1,721,046 research outputs found
Exercise training in pulmonary hypertension: improving performance but waiting for outcome
No full textPulmonary hypertension is a pathophysiological condition characterized by an increase of mean pulmonary arterial pressure ≥25 mmHg at rest.1 Pulmonary hypertension may complicate multiple clinical disorders and invariably it reduces exercise and functional capacity and represents a risk factor for morbidity and mortality.2 Although important progress in the pharmacotherapy of pulmonary arterial hypertension has been achieved in the past 15 years,3,4 limited functional capacity and reduced survival still characterize patient outcome. Further advances are needed in this area to improve the clinical results of a comprehensive treatment strategy.
Effects of exercise training
Ehlken and colleagues now present the data of a randomized controlled trial on the impact of exercise training on peak oxygen consumption and haemodynamics in 87 patients with pulmonary arterial hypertension or inoperable chronic thrombo-embolic pulmonary hypertension.5 The majority of subjects (91%) were on background approved pulmonary arterial hypertension therapies. The exercise training started with an in-hospital 3-week programme and was continued at home with at least 15 min/day for 5 days a week for the following 12 weeks.
After 15 weeks, the peak oxygen uptake (primary endpoint) significantly improved in the training group by +24.3% and the 6-min walk distance improved by 41 m. Haemodynamics at rest and during exercise significantly improved in the training group compared with the control group. However, the haemodynamic data were collected only in 74 patients (85%)
Evaluation of pulmonary arterial hypertension.
No full textAbstract
PURPOSE OF REVIEW:
Pulmonary arterial hypertension (PAH) is defined as a group of diseases characterized by a progressive increase of pulmonary vascular resistance leading to right ventricular failure and premature death. The purpose of this review is to analyze the current knowledge of the evaluation of PAH patients.
RECENT FINDINGS:
Recently, the diagnostic approach has been more clearly defined according to the new clinical classification and with consensus reached on algorithms of various investigative tests and procedures that exclude other causes and ensure an accurate diagnosis of PAH. The diagnostic procedures include clinical history and physical examination, ECG, chest radiography, transthoracic Doppler echocardiography, pulmonary function tests, arterial blood gases, ventilation and perfusion lung scan, high-resolution CT of the lung, contrast-enhanced spiral CT of the lung and pulmonary angiography, blood tests and immunology, abdominal ultrasound scan, exercise capacity assessment, and hemodynamic evaluation.
SUMMARY:
Invasive and noninvasive markers of disease severity, either biomarkers or physiologic parameters and tests that can be widely applied, have been proposed to reliably diagnose PAH and monitor the clinical course
The difficult diagnosis of pulmonary vascular disease in heart failure
No full textPulmonary hypertension (PH), defined as a mean pulmonary arterial pressure (PAP) ≥25 mmHg, is a well-recognised complication of left heart disease (LHD). PH prevalence is variable ranging from 25% to 80% of LHD patients according to the methods of assessment, cut-off values and characteristics of the patient population [1–3]. All aetiological types of LHD are affected, including heart failure with reduced (HFrEF) or preserved (HFpEF) left ventricular ejection fraction, and valvular LHD. The presence of PH-LHD is associated with advanced symptoms, reduced exercise capacity and impaired outcome after medical, interventional or surgical therapy [1, 3, 4].
The relevance of PH-LHD is highlighted by the recognised epidemiological predominance of this condition, which represents the most common form among the five groups included in the PH clinical classification, accounting for 65–80% of the PH cases [1, 3, 5, 6]. PH-LHD is distinctively characterised by an increase of the pulmonary artery wedge pressure (PAWP) >15 mmHg [5, 6], an accepted surrogate for left atrial pressure
GPs meet rare lung disorders task force factsheet: Pulmonary arterial hypertension
Full text linkDiscussion on pulmonary hypertension with GP
Thrombolysis in high-risk patients with acute pulmonary embolism: underuse of a life-saving treatment in the real-world setting
No full textThis editorial refers to ‘Trends in thrombolytic treatment and outcomes of acute pulmonary embolism in Germany’, by K. Keller et al., doi:10.1093/eurheartj/ehz236
Aiming at the appropriate target for the treatment of pulmonary hypertension due to left heart disease
No full textThis editorial refers to ‘Sildenafil for improving outcomes
in patients with corrected valvular heart disease and persistent
pulmonary hypertension’, by J. Bermejo et al.
doi:10.1093/eurheartj/ehx700
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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