Wave Intensity Analysis Provides Novel Insights into Pulmonary Hypertension
|
|
|
- Eileen Reed
- 5 years ago
- Views:
Transcription
1 ARTERY 2016, Copenhagen Wave Intensity Analysis Provides Novel Insights into Pulmonary Hypertension Junjing Su 1,2, Charlotte Manisty 3, Kim Parker 4, Ulf Simonsen 1, Jens Erik Nielsen-Kudsk 5, Soren Mellemkjaer 5, Luke Howard 2, Alun Hughes 2,3 1. Department of Biomedicine, Aarhus University 2. National Heart and Lung Institute, Imperial College London 3. Institute of Cardiovascular Sciences, University College London 4. Department of Bioengineering, Imperial College London 5. Department of Cardiology, Aarhus University Hospital, Skejby NHLI DEPARTMENT OF BIOMEDICINE
2 Background
3 Arterial waves dp du Su et al., Acta Physiol, 2016
4 Arterial waves dp du dp du Su et al., Acta Physiol, 2016
5 Arterial waves dp du dp du dp du dp du Su et al., Acta Physiol, 2016
6 Wave intensity analysis (WIA) Analysis of the incremental changes in pressure (P) and flow velocity (U) in a circulation Wave intensity: energy carried by a wave di = dp x du (Unit W/m 2 = J/sm 2 )
7 Pulmonary hypertension (PH) Mean pulmonary arterial pressure (PAPm) 25 mmhg right heart failure PAH (Pulmonary arterial hypertension) CTEPH (Chronic thromboembolic PH) PH due to left heart disease PH with unclear or multifactorial causes PH due to lung disease
8 WIA in pulmonary artery WIA in the pulmonary artery in man is feasible! Clinical implications? Lau et al, Eur Respir J, 2014 Quail et al, Am J Physiol, 2015
9 Objective Assess arterial wave characteristics in the pulmonary artery Explore the clinical usefulness of WIA in pulmonary hypertension Right PA Left PA Main PA RV
10 Study design
11 Inclusion criteria Patients referred to the cardiac catheterisation laboratory for clinical reasons Control subjects: no significant heart or lung disease PH patients: patients with confirmed or suspected PAH or CTEPH
12 Right heart catheterisation Right heart catheterisation with simultaneous pressure and velocity measurements. ECG Pressure Velocity
13 Data processing Data ensemble averaged using the R-wave of ECG
14 Data processing Data ensemble averaged using the R-wave of ECG Calculation of wave speed (sum of squares method) 1 c dp 2 du 2
15 Data processing Data ensemble averaged using the R-wave of ECG Calculation of wave speed (sum of squares method) Wave intensity (WI) normalized to number of samples in the cardiac cycle WI CCD dp dt du CCD dt CCD: cardiac cycle duration
16 Data processing Data ensemble averaged using the R-wave of ECG Calculation of wave speed (sum of squares method) Wave intensity (WI) normalized to number of samples in the cardiac cycle Separation of forward and backward waves Forward: WI dp CCD dt du CCD c 4c dt Backward: WI dp CCD dt du CCD c 4c dt
17 Results
18 Study subjects Recruited N = 36 Excluded N = 5 Control N = 10 PAPm: 17 mmhg PAH N = 11 PAPm: 47 mmhg CTEPH N = 10 PAPm: 48 mmhg
19 Control WIA pattern
20 WIA pattern Control PAH FCW BCW FDW FCW BCW FDW
21 WIA pattern CTEPH PAH FCW FDW FCW FDW BCW BCW
22 Wave speed PH patients = PAH + CTEPH Mild PH: mmhg Moderate PH: mmhg Severe PH: > 45 mmhg
23 Wave reflection Wave reflection index (WRI) = BCW/FCW
24 Wave reflection No significant difference Impedance mismatch
25 The right ventricle FCW energy No significant difference
26 No significant difference The right ventricle FCW energy RV stroke energy
27 FCW energy The right ventricle FCW to RV energy ratio RV stroke energy
28 FCW energy The right ventricle FCW to RV energy ratio RV stroke energy Differentiating CTEPH from PAH (FCW to RV energy ratio) AUROC = 0.87 p < 0.001
29 Discussion and conclusion
30 Early detection of disease Progressive loss of microcirculation 25 mmhg Vascular damage in > 50 % of the microcirculation Impedance mismatch occurs in the initial phase of disease (as indicated by wave reflection) Lau et al., Eur Heart J, 2011
31 PAH versus CTEPH PAH: pharmacological treatment CTEPH: pulmonary endarterectomy FCW to RV energy ratio greater in CTEPH than PAH differences in RV function CTEPH: rapid adaptation PAH: gradual adaptation May serve as an additional measurement
32 Conclusion Wave speed increases in PH greater arterial stiffness. Wave reflection is minimal in individuals without pulmonary vascular disease. Large wave reflection in pulmonary hypertension and it is unrelated to severity. Increased wave reflection may be an early indicator of pulmonary vascular disease. FCW to RV energy ratio can differentiate between PAH and CTEPH.
