Riociguat in patients with sickle cell disease and hypertension or proteinuria (STERIO-SCD): a randomised, double-blind, placebo controlled, phase 1-2 trial.

Background: Although nitric oxide based therapeutics have been shown in preclinical models to reduce vaso-occlusive events and improve cardiovascular function, a clinical trial of a phosphodiesterase 5 inhibitor increased rates of admission to hospital for pain. We aimed to examine if riociguat, a direct stimulator of the nitric oxide receptor soluble guanylate cyclase, causes similar increases in vaso-occlusive events.

Methods: This was a phase 1-2, randomised, double blind, placebo-controlled trial.

The Value of Bedside Echocardiogram in the Setting of Acute and Chronic Pulmonary Embolism.

Echocardiography is valuable in the evaluation and risk stratification of patients with acute and chronic pulmonary embolism (PE). Patients with acute PE who have echocardiographic evidence of right ventricular dilatation and/or right ventricular dysfunction have a worse prognosis. A minority of patients with acute PE can develop chronic thromboembolic pulmonary hypertension.

Effect of 6-min Walk Test on pro-BNP Levels in Patients with Pulmonary Arterial Hypertension.

Background: Plasma pro-BNP (brain natriuretic peptide) levels are often elevated in response to right ventricular (RV) volume and pressure overload, parameters potentially affected by exercise. Plasma pro-BNP levels change in association with long-term changes in pulmonary hemodynamics, thereby serving as a potential biomarker in pulmonary arterial hypertension (PAH). The 6-min Walk Test (6MWT) and pro-BNP level are often checked in a single office visit.

Safety and feasibility of obtaining wedged pulmonary artery samples and differential distribution of biomarkers in pulmonary hypertension.

This study aims to evaluate the safety and feasibility of obtaining wedged pulmonary artery (PA) samples and investigate the differential vascular beds' distribution of select inflammatory and cellular adhesion molecules that are implicated in pulmonary arterial hypertension (PAH) pathogenesis. This is a cross-sectional study of adult patients. Serum samples were simultaneously drawn from three different vascular sites during right heart catheterization as part of PAH evaluation: The superior vena cava, distal pulmonary artery prior to wedging, and distal pulmonary artery after (and distal to) wedging.

Thermodilution and Fick cardiac outputs differ: impact on pulmonary hypertension evaluation.

Background: The relationship between thermodilution and indirect Fick cardiac output determination methods has not been well described.

Objective: To describe the relationship between these two cardiac output determination methods in patients evaluated for pulmonary hypertension and to highlight potential clinical implications.

Methods: A retrospective review of charts of all adult patients who underwent a right heart catheterization (RHC) between January 1, 2007 and November 10, 2010, and participated in the pulmonary hypertension program of the pulmonary division at an academic institution was conducted.