A presente pesquisa avaliou a determinação dos valores da pressão da artéria pulmonar, da oximetria, da hemogasometria e dos teores plasmáticos de lactato em bezerros neonatos, com a finalidade de contribuir nos estudos de clonagem e no desenvolvimento de neonatologia veterinária. A monitorização logo após o parto e o nascimento se tornou necessária para a manutenção da vida destes animais, aprimorando-se os protocolos e procedimento tomados, a avaliação clínica do sistema cardiovascular e respiratório neste momento de transição e a partir disto, o objetivo deste trabalho foi padronizar a metodologia utilizada para avaliações hemodinâmica da pressão da artéria pulmonar por meio da utilização do cateter de Swan-Ganz em bezerros, padronizar a técnica de oximetria e correlacionar os resultados obtidos para saturação de oxigênio com aqueles encontrados na hemogasometria de sangue arterial, e estabelecer valores de referência e avaliar a influência dos primeiros 30 dias de vida na mensuração da pressão da artéria pulmonar, da oximetria, da hemogasometria e dos teores plasmáticos de lactato obtidos em bezerros sadios. Foram utilizados 10 bezerros hígidos do estado de São Paulo, acompanhados do nascimento aos 30 dias de vida, onde pudemos observar o fechamento do forame ovale e ducto arterioso na 1º semana de vida, utilizando o sangue misto, o sangue venoso também foi um ótimo avaliador de distúrbios acidobásico, no entanto não avalia a função respiratória; para isso bastou utilizar a oximetria de pulso como um método não invasivo, que nos fornece dados que a gasometria arterial iria fornecer com a saturação de oxigênio. E a mensuração do lactato sérico serve como um marcador biológico para prognóstico de diversas enfermidades, onde seu aumento no sangue demonstra uma má perfusão tecidual (hipóxia) / This study investigated the measurement of the pulmonary artery pressure, pulse oximetry, the blood gas, plasma lactate and glucose levels in newborn calves, in order to contribute in cloning studies and the development of neonatal veterinary medicine. Monitoring soon after birth or help the calving became necessary for the maintenance of life of these animals, improving the protocols and procedures taken, the clinical assessment of cardiovascular and respiratory systems in this time of life transition, the objective of this study was to standardize the methodology used for hemodynamic assessment of pulmonary artery pressure using a Swan-Ganz catheter in calves, standardize the technique of pulse oximetry and correlate the results obtained for oxygen saturation found in blood gas analysis of arterial blood, and set reference values and to evaluate the influence of the first 30 days of life in the measurement of pulmonary artery pressure, pulse oximetry, blood gas and the plasma lactate levels obtained in healthy calves. We used 10 calves healthy from Sao Paulo state, followed from birth to 30 days of life, where we could see the closure of the foramen ovale and ductus arteriosus in the 1st week of life, using the mixed blood, venous blood was also a great evaluator acid-base disturbance, but does not assess respiratory function. The pulse oximetry was good enough to evaluate the oxygen saturation like a noninvasive method. And the measurement of serum lactate serves as a biomarker for prognosis of various diseases, when increase in blood shows poor tissue perfusion (hypoxia)

Background: Pulmonary artery sarcoma is a rare tumor with a poor prognosis. Case Report: We report the case of a 64-year-old man with an intimal pulmonary artery sarcoma presenting with severe high oxygen flow-demanding dyspnea and weight loss of 12 kg in the last 6 months. On echocardiography, right heart insufficiency, markedly elevated right ventricular pressure, a pressure gradient along the right outflow tract, and a tumor mass adherent to the wall of the truncus pulmonalis were detected. The tentative diagnosis by echocardiographic findings was pulmonary artery sarcoma. Computed tomography of the thorax and 18-fluorodeoxyglucose positron emission tomography showed an advanced local tumor manifestation. Surgical resection of the tumor to improve hemodynamics confirmed the diagnosis. Conclusions: Pulmonary artery sarcoma should be considered as a rare differential diagnosis in patients with dyspnea due to right heart failure, particular in the case of additional weight loss, and echocardiographic examination is a useful first diagnostic approach in establishing the diagnosis. / Hintergrund: Das Pulmonalarteriensarkom ist eine seltene Erkrankung mit einer schlechten Prognose. Fallbericht: Wir berichten über einen 64-jährigen Mann mit einem intimalen Pulmonalarteriensarkom, der sich mit starker Luftnot trotz hoher Sauerstoffsubstitution und einem Gewichtsverlust von 12 kg in den letzten 6 Monaten vorstellte. Echokardiographisch fielen eine Rechtsherzinsuffizienz, ein deutlich erhöhter rechtsventrikulärer Druck, ein Druckgradient über dem rechten Ausflusstrakt und eine Tumormasse im Bereich des Trunkus pulmonalis mit Kontakt zur Gefäßwand auf. Die mittels Echokardiographie erhobene Verdachtsdiagnose lautete Pulmonalarteriensarkom. Die Computertomographie des Thorax und die 18-Flur-Desoxyglukose-Positron-Emissionstomographie erbrachten den Befund eines lokal fortgeschrittenen Tumors. Die chirurgische Resektion des Tumors, die zur Verbesserung der Hämodynamik durchgeführt wurde, bestätigte die Diagnose. Schlussfolgerungen: Das Pulmonalarteriensarkom sollte differenzialdiagnostisch als eine seltene Ursache der Luftnot im Rahmen einer Rechtsherzinsuffizienz, insbesondere bei zusätzlichem Gewichtsverlust, in Erwägung gezogen werden. Die Echokardiographie stellt eine wertvolle initiale Untersuchungsmethode bei der Diagnosestellung dar. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

