New research on pulmonary hypertension ahead of 'Heart Walk' - WTNH.com

New research on pulmonary hypertension ahead of 'Heart Walk' - WTNH.com

New research on pulmonary hypertension ahead of 'Heart Walk' - WTNH.com

Posted: 29 Apr 2019 08:39 AM PDT

(WTNH) - New research is underway in Connecticut for pulmonary hypertension; a devastating disease that lacks a definitive cure.

Dr. Indy Singh is part of a new team with Yale New Haven Hospital called "Cure Pulmonary Hypertension and Right Heart Failure"  which aims to raise awareness and find new treatments through research. The team is currently the top findraising team from Yale. 

The Greater New Haven Heart Walk through the American Heart Association will take place on Saturday, May 4th at Savin Rock Park in West Haven. Registration begins at 9:00am, and the walk steps off at 10:00am. Click here to sign up.

IPAH, Poor Heart Function Linked to Early Death After Transplant, Study Finds - Pulmonary Hypertension News

Posted: 29 Apr 2019 02:30 AM PDT

Certain parameters of poor heart function are risk factors for early death among idiopathic pulmonary arterial hypertension (IPAH) patients who undergo lung transplant, a small Chinese study suggests.

The study, "Risk Analysis of Perioperative Death in Lung Transplant Patients With Severe Idiopathic Pulmonary Hypertension," was published in the journal Transplantation Proceedings.

Lung transplant remains the most effective treatment to improve an IPAH patient's survival. However, the death rate associated with the procedure is high: 2015 estimates from the International Society for Heart and Lung Transplantation Registry show that 23% of patients with IPAH die within three months of their lung transplants.

Researchers in the study decided to investigate the risk factors associated with an early death among IPAH patients undergoing lung transplants.

The study enrolled 22 critically ill IPAH patients who underwent lung transplants at the Affiliated Wuxi People's Hospital of Nanjing Medical University, between November 2007 and October 2016.

The mortality rate for these patients was 22.99% three months after their transplants. The researchers then divided patients into two groups: an early death group that included five patients who died within three months following transplant, and a control group with the 17 remaining patients.

When comparing potential risk factors between both groups, the researchers saw that patients who died within three months of the transplant had a significantly higher frequency of syncope — a sudden transient loss of consciousness (fainting) — and lower salt (sodium) concentration of 116.80 mmol/L in their blood (a condition called hyponatremia), when compared with the control group, which had a sodium concentration of 129.88 mmol/L.

Syncope frequency is a symptom that can arise from several underlying causes, including cardiac problems.

The researchers then analyzed patients' cardiac characteristics before surgery. The cardiac index, which measures the amount of blood pumped from the left side of the heart to the whole body and is proportional to heart performance, was lower in the early death group (1.30 L/min/m2) compared with the control group (1.58 L/min/m2).

Also, an echocardiogram of the heart showed that the right ventricle (the heart's right chamber) was enlarged in the early death group, which indicates a lower ability of the heart to pump out blood, often leading to blood supply complications. The heart's left ventricle was also smaller in the early death group.

The results suggest that "lung transplant patients with severe idiopathic pulmonary hypertension are at higher risk of perioperative mortality," and that "high frequencies of syncope, hyponatremia, lower CI [cardiac index], inner diameter of the LV [left ventricle], and upward RV/LV [right ventricle/LV]" are risk factors for an early death in this patient population, the researchers wrote.

According to the team, the data "support the need for a careful assessment of cardiovascular risks before lung transplant to improve IPAH patients' outcomes," they concluded.

Red Cell Distribution Width May Be a Biomarker for Early Pulmonary Hypertension - Pulmonology Advisor

Posted: 25 Apr 2019 01:00 AM PDT

A new study found that red cell distribution width (RDW) is higher in patients with pulmonary hypertension (PH) and at-risk patients with systemic sclerosis (SSc) compared with healthy individuals. Findings from this study, which suggest that RDW may be a potential biomarker for detecting incident PH in its earlier stages, were published in Respiratory Medicine.

Researchers performed a retrospective cross-sectional analysis of patients who were observed at a PH specialty center over a 1-year period. PH was defined as a mean pulmonary artery pressure ≥25 mmHg at rest during right heart catheterization. Patients with PH (n=181) and patients with SSc at risk for PH development (n=52) were compared. A total of 100 non-diseased controls were also included for comparison.  The groups were compared in terms of their relevant baseline characteristics, and researchers also made comparisons across World Health Organization (WHO) PH groups 1-4.

The overall value of RDW was higher in patients with PH compared with the at-risk patients with SSc and matched controls (15.9±2.8 vs 14.8±2.8 vs 14.2±1.1%, respectively; P <.0001).

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Patients with PH in the SSc cohort (n=21) had higher RDW values vs the 15 patients without PH in the same cohort (16.0±2.2 vs 14.4±1.9%, respectively; P =.03). For discriminating between patients with SSc with and without PH, the optimal cut-point was 13.25% (100% sensitivity and 40% specificity).

No differences were observed across WHO PH groups with regard to RDW values (P =.50). Specifically, in the PH cohort there was no RDW difference between patients of functional class 1 or (15.6±2.7% [n=81]) vs functional class 3 or 4 (16.4±3.0% [n=88]; P =.10).

Study limitations include its retrospective design, the small size of the subgroups, and the inclusion of patients from a single center.

The researchers commented that the ease of obtaining RDW "in SSc patients may help to detect PH at earlier stages, leading to better outcomes and better quality of life."

Reference

Petrauskas LA, Saketkoo LA, Kazecki T, et al. Use of red cell distribution width in a population at high risk for pulmonary hypertension. Respir Med. 2019;150:131-135.

This article originally appeared on The Cardiology Advisor

Topics:

Pulmonary Hypertension

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