33 Thank you!
34 Aarhus group: Acknowledgements 1 Prof Ulf Simonsen, 2 Dr Jens Erik Nielsen-Kudsk, 3 Dr Ole Hilberg, 2 Dr Soren Mellemkjaer, 1. Department of Biomedicine, Aarhus University 2. Department of Cardiology, Aarhus University Hospital 3. Department of Respiratory Medicine, Aarhus University Hospital London group: 1,2 Prof Alun Hughes, 3 Prof Kim Parker, 1 Dr Charlotte Manisty, 2 Dr Luke Howard 1. Department of Cardiovascular Sciences, University College London 2. National Heart and Lung Institute, Imperial College London 3. Department of Bioengineering, Imperial College London Funding: European Respiratory Society Aarhus University Graduate School Health Research Fund of Central Denmark Region St. Mary s Coronary Flow Trust Fonden til Lægevidenskabens Fremme Kornings Fond Bønnelyckes Fond Eva og Henry Frænkels Mindefond
35 Combowires Right heart catheterisation Sensor
36 Calculations wave intensity Original wave intensity (Wm -2 ) di dp du Time-normalized Wave intensity (Wm -2 s -2 ) WI dp dt du dt Wave intensity normalized to sample numbers (Wm -2 ) WI dp CCD dt du CCD dt
37 Calculations RV energy RV stroke work RVSW ( PAPm RAP) RVSV RV energy density RV energy density RVSW CSA ( PAPm RAP) HR / U ( PAPm ( PAPm RAP) RVSV RVSV HR / mean RAP) U mean U mean CCD
38 Participant characteristics Control N = 10 PAH N = 11 CTEPH N = 10 Age (yrs) Male, n (%) 8 (80 %) 2 (18 %) 2 (20 %) BMI (kg/m 2 ) HR (beats/min) PAPm (mmhg) TPRI (WU/m2) CI, L/min/m BNP (ng/l) p < 0.05 vs control
39 Pressure separation
40 Compliance Wave speed mpap rho = 0.71 p < 0.01 rho = 0.61 p < 0.01 TAPSE BNP No association rho = 0.57 p = 0.01 rho = 0.26 p = 0.28
41 Compliance Wave reflection mpap No association No association rho = 0.34 p < 0.16 rho = p < 0.68 TAPSE BNP No association No association rho = 0.22 p = 0.37 rho = 0.06 p = 0.81
Wave Intensity Analysis Provides Novel Insights Into Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension
Wave Intensity Analysis Provides Novel Insights Into Pulmonary Arterial Hypertension and Chronic Thromboembolic Pulmonary Hypertension Junjing Su, MD; Charlotte Manisty, PhD; Kim H. Parker, PhD; Ulf Simonsen,
The Journal of Physiology
J Physiol 595.2 (217) pp 6463 6476 6463 Pulmonary artery wave propagation and reservoir function in conscious man: impact of pulmonary vascular disease, respiration and dynamic stress tests Junjing Su
Mechanisms of heart failure with normal EF Arterial stiffness and ventricular-arterial coupling. What is the pathophysiology at presentation?
Mechanisms of heart failure with normal EF Arterial stiffness and ventricular-arterial coupling What is the pathophysiology at presentation? Ventricular-arterial coupling elastance Central arterial pressure
IS PVR THE RIGHT METRIC FOR RV AFTERLOAD?
Echo Doppler Assessment of PVR The Children s Hospital Denver, CO Robin Shandas Professor of Pediatrics, Cardiology Professor of Mechanical Engineering Director, Center for Bioengineering University of
Assessing the Impact on the Right Ventricle
Advances in Tricuspid Regurgitation Congress of the European Society of Cardiology (ESC) Munich, August 25-29, 2012 Assessing the Impact on the Right Ventricle Stephan Rosenkranz, MD Clinic III for Internal
ΔΙΑΓΝΩΣΗ ΚΑΙ ΘΕΡΑΠΕΙΑ ΤΗΣ ΧΡΟΝΙΑΣ ΘΡΟΜΒΟΕΜΒΟΛΙΚΗΣ ΥΠΕΡΤΑΣΗΣ (CTEPH)
Aristotle University of Thessaloniki Cardiology Clinic, AHEPA Hospital ΔΙΑΓΝΩΣΗ ΚΑΙ ΘΕΡΑΠΕΙΑ ΤΗΣ ΧΡΟΝΙΑΣ ΘΡΟΜΒΟΕΜΒΟΛΙΚΗΣ ΥΠΕΡΤΑΣΗΣ (CTEPH) Charalampos I. Karvounis, MD Professor of Cardiology Aristotle
THE RIGHT VENTRICLE IN PULMONARY HYPERTENSION R. DRAGU
THE RIGHT VENTRICLE IN PULMONARY HYPERTENSION R. DRAGU Cardiology Dept. Rambam Health Care Campus Rappaport Faculty of Medicine Technion, Israel Why the Right Ventricle? Pulmonary hypertension (PH) Right
Disclosures. Afterload on the PV loop. RV Afterload THE PULMONARY VASCULATURE AND ASSESSMENT OF THE RIGHT VENTRICLE
THE PULMONARY VASCULATURE AND ASSESSMENT OF THE RIGHT VENTRICLE Ryan J. Tedford, MD Heart Failure, Mechanical Circulatory Support, and Cardiac Transplantation Division of Cardiology, Department of Medicine
Prognostic value of echocardiographic parameters in patients with pulmonary arterial hypertension (PAH) treated with targeted therapies
Prognostic value of echocardiographic parameters in patients with pulmonary arterial hypertension (PAH) treated with targeted therapies E. Beciani, M. Palazzini, C. Bachetti, F. Sgro, E. Conficoni, E.