A presente pesquisa avaliou a determinação dos valores da pressão da artéria pulmonar, da oximetria, da hemogasometria e dos teores plasmáticos de lactato em bezerros neonatos, com a finalidade de contribuir nos estudos de clonagem e no desenvolvimento de neonatologia veterinária. A monitorização logo após o parto e o nascimento se tornou necessária para a manutenção da vida destes animais, aprimorando-se os protocolos e procedimento tomados, a avaliação clínica do sistema cardiovascular e respiratório neste momento de transição e a partir disto, o objetivo deste trabalho foi padronizar a metodologia utilizada para avaliações hemodinâmica da pressão da artéria pulmonar por meio da utilização do cateter de Swan-Ganz em bezerros, padronizar a técnica de oximetria e correlacionar os resultados obtidos para saturação de oxigênio com aqueles encontrados na hemogasometria de sangue arterial, e estabelecer valores de referência e avaliar a influência dos primeiros 30 dias de vida na mensuração da pressão da artéria pulmonar, da oximetria, da hemogasometria e dos teores plasmáticos de lactato obtidos em bezerros sadios. Foram utilizados 10 bezerros hígidos do estado de São Paulo, acompanhados do nascimento aos 30 dias de vida, onde pudemos observar o fechamento do forame ovale e ducto arterioso na 1º semana de vida, utilizando o sangue misto, o sangue venoso também foi um ótimo avaliador de distúrbios acidobásico, no entanto não avalia a função respiratória; para isso bastou utilizar a oximetria de pulso como um método não invasivo, que nos fornece dados que a gasometria arterial iria fornecer com a saturação de oxigênio. E a mensuração do lactato sérico serve como um marcador biológico para prognóstico de diversas enfermidades, onde seu aumento no sangue demonstra uma má perfusão tecidual (hipóxia) / This study investigated the measurement of the pulmonary artery pressure, pulse oximetry, the blood gas, plasma lactate and glucose levels in newborn calves, in order to contribute in cloning studies and the development of neonatal veterinary medicine. Monitoring soon after birth or help the calving became necessary for the maintenance of life of these animals, improving the protocols and procedures taken, the clinical assessment of cardiovascular and respiratory systems in this time of life transition, the objective of this study was to standardize the methodology used for hemodynamic assessment of pulmonary artery pressure using a Swan-Ganz catheter in calves, standardize the technique of pulse oximetry and correlate the results obtained for oxygen saturation found in blood gas analysis of arterial blood, and set reference values and to evaluate the influence of the first 30 days of life in the measurement of pulmonary artery pressure, pulse oximetry, blood gas and the plasma lactate levels obtained in healthy calves. We used 10 calves healthy from Sao Paulo state, followed from birth to 30 days of life, where we could see the closure of the foramen ovale and ductus arteriosus in the 1st week of life, using the mixed blood, venous blood was also a great evaluator acid-base disturbance, but does not assess respiratory function. The pulse oximetry was good enough to evaluate the oxygen saturation like a noninvasive method. And the measurement of serum lactate serves as a biomarker for prognosis of various diseases, when increase in blood shows poor tissue perfusion (hypoxia)

