chronic thromboembolic pulmonary hypertension.

Patients with inoperable chronic thromboembolic pulmonary hypertension (Inop-CTEPH) treated with conventional therapy have a poor survival. We compare the 3-year survival between those treated with conventional therapy and those treated with conventional therapy and a combination of novel drugs. We also evaluate the clinical course.

Arterial base deficit in pulmonary embolism is an index of severity and diagnostic delay.

In acute pulmonary embolism, patients free from circulatory failure usually present a blood gas pattern consistent with respiratory alkalosis. We investigated whether the appearance of arterial base deficit in these patients indicates disease severity and diagnostic delay. Twenty-four consecutive patients with pulmonary embolism were retrospectively evaluated.

Fibrin resistance to lysis in patients with pulmonary hypertension other than thromboembolic.

Rationale: Reportedly, fibrin isolated from patients with chronic thromboembolic pulmonary hypertension (CTEPH) is resistant to lysis. Persistence of regions within the fibrin beta chain, which mediate cell signaling and migration, could trigger the organization of pulmonary thromboemboli into chronic intravascular scars.

Objectives: Ascertain whether fibrin resistance to lysis occurs in patients with pulmonary hypertension (PAH) other than CTEPH, and in those with prior pulmonary embolism (PE) and no pulmonary hypertension.

Survival and restoration of pulmonary perfusion in a long-term follow-up of patients after acute pulmonary embolism.

We followed prospectively 834 consecutive patients (70% inpatients), evaluated for suspected pulmonary embolism, for a median time of 2.1 years (range, 0-4.8 yr), and compared the survival rates in patients with proven pulmonary embolism (n=320) with those without (n=514).

Role of the chest radiograph in the preoperative assessment of the pulmonary function in patients with cirrhosis candidates to liver transplant.

Purpose: To appraise the role of chest radiography (CXR) in the clinical assessment of pulmonary complications occurring as a result of liver disease of any cause, a standardised reading of CXR was compared both with the results of lung function studies and with the severity of liver disease in 60 consecutive patients with cirrhosis candidates to liver transplant.

Materials And Methods: CXR were scored for signs of cardiomegaly, enlargement of central and or peripheral vessels, hyperkinetic circulatory and/or intravascular volume states, abnormally increased interstitial lung markings, and pleural effusion by three independent observers.

Results: The CXR score of this complete vascular-interstitial deficiency showed a high interobserver reproducibility and was significantly increased in those patients with a more decompensated liver cirrhosis.

A diagnostic strategy for pulmonary embolism based on standardised pretest probability and perfusion lung scanning: a management study.

Pulmonary embolism remains a challenging diagnostic problem. We developed a simple diagnostic strategy based on combination of assessment of the pretest probability with perfusion lung scan results to reduce the need for pulmonary angiography. We studied 390 consecutive patients (78% in-patients) with suspected pulmonary embolism.