Right Heart Catheterization. Franz R. Eberli MD Chief of Cardiology Stadtspital Triemli, Zurich
Right Heart Catheterization Franz R. Eberli MD Chief of Cardiology Stadtspital Triemli, Zurich Right Heart Catheterization Pressure measurements Oxygen saturation measurements Cardiac output, Vascular
Navigating the identification, diagnosis and management of pulmonary hypertension using the updated ESC/ERS guidelines
Navigating the identification, diagnosis and management of pulmonary hypertension using the updated ESC/ERS guidelines Host: Marc Humbert Speaker: Simon Gibbs Marc HUMBERT, MD, PhD Professor of Respiratory
Evaluation of Left Ventricular Diastolic Dysfunction by Doppler and 2D Speckle-tracking Imaging in Patients with Primary Pulmonary Hypertension
ESC Congress 2011.No 85975 Evaluation of Left Ventricular Diastolic Dysfunction by Doppler and 2D Speckle-tracking Imaging in Patients with Primary Pulmonary Hypertension Second Department of Internal
Dr.Fayez EL Shaer Consultant cardiologist Assistant professor of cardiology KKUH
Pulmonary Hypertension in patients with Heart Failure with Preserved Ejection Fraction Dr.Fayez EL Shaer Consultant cardiologist Assistant professor of cardiology KKUH Recent evaluation of available data
Acta Physiologica. A review of wave mechanics in the pulmonary artery with an emphasis on wave intensity analysis
Acta Physiologica A review of wave mechanics in the pulmonary artery with an emphasis on wave intensity analysis Journal: Acta Physiologica Manuscript ID APH-0-0-0.R Manuscript Type: Review Article Date
Comparison between adult and pediatric populations with I/HPAH and PAH-CHD in the Bologna ARCA registry
nazzareno.galie@unibo.it Comparison between adult and pediatric populations with I/HPAH and PAH-CHD in the Bologna ARCA registry Nazzareno Galiè, MD, FESC, FRCP (Hon), DIMES 2 Comprehensive clinical classification
WHAT IS. Helping your patients understand their type of PH. Educational program by. Material endorsed by
Educational program by Material endorsed by WHAT IS CTEPH Helping your patients understand their type of PH Provided by Bayer to help education of the PH community What is ph? B lood travels from your
WHAT IS CTEPH. Helping you understand your type of PH. Provided by Bayer to help education of the PH community
Educational program by Material endorsed by WHAT IS CTEPH Helping you understand your type of PH Provided by Bayer to help education of the PH community WHAT IS PH? lood travels from your heart to the
Case Presentation : Pulmonary Hypertension: Diagnosis and Imaging
Case Presentation 9.40-11.20: Pulmonary Hypertension: Diagnosis and Imaging Eftychia Demerouti MD, MSc, PhD Cardiologist Onassis Cardiac Surgery Center Conflicts of interest Consulting fees and fees for
WHAT IS CTEPH. Helping you understand your type of PH. Provided by Bayer to help education of the PH community
Educational program by Material endorsed by WHAT IS CTEPH Helping you understand your type of PH Provided by Bayer to help education of the PH community WHAT IS PH? lood travels from your heart to the
Quantitation of right ventricular dimensions and function
SCCS Basics of cardiac assessment Quantitation of right ventricular dimensions and function Tomasz Kukulski, MD PhD Dept of Cardiology, Congenital Heart Disease and Electrotherapy Silesian Medical University
Cardiac Catheterization is Unnecessary in the Evaluation of Patients with Pulmonary Hypertension: CON
Cardiac Catheterization is Unnecessary in the Evaluation of Patients with Pulmonary Hypertension: CON Dunbar Ivy, MD The Children s s Hospital Heart Institute 1 Diagnostic Evaluation: Right Heart Cardiac
HEMODYNAMIC ASSESSMENT
HEMODYNAMIC ASSESSMENT INTRODUCTION Conventionally hemodynamics were obtained by cardiac catheterization. It is possible to determine the same by echocardiography. Methods M-mode & 2D echo alone can provide
The Case of Lucia Nazzareno Galiè, M.D.
