Effects of body position during cardiopulmonary exercise testing with right heart catheterization.

Cardiopulmonary exercise testing (CPX) with right heart catheterization (RHC) widely used for early diagnosis and evaluation of pulmonary vascular disease in patients with pulmonary arterial hypertension and early stage heart failure with preserved ejection fraction, who display normal hemodynamics at rest. The aim of this study was to investigate that whether body position affects pulmonary hemodynamics, pulmonary arterial wedge pressure (PAWP), and CPX parameters during invasive CPX. Seventeen patients (58 ± 14 years; 5/12 male/female) with chronic thromboembolic pulmonary hypertension treated with percutaneous transluminal pulmonary angioplasty and near-normal pulmonary artery pressure (PAP) underwent invasive CPX twice in supine and upright position using a cycle ergometer with 6 months interval.

Successful Treatment of Severe Right-Sided Heart Failure Due to Postoperative Constrictive Pericarditis With Tolvaptan.

The prognosis of inoperative constrictive pericarditis is poor due to subsequent severe right-sided heart failure that is refractory to conventional medical treatment. This case report describes the long-term treatment with tolvaptan, a new selective vasopression V2-receptor antagonist, was remarkably effective for inoperative constrictive pericarditis. Despite that tolvaptan was approved for the treatment of hyponatremia in Europe and the United States, the indications and treatment duration of it are not yet well established clinically.