La procédure de Ross: Propriétés biomécaniques de l'artère pulmonaire en fonction du phénotype valvulaire aortique Pierre Olivier Dionne, Evan Wener, Alexander Emmott, Raymond Cartier, Rosaire Mongrain, Richard Leask et Ismail El-Hamamsy OBJECTIFS: Le but de cette étude est de déterminer si les propriétés des artères pulmonaires des patients bénéficiant d'une procédure de Ross ayant une valve aortique bicuspide sont différentes que celles des patients ayant une valve aortique tricuspide. MÉTHODOLOGIE: Trente-deux artères pulmonaires et 20 aortes ont été prélevées chez des patients subissant une procédure de Ross au moment de la chirurgie, dans une cohorte de 32 patients. L'analyse histologique et l'étude tensile equi-biaxiale ex-vivo complétées dans les 8 heures suivant le prélèvement furent utilisées afin d'évaluer les différences entre les groupes de patients et entre les artères pulmonaires et les aortes ascendantes. RÉSULTATS: Il n'y avait aucune différence d'épaisseur au niveau des artères pulmonaires lorsque comparées en fonction du phénotype valvulaire aortique (P = 0.94). Il n'y avait aucune différence au niveau des propriétés tensiles parmi les aortes et les artères pulmonaires lorsque comparées en fonction du phénotype valvulaire. Lorsque comparées en fonction de leur indication chirurgicale, les artères pulmonaires de patients ayant une régurgitation aortique pure étaient moins rigides que leur contre-partie (P = 0.002). Il n'y avait aucune différence au niveau du nombre de lamelles élastiques entre les spécimens d'artère pulmonaire en fonction du phénotype valvulaire aortique (Tricuspide, bicuspide ou unicuspide), ni entre les spécimens aortiques. CONCLUSION: Aucune différence significative ne fut observée au niveau des propriétés biomécaniques des artères pulmonaires lorsque comparées selon leur phénotype valvulaire aortique associé. / The Ross procedure: biomechanical properties of the pulmonary artery according to aortic valve phenotype Pierre Olivier Dionne, Evan Wener, Alexander Emmott, Raymond Cartier, Rosaire Mongrain, Richard Leask and Ismail El-Hamamsy OBJECTIVES: The aim of this study is to determine whether patients undergoing the Ross procedure with bicuspid aortic valves have different pulmonary artery biomechanical properties from those with tricuspid valves. METHODS: Thirty-two pulmonary arteries and 20 aortas were obtained from patients undergoing the Ross procedure at the time of surgery, from a cohort of 32 patients. Histological analysis and ex vivo equi-biaxial tensile testing completed within 8 hours of surgery were used to evaluate differences in patient groups and between the pulmonary artery and the ascending aorta. RESULTS: There was no difference in thickness among pulmonary arteries when compared according to aortic valve phenotype (P = 0.94). There was no difference in the tensile tissue properties among aortas and pulmonary arteries when compared according to aortic valve phenotype, in either the circumferential or longitudinal axis. When compared according to the main surgical indication, pulmonary artery walls from patients with pure aortic regurgitation were less stiff than their counterparts (P = 0.002). There was no difference in the number of elastic lamellae in pulmonary artery specimens from the three different aortic valve phenotypes (Tricuspid, bicuspid or unicuspid), as well as in the aortic specimens. CONCLUSION: No significant differences were observed in the biomechanical properties of pulmonary arteries when compared according to aortic valve phenotype.

Background: Pulmonary artery (PA) diameter may be altered in association with cardiovascular (CV) risk factors as noted in aorta in systemic hypertension. The flow of blood from the right ventricle to the PA and all the way to the capillary level depends on the pulmonary vascular resistance and to a lesser extent compliance and impedance of the PA, which are the fundamental conduit for maintenance of the right heart hemodynamics. Our objective is to determine the association between CV risk factors and the main pulmonary artery (MPA) diameter. Methods: The study population are asymptomatic individuals with no known diagnosis of CV diseases in central Appalachia (n=1,282). Adults aged 18 years or older were eligible for the screening if they were referred by a physician. For self-referral, only males aged ≥45 years and females aged ≥55 years were eligible. Unadjusted and adjusted linear regression analyses were performed. Results: The mean MPA diameter was significantly higher among males compared to females (27.19±4.20 vs. 24.99±3.91 mm, P<0.0001). Participants with diabetes also had wider MPA diameter (26.79±4.56 mm) compared to those without diabetes (25.93±4.11 mm) (P=0.015). Further, hypertensive (26.42±4.15 vs. 25.71±4.21 mm, P=0.002) and obese (27.25±4.11 vs. 25.28±4.07 mm, P<0.0001) participants had significantly wider MPA diameter compared to non-hypertensive and non-obese participants, respectively. Multivariable model showed that age, sex and body mass index (BMI) were significantly associated with MPA diameter. A 1-year increase in age increased MPA diameter by 0.046 mm (P<0.0001). The diameter of MPA was wider among males by 2.16 mm compared to females (P<0.0001). Finally, with one unit increase in BMI, the MPA diameter increased by 0.16 mm (P<0.0001). Conclusions: MPA diameter was significantly associated with age, sex, and BMI. Further prospective studies are needed to correlate computed tomography (CT) measurement of MPA diameter with pulmonary pressure as assessed by echocardiogram to diagnose pulmonary hypertension (PH).