The Case of Lucia Nazzareno Galiè, M.D. DIMES Disclosures Consulting fees and research support from Actelion Pharmaceuticals Ltd, Bayer HealthCare, Eli Lilly and Co, GlaxoSmithKline and Pfizer Ltd Clinical
From Pulmonary Embolism to Chronic Thromboembolic Pulmonary Hypertension
From Pulmonary Embolism to Chronic Thromboembolic Pulmonary Hypertension Dr Rachel Davies Respiratory Physician National Pulmonary Hypertension Service Hammersmith Hospital Royal College of Physicians
PULMONARY HYPERTENSION
PULMONARY HYPERTENSION REVIEW & UPDATE Olga M. Fortenko, M.D. Pulmonary & Critical Care Medicine Pulmonary Vascular Diseases Sequoia Hospital 650-216-9000 Olga.Fortenko@dignityhealth.org Disclosures None
PADN-5 Trial. Pulmonary artery denervation significantly increases 6-minute walk distance for patients with CpcPH: The PADN-5 Study
PADN-5 PADN-5 Trial Pulmonary artery denervation significantly increases 6-minute walk distance for patients with CpcPH: The PADN-5 Study Shao-Liang Chen, MD Hang Zhang, Juan Zhang, Mengxuan Chen, Dujiang
Disclosure. RV is not the innocent bystander 10/1/16. Assessment and Management of Pulmonary Heart Disease in the Female Patient
Assessment and Management of Pulmonary Heart Disease in the Female Patient Oct 1, 2016 Deborah Women s Heart Center Susan E Wiegers, MD, FASE, FACC Professor of Medicine Senior Associate Dean of Faculty
Μαρία Μπόνου Διευθύντρια ΕΣΥ, ΓΝΑ Λαϊκό
Μαρία Μπόνου Διευθύντρια ΕΣΥ, ΓΝΑ Λαϊκό Diastolic HF DD: Diastolic Dysfunction DHF: Diastolic HF HFpEF: HF with preserved EF DD Pathophysiologic condition: impaired relaxation, LV compliance, LV filling
Special Lecture 10/28/2012
Special Lecture 10/28/2012 HYPERTENSION Dr. HN Mayrovitz Special Lecture 10/28/2012 Arterial Blood Pressure (ABP) - Definitions ABP Review Indirect Oscillographic Method Resistance (R), Compliance (C)
Correspondence should be addressed to Tor Skibsted Clemmensen;
Case Reports in Transplantation, Article ID 173589, 4 pages http://dx.doi.org/10.1155/2014/173589 Case Report Case of Acute Graft Failure during Suspected Humoral Rejection with Preserved Ejection Fraction,
Is the percutaneous approach the future?
Chronic ThromboEmbolic Pulmonary Hypertension Is the percutaneous approach the future? Dr Hélène Bouvaist Cardiology Department Thorax Center Grenoble -France Mr R, 75 years old Dyspnea NYHA 4 Heart failure,
Καθετηριασμός δεξιάς κοιλίας. Σ. Χατζημιλτιάδης Καθηγητής Καρδιολογίας ΑΠΘ
Καθετηριασμός δεξιάς κοιλίας Σ. Χατζημιλτιάδης Καθηγητής Καρδιολογίας ΑΠΘ The increasing interest in pulmonary arterial hypertension (PAH), the increasing interest in implantation of LVADs, and the evolution
Effectively treating patients with pulmonary hypertension: The next chapter. Lowering PAP will improve RV function in PH
Effectively treating patients with pulmonary hypertension: The next chapter Stuart Rich, M.D. Hemodynamic Progression of PAH Preclinical Symptomatic/ Stable Pulmonary Pressure Progressive/ Declining Level
DECLARATION OF CONFLICT OF INTEREST
DECLARATION OF CONFLICT OF INTEREST ESC Congress 2011 Pathophysiology of HFPEF Vascular Remodeling & Pulmonary Hypertension Carolyn S.P. Lam MBBS, MRCP, MS Case Presentation 81 yo woman with dyspnoea &
Impedance Cardiography (ICG) Application of ICG for Hypertension Management
Application of ICG for Hypertension Management 1mA @ 100 khz Impedance Cardiography (ICG) Non-invasive Beat-to-beat Hemodynamic Monitoring Diastole Systole Aortic valve is closed No blood flow in the aorta
Teaching Round Claudio Sartori
Teaching Round 14.03.2017 Claudio Sartori Cas clinique Femme 47 ans, connue pour un BPCO, asthénie, douleurs thoraciques, dyspnée à l effort, œdèmes membres inférieurs, deux syncopes. Tabac, BMI 31 kg/m2
Real life management of CTEPH: patient case
2 nd International Congress on cardiovascular imaging in clinical practice k Real life management of CTEPH: patient case Anastasia Anthi Pulmonary Hypertension Clinic, Attikon University Hospital, Athens
DOPPLER HEMODYNAMICS (1) QUANTIFICATION OF PRESSURE GRADIENTS and INTRACARDIAC PRESSURES
THORAXCENTRE DOPPLER HEMODYNAMICS (1) QUANTIFICATION OF PRESSURE GRADIENTS and INTRACARDIAC PRESSURES J. Roelandt DOPPLER HEMODYNAMICS Intracardiac pressures and pressure gradients Volumetric measurement
The Case of Marco Nazzareno Galiè, M.D.
