Exploring the patient perspective in pulmonary hypertension.

The global impacts of pulmonary hypertension (PH) were formally recognised in 1973 at the 1st World Health Organization meeting dedicated to primary pulmonary hypertension, held in Geneva. Investigations into disease pathogenesis and classification led to the development of numerous therapies over the ensuing decades. While the impacts of the disease have been lessened due to treatments, the symptoms and adverse effects of PH and its therapies on patients' wellbeing and mental health remain significant.

Symptoms Suggestive of Postpulmonary Embolism Syndrome and Utilization of Diagnostic Testing.

Background: Persistent symptoms of chest pain, dyspnea, fatigue, lightheadedness, and/or syncope more than 3 months after an acute pulmonary embolism (PE) are collectively classified as postpulmonary embolism syndrome (PPES). Although PPES is increasingly recognized as an important long-term sequel of acute PE, its contemporary incidence is unclear. Furthermore, the utilization of diagnostic testing for further phenotypic characterization of these patients is unknown.

Periprocedural Complications With Balloon Pulmonary Angioplasty: Analysis of Global Studies.

Background: Balloon pulmonary angioplasty (BPA) was introduced as a treatment modality for patients with inoperable, medically refractory chronic thromboembolic pulmonary hypertension decades ago; however, reports of high rates of pulmonary vascular injury have led to considerable refinement in procedural technique.

Objectives: The authors sought to better understand the evolution of BPA procedure-related complications over time.

Methods: The authors conducted a systematic review of original articles published by pulmonary hypertension centers globally and performed a pooled cohort analysis of procedure-related outcomes with BPA.

Safe and Effective Balloon Pulmonary Angioplasty in the Outpatient Setting: The Michigan Medicine Experience.

Background: Balloon pulmonary angioplasty (BPA) is currently performed at select centers worldwide, with the current standard of practice being postprocedural inpatient monitoring for 24 to 72 hours. We sought to evaluate the safety and efficacy of BPA in a cohort of patients with chronic thrombo-embolic pulmonary disease (CTEPD) and chronic thromboembolic pulmonary hypertension (CTEPH) and outline a protocol for implementation in the outpatient setting.

Methods: All patients with distal, inoperable CTEPH, residual symptoms after pulmonary endarterectomy, or symptomatic CTEPD from July 1, 2020, to June 30, 2022, were evaluated by a multidisciplinary chronic thromboembolic pulmonary hypertension team for consideration of BPA.

Pulmonary Hypertension in Heart Failure with Preserved Ejection Fraction.

Heart failure with preserved ejection fraction (HFpEF) is a common medical condition associated with increased morbidity and mortality. Through different mechanisms, including passive left-sided congestion and/or vasculopathy, patients with HFpEF can develop pulmonary hypertension (PH). This association -PH-HFpEF- is linked with worsening symptomatology and long-term outcomes.

Interventional Imaging Roadmap to Successful Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension.

Balloon pulmonary angioplasty (BPA) is an evolving treatment modality for patients with chronic thromboembolic pulmonary hypertension (CTEPH) who are not candidates for pulmonary endarterectomy. Although several imaging modalities currently exist for evaluating CTEPH, their individual use, specifically in the clinical practice of BPA, has not been well described. In this article, we provide a preprocedural, intraprocedural, and postprocedural interventional imaging roadmap for safe and effective BPA performance in routine clinical practice.

Considerations for Inotrope and Vasopressor Use in Critically Ill Patients With Pulmonary Arterial Hypertension.

Pulmonary arterial hypertension (PAH) is a rare and progressive cardiopulmonary disease, characterized by pulmonary vasculopathy. The disease can lead to increase pulmonary arterial pressures and eventual right ventricle failure due to elevated afterload. The prevalence of PAH in patients admitted to the intensive care unit (ICU) is unknown, and pulmonary hypertension (PH) in the ICU is more commonly the result of left heart disease or hypoxic lung injury (PH due to left heart disease and PH due to lung diseases and/or hypoxia, respectively), as opposed to PAH.

Performance of the DETECT Algorithm for Pulmonary Hypertension Screening in a Systemic Sclerosis Cohort.

Objective: Pulmonary arterial hypertension (PAH) is one of the leading causes of mortality in systemic sclerosis (SSc). This study was undertaken to assess predictive accuracies of the DETECT algorithm and the 2015 European Society of Cardiology/European Respiratory Society (ESC/ERS) guidelines in SSc patients who underwent right-sided heart catheterization (RHC) for pulmonary hypertension (PH) evaluation.

Methods: Patients with SSc who had diagnostic RHC, had no PH or had PAH, and had available data on variables to allow application of the DETECT and 2015 ESC/ERS guidelines were included for analysis.

Barriers to physical activity in patients with pulmonary hypertension.

Patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) have low levels of physical activity (PA). Increased PA has health benefits including improved quality of life. This study aimed to identify patient-perceived barriers to PA that correlate with objectively measured PA in this population.

Safety of regadenoson stress testing in patients with pulmonary hypertension.

Objectives: We sought to determine the safety of regadenoson stress testing in patients with PH.

Background: PH is increasingly recognized at more advanced ages. As many as one-third of patients with PH have coronary artery disease.

Percutaneous transluminal coronary angioplasty of left main coronary artery.

The present study is a retrospective analysis of 15 percutaneous angioplasty procedures of the left main coronary artery performed in 12 patients (8 males (66%) with a mean age of 64 +/- 12 (range 45-79) years. Twelve dilatations were elective: 8 for unstable angina, 3 for stable angina, and 1 after a recent myocardial infarction. All elective patients were protected with at least 1 patent graft to the distal left coronary artery.

Success with coronary angioplasty as seen at demonstrations of procedure.

To assess the real-life results of coronary angioplasty, unidentified participants made notes on 104 cases demonstrated live at twelve international angioplasty courses in 1991. The initially planned procedure was successful in 73% with crossover to another device in 20% for an ultimate success rate of 93%. Interventions lasted an hour on average and two devices on average were used per artery tackled.

PTCA at first sight: angioplasty based on video only.

The results of 326 coronary angioplasties (PTCAs) performed during a first diagnostic angiography and based on video images only (PTCA at first sight, Group I) are compared with those of 756 PTCAs done during the same time period in patients with a previous cine-film and therefore a known or predictable coronary anatomy (Group II). Group I patients had more single vessel disease (74% versus 58%, p less than 0.001), single vessel PTCA (93% versus 84%, p<0.

Percutaneous transluminal coronary angioplasty through six French catheters.

We present the results of 221 coronary angioplasty (PTCA) procedures in which a 6 French diagnostic catheter was chosen as a guiding catheter. A total of 218 were done through a femoral and 3 through an axillary approach. Total occlusion PTCA was done in 9 (4%) and multivessel PTCA in 19 procedures (9%).

Intracoronary electrocardiogram during coronary angioplasty.

This prospective study examines the data derived from the intracoronary electrocardiogram (ECG) (derived from the coronary guide wire) compared with that from four standard surface leads (I, II, III, and V2) in documenting myocardial ischemia during coronary angioplasty. Intracoronary and surface ECGs were simultaneously recorded in 300 consecutive patients (mean age 59 +/- 10; range 33 to 80 years; 246 males [82%] during coronary angioplasty in 368 lesions (167 left anterior descending [46%], 85 left circumflex [23%], 107 right coronary arteries [29%], and nine bypass grafts [2%]), before balloon inflation, at 1 minute of inflation, and at the end of the procedure. ST segment changes (greater than 0.