Klaffvitier är några av de vanligaste hjärtsjukdomarna och studier visar att fysisk aktivitet är en viktig del av den kliniska diagnostiken speciellt för individer med symtomfri problematik. Fysisk aktivitet leder hos en del individer till typiska symtom för klaffvitium och ger således möjlighet till förbättrad gradering av klaffvitier jämfört med i vila. Syftet med studien är att ekokardiografiskt studera eventuell förändring av trikuspidalisklaffunktion i vila och efter lättare fysisk ansträngning, samt undersöka hypotesen om trikuspidalisinsufficiens samt tryckgradienten över trikuspidalisklaffen förändras i samband med denna typ av diagnostik. Sexton deltagare inkluderas vid anamnes på andfåddhet eller ansträngningsutlösta hjärtbesvär samt även fynd av trikuspidalisinsufficiens i samband med ordinarie undersökningstillfälle. Även de med känd trikuspidalis-insufficiens sedan tidigare inkluderades. Efter ordinarie ekokardiografisk undersökning som individerna var remitterade till fick inkluderade deltagare utföra ett cykeltest på ergometercykel under sex minuter med en lättare belastning. Ultraljudsbilder på hjärtat samlades in direkt efter avslutad ansträngning. Två variabler, tryckgradient före respektive efter ansträngning över trikuspidalisklaffen, analyserades enligt dess differens och därefter analyserades differenserna i förhållande till nollhypotesen. Medianvärden av variablerna jämfördes i Wilcoxons teckenrangtest och med Spearmans rangkorrelation studerades förhållandet mellan stigande hjärtfrekvens samt tryckgradient vid fysisk ansträngning. Studien visade att tryckgradienten hos trikuspidalis-insufficiensen förändrades vid utförande av lättare fysisk ansträngning hos individer med ansträngningsutlösta hjärtbesvär samt att denna form av undersökning i anslutning till ordinarie undersökningstillfälle kan vara av värde bland individer med anamnes på ansträngningsutlösta hjärtbesvär. / Valvular heart disease are one of the most common heart diseases and previous studies have shown that exercise is an important part of the clinical diagnostics, especially in asymphtomatic individuals. In some cases, exercise lead to typical symptoms of valvular heart disease and improved grading compared to rest. The aim of the present study was to analyze tricuspid valvular function in rest compared to exercise and examine whether or not tricuspid regurgitation and pressure gradient over the tricuspid valve will alter after exercise. Sixteen participants was included with anamnesis of dyspnea or cardiac symptoms related to exercise as well as findings of tricuspid regurgitation during the echocardio-graphic examination. Individuals with known tricuspid regurgitation were also included. After the transthoracic echocardiographic examination, included individuals performed a bicycle test for six minutes with light workload. Additional ultrasound images of the heart was collected immediately after finished bicycle test. Two variables, pressure gradient over the tricuspid valve before and after right exercise, were analyzed according to its difference and then the differences were analyzed relative to the zero hypothesis. Median values of the variables were compared in Wilcoxon's signed-rank test and Spearman's rank correlation analyzed the relationship between increasing heart rate and pressure gradient under the influence of exercise. This study has shown that the pressure gradient of the tricuspid regurgitation changes in the performance of light exercise in individuals with history of dyspnea or cardiac symptoms related to exercise. It also showed the value of an exercise test in adherence to the echocardiographic examination in this group of individuals.