The Case of Marco Nazzareno Galiè, M.D. DIMES Disclosures Consulting fees and research support from Actelion Pharmaceuticals Ltd, Bayer HealthCare, Eli Lilly and Co, GlaxoSmithKline and Pfizer Ltd Clinical
Pulmonary arterial hypertension. Pulmonary arterial hypertension: newer therapies. Definition of PH 12/18/16. WHO Group classification of PH
Pulmonary arterial hypertension Pulmonary arterial hypertension: newer therapies Ramona L. Doyle, MD Clinical Professor of Medicine, UCSF Attending Physician UCSF PH Clinic Definition and classification
RV dysfunction and failure PATHOPHYSIOLOGY. Adam Torbicki MD, Dept Chest Medicine Institute of Tuberculosis and Lung Diseases Warszawa, Poland
RV dysfunction and failure PATHOPHYSIOLOGY Adam Torbicki MD, Dept Chest Medicine Institute of Tuberculosis and Lung Diseases Warszawa, Poland Normal Right Ventricle (RV) Thinner wall Weaker myocytes Differences
PULMONARY HYPERTENSION & THALASSAEMIA
3rd Pan-American Thalassaemia Conference Buenos Aires 2010 Dr Malcolm Walker Cardiologist University College & the Heart Hospital LONDON Clinical Director Hatter Cardiovascular Institute - UCLH PULMONARY
Low fractional diastolic pressure in the ascending aorta increased the risk of coronary heart disease
(2002) 16, 837 841 & 2002 Nature Publishing Group All rights reserved 0950-9240/02 $25.00 www.nature.com/jhh ORIGINAL ARTICLE Low fractional diastolic pressure in the ascending aorta increased the risk
Sleep Disordered Breathing and HH with Preserved Ejection Fraction:
Sleep Disordered Breathing and HH with Preserved Ejection Fraction: Pr Thibaud DAMY Heart Failure Unit Department of Cardiology CHU Mondor, Créteil, France Definition of HF-PEF The diagnosis of HF-PEF
Pulmonary Arterial Hypertension: Biomarkers and Treatment
Pulmonary Arterial Hypertension: Biomarkers and Treatment Demos Papamatheakis, MD Assistant Clinical Professor Division of Pulmonary, Critical Care and Sleep Medicine UC San Diego Health Definition EHJ
Pulmonary Hypertension: Echocardiographic Evaluation of Pulmonary Hypertension and Right Ventricular Function. Irmina Gradus-Pizlo, MD
Pulmonary Hypertension: Echocardiographic Evaluation of Pulmonary Hypertension and Right Ventricular Function Irmina Gradus-Pizlo, MD Disclosures: Nothing to disclose Overview Is pulmonary hypertension
Pulmonary Hypertension: Follow-up in adolescence and adults
Pulmonary Hypertension: Follow-up in adolescence and adults Helmut Baumgartner Westfälische Wilhelms-Universität Münster Adult Congenital and Valvular Heart Disease Center University of Muenster Germany
Pulmonary hypertension in sarcoidosis
Pulmonary hypertension in sarcoidosis Olivier SITBON Centre de Référence de l Hypertension Pulmonaire Sévère Hôpital Universitaire de Bicêtre INSERM U999 Université Paris-Sud Le Kremlin-Bicêtre France
Anjali Vaidya, MD, FACC, FASE, FACP Associate Director, Pulmonary Hypertension, Right Heart Failure, Pulmonary Thromboendarterectomy Program Advanced
Anjali Vaidya, MD, FACC, FASE, FACP Associate Director, Pulmonary Hypertension, Right Heart Failure, Pulmonary Thromboendarterectomy Program Advanced Heart Failure & Cardiac Transplant Temple University
The right ventricle in chronic heart failure
The right ventricle in chronic heart failure ESC 2012 Christian Opitz, Berlin There are no conflicts of interest relevant to this presentation Percent of Population Prevalence of Heart Failure by Age and
Central pressures and prediction of cardiovascular events in erectile dysfunction patients
Central pressures and prediction of cardiovascular events in erectile dysfunction patients N. Ioakeimidis, K. Rokkas, A. Angelis, Z. Kratiras, M. Abdelrasoul, C. Georgakopoulos, D. Terentes-Printzios,
Squeeze, Squeeze, Squeeze: The Importance of Right Ventricular Function and PH
Squeeze, Squeeze, Squeeze: The Importance of Right Ventricular Function and PH Javier Jimenez MD PhD FACC Director, Advanced Heart Failure and Pulmonary Hypertension Miami Cardiac & Vascular Institute
PFIZER INC. THERAPEUTIC AREA AND FDA APPROVED INDICATIONS: See United States Package Insert (USPI)
PFIZER INC. These results are supplied for informational purposes only. Prescribing decisions should be made based on the approved package insert. For publications based on this study, see associated bibliography.
