Hypertension

The Pulmonary Hypertension Association recently designated Banner Health’s Cardiovascular Institute of North Colorado a Regional Clinical Program for its pulmonary hypertension program. Located at 1800 15th St., #340A in Greeley, the Cardiovascular Institute’s program is the only one in the state with the Regional Clinical Program designation. The next closest regional clinical program is located in Dallas, Texas, with a total of six in the U.S. The Pulmonary Hypertension Association launched the Pulmonary Hypertension Care Centers accreditation program in 2014 to help patients with the life-threatening lung disease get care from expert clinicians. Also known as high blood pressure of the lungs, pulmonary hypertension affects people of all ages and ethnic backgrounds. The disease can result from the arteries in the lungs becoming damaged, narrowed or stiffened, which forces the right side of the heart to pump with additional force and leads to right heart failure and death. Common ...

January 28, 2019 Share this content: A gene panel was designed to focus on all exons and included BMPR-2, EIF2AK4, TBX4, CAV1, SMAD9, KCNK3, ACVRL1, BMP9, ENG, and BMP10. Heritable pulmonary arterial hypertension (PAH) involves mutations in genes other than Bone Morphogenetic Protein Receptor Type 2 ( BMPR-2 ), according to a study published in the  European Respiratory Journal.  The roles of  TBX4 ,  BMP9 , and  BMP10 , a new gene in PAH, have been bolstered by this research. This study included 268 participants with PAH that was familial or sporadic (n=181), induced by toxins or drugs (n=13), linked with a familial history (n=11), or sporadic pulmonary veno-occlusive disease/pulmonary capillary hemangiomatosis (PVOD/PCH; n=63). A gene panel was designed to focus on all exons and included  BMPR- 2 ,  EIF2AK4 ,  TBX4 ,  CAV1 ,  SMAD9 ,  KCNK3 ,  ACVRL1 ,  BMP9 ,  ENG , and  BMP10 . Using this gene pan...

January 24, 2019 Share this content: After 6 months of riociguat treatment, there were significant decreases in right ventricular thickness tricuspid regurgitation velocity, right atrial area, and right ventricular area. Smaller right heart size and better right ventricular function have been observed in individuals with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH) undergoing long-term riociguat treatment, according to a study recently published in Respiratory Research. This retrospective study included 71 participants, 45% of whom had PAH and 55% of whom had CTEPH . A little more than 50% of the participants were women, the average age was 60, and had taken 1.0 to 2.5 mg of riociguat 3 times daily for 3 to 12 months within the CHEST, Early Access Study, PATENTplus, or PATENT trials. Blinded, offline analysis of echocardiography by investigators took place at baseline, 3, 6, and 12 months. The change in right atrial area at 1 year ...

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In this episode, Andrew Perry, MD, discusses pulmonary hypertension with Murali Chakinala, MD, who specializes in pulmonary vascular diseases at Washington University School of Medicine in St. Louis. During the course of the conversation, they cover the diagnosis and disease groupings related to this condition, as well as the available treatments. A transcript of the podcast follows: Perry: Maybe first let's start with you maybe saying your name and your title, and then I'll describe that case that I encountered. Chakinala: I'm Murali Chakinala. I'm a member of the pulmonary division at Washington University. I'm a Professor of Medicine, and I direct our Pulmonary Hypertension Care Center. Perry: Thank you for meeting with me today. This is actually a few months ago, starting with a patient case. I was rotating through the cardiothoracic ICU as an elective, and we had a gentleman come up from the OR with a mitral valve repair from mitral stenosis. Past medi...

January 21, 2019 Share this content: Patients with CTEPH had a higher antiphospholipid prevalence rate compared with the general population, as well as patients with pulmonary embolism. Antiphospholipid (aPL) antibodies are commonly found in patients with chronic thromboembolic pulmonary hypertension (CTEPH), and may be predictive biomarkers for the disease. This is according to a systematic review and meta-analysis published in Internal and Emergency Medicine . Investigators independently reviewed online databases for studies reporting inherited acquired thrombophilia results in patients with CTEPH . A total of 8 studies that included patients with CTEPH and data on patients' aPL antibody profiles were included in the final analysis. Continue Reading Below Significant heterogeneity among included studies was observed ( I 2 , 76.33%; 95% CI, 52.75%-88.14%; P =.0001). In the crude analysis, patients with CTEPH had a higher aPL prevalence rate (11.8%) compared with the ge...

Two cardiologists in the Netherlands are using an artificial intelligence (AI) tool called the VMS Heart Analysis System, developed by Ventripoint Diagnostics , for the early diagnosis of pulmonary hypertension in sarcoidosis patients. With this tool, Marco Post, MD, PhD, and Marloes Huitema, MD, at the St. Antonius Hospital in Utrecht/ Nieuwegei n , have already diagnosed nearly 20 out of approximately 500 sarcoidosis patients with confirmed pulmonary hypertension (PH). Sarcoidosis is an inflammatory disorder that can affect several organs in the body. PH — a disease characterized by high pressure in vessels that supply blood from the heart to the lungs — is estimated to develop in 6-74 percent of patients with sarcoidosis. In PH patients, the heart needs to work harder to force blood through the vessels. Over time, this extra work causes the right side of the heart to become larger, potentially causing right-sided heart failure, and premature death. Therefore, an early and...

January 17, 2019 Share this content: Lung transplantation is still an important treatment option for patients with refractory disease. When clinicians have a clear treatment objective like transplantation or recovery for patients with pulmonary arterial hypertension (PAH), advanced intensive care treatment and extracorporeal life support (ECLS) is warranted; however, advanced intensive care can be futile when these treatment goals are not realistic, and best supportive care becomes the superior choice, according to an article published in the  European Respiratory Journal . Although there has been therapeutic progress, PAH remains an incurable, chronic disease that is often fatal. Intensive care of these patients focuses on careful fluid management, management of factors that can cause or contribute to heart failure , and strategies to improve cardiac function and reduce ventricular afterload. In distinct situations with clear treatment goals, such as in candidates for lung tr...

January 17, 2019 Share this content: Lung morphometry demonstrated that fucoidan significantly decreased the number of fully muscularized pulmonary arteries. Mice chronically exposed to hypoxia and given fucoidans exhibited improved vascular remodeling, right ventricular (RV) function, and an attenuated inflammatory response, according to study results published in the American Journal of Respiratory and Critical Care Medicine . Mice induced with pulmonary hypertension (PH) by chronic hypoxia for 35 days were given either fucoidan (from Fucus vesiculosus ), anti-P-selectin antibody (Rb40.34), or saline by intraperitoneal injection from days 21 through 35. Parameters associated with PH such as RV function, vascular morphometry, and inflammatory responses were compared between groups. Continue Reading Below Hypoxia exposure for 35 days resulted in significant RV hypertrophy confirming the occurrence of PH. Control mice also exhibited RV dilatation, increased RV systolic press...