No description available.

yes / We investigated the steepened dynamic action potential duration (APD) restitution of rats with pulmonary artery hypertension (PAH) and right ventricular (RV) failure and tested whether the observed APD restitution properties were responsible for negative mechanical restitution in these myocytes. PAH and RV failure were provoked in male Wistar rats by a single injection of monocrotaline (MCT) and compared with saline-injected animals (CON). Action potentials were recorded from isolated RV myocytes at stimulation frequencies between 1 and 9Hz. Action potential waveforms recorded at 1Hz were used as voltage clamp profiles (action potential clamp) at stimulation frequencies between 1 and 7Hz to evoke rate-dependent currents. Voltage clamp profiles mimicking typical CON and MCT APD restitution were applied and cell shortening simultaneously monitored. Compared with CON myocytes, MCT myocytes were hypertrophied; had less polarized diastolic membrane potentials; had action potentials that were triggered by decreased positive current density and shortened by decreased negative current density; APD was longer and APD restitution steeper. APD90 restitution was unchanged by exposure to the late Na+-channel blocker (5μM) ranolazine or the intracellular Ca2+ buffer BAPTA. Under AP clamp, stimulation frequency-dependent inward currents were smaller inMCTmyocytes and were abolished by BAPTA. In MCT myocytes, increasing stimulation frequency decreased contraction amplitude when depolarization duration was shortened, to mimic APD restitution, but not when depolarization duration was maintained. We present new evidence that the membrane potential of PAH myocytes is less stable than normal myocytes, being more easily perturbed by external currents. These observations can explain increased susceptibility to arrhythmias. We also present novel evidence that negative APD restitution is at least in part responsible for the negative mechanical restitution in PAH myocytes. Thus, our study links electrical restitution remodeling to a defining mechanical characteristic of heart failure, the reduced ability to respond to an increase in demand.

Background-Previously we found that smooth muscle cell (SMC)-specific knockout of miR-17 similar to 92 attenuates hypoxia-induced pulmonary hypertension. However, the mechanism underlying miR-17 similar to 92-mediated pulmonary artery SMC (PASMC) proliferation remains unclear. We sought to investigate whether miR-17 similar to 92 regulates hypoxia-inducible factor (HIF) activity and PASMC proliferation via prolyl hydroxylases (PHDs). Methods and Results-We show that hypoxic sm-17 similar to 92(-/-) mice have decreased hematocrit, red blood cell counts, and hemoglobin contents. The sm-17 similar to 92 (-/-) mouse lungs express decreased mRNA levels of HIF targets and increased levels of PHD2. miR-17 similar to 92 inhibitors suppress hypoxia-induced levels of HIF1 alpha, VEGF, Glut1, HK2, and PDK1 but not HIF2 alpha in vitro in PASMC. Overexpression of miR-17 in PASMC represses PHD2 expression, whereas miR-17/20a inhibitors induce PHD2 expression. The 3'-UTR of PHD2 contains a functional miR-17/20a seed sequence. Silencing of PHD2 induces HIF1a and PCNA protein levels, whereas overexpression of PHD2 decreases HIF1 alpha and cell proliferation. SMC-specific knockout of PHD2 enhances hypoxia-induced vascular remodeling and exacerbates established pulmonary hypertension in mice. PHD2 activator R59949 reverses vessel remodeling in existing hypertensive mice. PHDs are dysregulated in PASMC isolated from pulmonary arterial hypertension patients. Conclusions-Our results suggest that PHD2 is a direct target of miR-17/20a and that miR-17 similar to 92 contributes to PASMC proliferation and polycythemia by suppression of PHD2 and induction of HIF1 alpha.

A lesão pulmonar é a principal causa de morte da Esclerose Sistêmica (ES), e as alterações principais são: o acometimento intersticial e o vascular. No presente estudo analisamos através do microscópio confocal a laser 40 artérias pulmonares de pequeno e médio calibre de pacientes com ES e 16 controles. Medimos a área do lúmen, a área total do vaso e fizemos a subtração da área total do vaso menos a do lúmen, e a porcentagem da área do lúmen em relação à área total do vaso. Observou-se que a área do lúmen e a porcentagem da área do lúmen em relação a área total do vaso são significativamente menores na ES em relação ao controle, e que a diferença entre a área total do vaso e a área do lúmen foi maior no grupo ES. Os achados confirmaram a hipótese inicial de acometimento das artérias pulmonares na ES, que se encontram espessadas devido à inflamação, infiltração celular em suas camadas e ativação endotelial / Lung injury is the leading cause of death in Systemic Sclerosis (SSc), and the main changes are: the vascular and interstitial involvement. In this study we analyzed through the confocal laser microscope 40 lung arteries of small and medium-sized of patients with SSc and 16 arteries of control group. We measured the lumen area, the total vessel area, made the subtracting the total vessel area minus the lumen area and the percentage between the lumen area and total vessel area. It was observed that the lumen area and the percentage between the lumen area and total vessel area were significantly lower in SSc group compared to control group, and the difference between the total vessel and the lumen area was higher in SSc. The findings confirmed the initial hypothesis of pulmonary arterial injury in SSc, wich are thickened due to inflammation, cellular infiltration into its layers and endothelial activation