Clinical Science Working Group 6: Diagnosis & Assessment of PAH. Co-chairs: David B. Badesch, MD Marius M. Hoeper, MD. Working Group 6 Members
Clinical Science Working Group 6: Diagnosis & Assessment of PAH Co-chairs: David B. Badesch, MD Marius M. Hoeper, MD Working Group 6 Members Harm Jan Bogaard, Robin Condliffe, Robert Frantz, Dinesh Khanna,
Πνευμονική Υπέρταση Ι.Ε. ΚΑΝΟΝΙΔΗΣ
Πνευμονική Υπέρταση Ι.Ε. ΚΑΝΟΝΙΔΗΣ PH is defined as PAPm 25 mm Hg at rest The general definition of PH remains unchanged Most of the relevant epidemiological and therapeutic studies have used the 25 mm
SA XXXX Special Authority for Subsidy
SA XXXX Special Authority for Subsidy Special authority approved by the Pulmonary Arterial Hypertension (PAH) Panel. Application forms can be obtained from PHARMAC s website: www.pharmac.govt.nz or: PAH
The right heart: the Cinderella of heart failure
The right heart: the Cinderella of heart failure Piotr Ponikowski, MD, PhD, FESC Medical University, Centre for Heart Disease Clinical Military Hospital Wroclaw, Poland none Disclosure Look into the Heart
Επεμβατικές στρατηγικές στην πνευμονική υπέρταση
Επεμβατικές στρατηγικές στην πνευμονική υπέρταση Παναγιώτης Καρυοφύλλης Καρδιολόγος Ωνάσειο Καρδιοχειρουργικό Κέντρο Mortality in PAH 2015 ESC/ERS Guidelines. Treatment algorithm Since BAS is performed
Benoy N Shah 1,2,3, Gothandaraman Balaji 1, Abdalla Alhajiri 1, Ihab Ramzy 1, Shahram Ahmadvazir 1 & Roxy Senior 1,2,3
STRESS ECHOCARDIOGRAPHY PREDICTS ALL-CAUSE MORTALITY IN PATIENTS ADMITTED WITH SUSPECTED ACUTE CORONARY SYNDROME, NON-DIAGNOSTIC ECG AND NEGATIVE TROPONIN European Society of Cardiology Annual Congress
Survival and Predictors of Death in Eisenmenger Syndrome
Survival and Predictors of Death in Eisenmenger Syndrome E. Romeo, M. D'Alto, P. Argiento, B. Sarubbi, G. Scognamiglio, D. Alfano, N. Grimaldi, M.G. Russo, R. Calabrò. Cardiology, Second University of
Pulmonary Hypertension: When to Initiate Advanced Therapy. Jonathan D. Rich, MD Associate Professor of Medicine Northwestern University
Pulmonary Hypertension: When to Initiate Advanced Therapy Jonathan D. Rich, MD Associate Professor of Medicine Northwestern University Disclosures Medtronic, Abbott: Consultant Hemodynamic Definition of
Pulmonary hypertension; does gender matter?
Pulmonary hypertension; does gender matter? Nazzareno Galiè Istituto di Cardiologia Università di Bologna nazzareno.galie@unibo.it Galiè N et al. European Heart Journal (2009) 30, 2493 2537 Pulmonary Hypertension
Is adenosine administration necessary for the invasive functional assessment of coronary artery stenoses?
Is adenosine administration necessary for the invasive functional assessment of coronary artery stenoses? Sayan Sen MRC Clinical Research Training Fellow Coronary Flow Trust Background Pressure derived
Arterial function and longevity Focus on the aorta
Arterial function and longevity Focus on the aorta Panagiota Pietri, MD, PhD, FESC Director of Hypertension Unit Athens Medical Center Athens, Greece Secrets of longevity Secrets of longevity Unveiling
Nox-Dependent Mechanisms of Cardiomyocyte Dysfunction in a Model of Pressure Overload
Nox-Dependent Mechanisms of Cardiomyocyte Dysfunction in a Model of Pressure Overload Giovanna Frazziano, PhD Vascular Medicine Institute Department of Pharmacology and Chemical Biology University of Pittsburgh
Arterial waves in humans during peripheral vascular surgery
Clinical Science (2001) 101, 749 757 (Printed in Great Britain) 749 Arterial waves in humans during peripheral vascular surgery Ashraf W. KHIR*, Michael Y. HENEIN, Tat KOH, Saroj K. DAS, Kim H. PARKER*
Dr. Dermot Phelan MB BCh BAO PhD European Society of Cardiology 2012
Relative Apical Sparing of Longitudinal Strain Using 2- Dimensional Speckle-Tracking Echocardiography is Both Sensitive and Specific for the Diagnosis of Cardiac Amyloidosis. Dr. Dermot Phelan MB BCh BAO
Hemodynamic Assessment. Assessment of Systolic Function Doppler Hemodynamics
Hemodynamic Assessment Matt M. Umland, RDCS, FASE Aurora Medical Group Milwaukee, WI Assessment of Systolic Function Doppler Hemodynamics Stroke Volume Cardiac Output Cardiac Index Tei Index/Index of myocardial
Disclosure Information : No conflict of interest
Intravenous nicorandil improves symptoms and left ventricular diastolic function immediately in patients with acute heart failure : a randomized, controlled trial M. Shigekiyo, K. Harada, A. Okada, N.
Πνευμονική υπέρταση: Τα 10 πιο σημαντικά κενά και παραλείψεις των Κατευθυντήριων Οδηγιών του 2015
Πνευμονική υπέρταση: Τα 10 πιο σημαντικά κενά και παραλείψεις των Κατευθυντήριων Οδηγιών του 2015 Γεωργία Γ. Πίτσιου, MD, MSc, PhD Πνευμονολόγος- Εντατικολόγος Επίκουρη Καθηγήτρια Ιατρική Σχολή ΑΠΘ Γ.Ν.
Pulmonary Hypertension in 2012
Pulmonary Hypertension in 2012 Evan Brittain, MD December 7, 2012 Kingston, Jamaica VanderbiltHeart.com Disclosures None VanderbiltHeart.com Outline Definition and Classification of PH Hemodynamics of
Cath Lab Essentials: Basic Hemodynamics for the Cath Lab and ICU
Cath Lab Essentials: Basic Hemodynamics for the Cath Lab and ICU Ailin Barseghian El-Farra, MD, FACC Assistant Professor, Interventional Cardiology University of California, Irvine Department of Cardiology
Abstract nr AHA, Chicago November European Heart Journal Cardiovascular Imaging, in press. Nr Peter Blomstrand
Left Ventricular Diastolic Function Assessed by Echocardiography and Tissue Doppler Imaging is a strong Predictor of Cardiovascular Events in Patients with Diabetes Mellitus Type 2 Peter Blomstrand, Martin
Right Heart Hemodynamics: Echo-Cath Discrepancies
Department of cardiac, thoracic and vascular sciences University of Padua, School of Medicine Padua, Italy Right Heart Hemodynamics: Echo-Cath Discrepancies Luigi P. Badano, MD, PhD, FESC, FACC **Dr. Badano
Bedside assessment of fluid status
Bedside assessment of fluid status 2nd AKI Academy October 18 th 2014 David Treacher Guy s & St Thomas NHS Trust Assessing the circulation - the 3 key questions v Is my patient adequately filled? v What
Noninvasive and invasive evaluation of pulmonary arterial pressure in highlanders
Eur Respir J 2007; 29: 352 356 DOI: 10.1183/09031936.00137605 CopyrightßERS Journals Ltd 2007 Noninvasive and invasive evaluation of pulmonary arterial pressure in highlanders B.K. Kojonazarov*, B.Z. Imanov
Bogdan A. Popescu. University of Medicine and Pharmacy Bucharest, Romania. EAE Course, Bucharest, April 2010
Bogdan A. Popescu University of Medicine and Pharmacy Bucharest, Romania EAE Course, Bucharest, April 2010 This is how it started Mitral stenosis at a glance 2D echo narrow diastolic opening of MV leaflets
The Doctoral Thesis is available in the RSU library and at RSU webpage:
Andris Skride HEMODYNAMIC PARAMETER ASSESSMENT AND MORTALITY RISK FACTOR IDENTIFICATION IN PATIENTS WITH PULMONARY ARTERIAL AND CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION Summary of the Doctoral Thesis
PVDOMICS. Study Introduction. Kristin Highland, MD Gerald Beck, PhD. NHLBI Pulmonary Vascular Disease Phenomics Program
PVDOMICS Study Introduction Kristin Highland, MD Gerald Beck, PhD NHLBI Pulmonary Vascular Disease Phenomics Program Funded by the National Heart, Lung, and Blood Institute of the National Institutes of
Association between RV Function in PPCM and LV Recovery & Clinical Outcome
Association between RV Function in PPCM and LV Recovery & Clinical Outcome Lori A Blauwet, MD, MA Associate Professor of Medicine Co-Director, Cardio-OB Clinic Mayo Clinic Rochester, MN USA 2016 MFMER
different phenotypes
Pulmonary hypertension in scleroderma: different phenotypes UMR 995 Pr David LAUNAY, MD, PhD launayd@gmail.com Service de Médecine Interne. Unité d'immunologie Clinique CNRMR Maladies Systémiques et Autoimmunes
Heart Failure Dr ahmed almutairi Assistant professor internal medicin dept
Heart Failure Dr ahmed almutairi Assistant professor internal medicin dept (MBBS)(SBMD) Introduction Epidemiology Pathophysiology diastolic/systolic Risk factors Signs and symptoms Classification of HF
HEART FAILURE AND PRESERVED EJECTION FRACTION: CLINICAL STUDY DESIGN AND TREATMENT
THE SOUTHPAW STUDY HEART FAILURE AND PRESERVED EJECTION FRACTION: CLINICAL STUDY DESIGN AND TREATMENT Mardi Gomberg-Maitland, MD, MSc Professor of Medicine, Inova Heart and Vascular Institute, VA USA 2
Swan Song: Echocardiography as a Pulmonary Artery Catheter? Interdepartmental Division of Critical Care Medicine
Swan Song: Echocardiography as a Pulmonary Artery Catheter? The swan is without spot, and it sings sweetly as it dies, that song ending its life Leonardo Da Vinci Curr Opin Anesthesiol 2016, 29:36 45 Circulation.
Pulmonary Hypertension Essentials. PD Dr. med. Silvia Ulrich Somaini University Hospital of Zurich
Pulmonary Hypertension Essentials PD Dr. med. Silvia Ulrich Somaini University Hospital of Zurich Agenda Basics and Presentation Classification Diagnosis Pathogenesis Diagnosis Treatment Pathogenesis and
Exercise Training for PoTS and Syncope
B 140 120 100 80 60 40 20 0 Blood Pressure (mm Hg) Blood Pressure Heart Rate 60 degree Head Up Tilt Time 140 120 100 80 60 40 20 0 Heart Rate (beats.min -1 ) Exercise Training for PoTS and Syncope C Blood
An Inconvenient Choice Pulmonary Artery Systolic Pressure of 43 mmhg: Is a Work Up for Pulmonary Hypertension Warranted?
An Inconvenient Choice Pulmonary Artery Systolic Pressure of 43 mmhg: Is a Work Up for Pulmonary Warranted? Michael D. McGoon, MD Professor of Medicine Consultant in Cardiovascular Diseases Mayo Clinic
Ventricular-Pulmonary Vascular Coupling after the Total Cavopulmonary Anastomosis (Fontan)
Ventricular-Pulmonary Vascular Coupling after the Total Cavopulmonary Anastomosis (Fontan) 6th International Neonatal & Childhood Pulmonary Vascular Disease Conference Fontan Physiology Single ventricular
Pulmonary Hypertension: Definition and Unmet Needs
Heart Failure Center Hadassah University Hospital Pulmonary Hypertension: Definition and Unmet Needs Israel Gotsman The Heart Failure Center Hadassah University Hospital I DO NOT have a financial interest/
Pulmonary Hypertension Due to Left Heart Disease
ACC Middle East Conference 2018 Pulmonary Hypertension Due to Left Heart Disease Ammar Chaudhary, MBChB, FRCPC Advanced Heart Failure & Transplantation King Faisal Specialist Hospital and Research Center
Real-world experience with riociguat in CTEPH
Real-world experience with riociguat in CTEPH Matthias Held Center of Pulmonary Hypertension and Pulmonary Vascular Disease, Medical Mission Hospital, Würzburg, Germany Tuesday, 29 September ERS International
THERAPEUTICS IN PULMONARY ARTERIAL HYPERTENSION Evidences & Guidelines
THERAPEUTICS IN PULMONARY ARTERIAL HYPERTENSION Evidences & Guidelines Vu Nang Phuc, MD Dinh Duc Huy, MD Pham Nguyen Vinh, MD, PhD, FACC Tam Duc Cardiology Hospital Faculty Disclosure No conflict of interest
Cardiac Cycle MCQ. Professor of Cardiovascular Physiology. Cairo University 2007
Cardiac Cycle MCQ Abdel Moniem Ibrahim Ahmed, MD Professor of Cardiovascular Physiology Cairo University 2007 1- Regarding the length of systole and diastole: a- At heart rate 75 b/min, the duration of
Novel pathophysiological concepts for the development and impact of sleep apnea in CHF.
Olaf Oldenburg Novel pathophysiological concepts for the development and impact of sleep apnea in CHF. Sleep apnea the need to synchronize the heart, the lung and the brain. Heart Failure 2011 Gothenburg,
Case Report Resolution of Periodic Breathing in a Child with Idiopathic Pulmonary Arterial Hypertension
Hindawi Case Reports in Pediatrics Volume 2017, Article ID 3280572, 5 pages https://doi.org/10.1155/2017/3280572 Case Report Resolution of Periodic Breathing in a Child with Idiopathic Pulmonary Arterial
Impedance Cardiography (ICG) Method, Technology and Validity
Method, Technology and Validity Hemodynamic Basics Cardiovascular System Cardiac Output (CO) Mean arterial pressure (MAP) Variable resistance (SVR) Aortic valve Left ventricle Elastic arteries / Aorta
pulmonary artery vasoreactivity in patients with idiopathic pulmonary arterial hypertension
Supplementary material Jonas K, Magoń W, Waligóra M, et al. High density lipoprotein cholesterol levels and pulmonary artery vasoreactivity in patients with idiopathic pulmonary arterial hypertension Pol
Consensus document: Screening and Prevention of Atrial Fibrillation
Consensus document: Screening and Prevention of Atrial Fibrillation Yong-Seog Oh, M.D.,Ph.D. Division of Cardiology, Department of Internal Medicine, Seoul St. Mary s Hospital, College of Medicine, The
SONOGRAPHER & NURSE LED VALVE CLINICS
SONOGRAPHER & NURSE LED VALVE CLINICS Frequency of visits and alerts AORTIC STENOSIS V max > 4.0 m/s or EOA < 1.0 cm 2 V max 3.5 4.0 m/s + Ca+ V max 3.0 4.0 m/s or EOA 1.0-1.5 cm 2 V max 2.5 3.0 m/s every
Exercise Pulmonary Hypertension predicts the Occurrence of Symptoms in Asymptomatic Degenerative Mitral Regurgitation
Exercise Pulmonary Hypertension predicts the Occurrence of Symptoms in Asymptomatic Degenerative Mitral Regurgitation Julien Magne, PhD, Kim O Connor, MD, Giuseppe Romano, MD, Marie Moonen, MD, Luc A.