Chronic hypersensitivity pneumonitis is a common fibrotic interstitial lung disease. The prevalence of pulmonary hypertension diagnosed by right heart catheterisation and its cardiopulmonary function findings in patients with chronic hypersensitivity pneumonitis are unknown.Consecutive symptomatic patients with chronic hypersensitivity pneumonitis were prospectively evaluated. All patients were submitted to right heart catheterisation, pulmonary function testing, a 6-min walk test, echocardiography, blood gas determination and N-terminal pro-brain natriuretic peptide analyses. Nonhypoxaemic patients also underwent incremental cardiopulmonary exercise testing. 50 patients underwent right heart catheterisation; 25 (50%) of these had pulmonary hypertension and 22 (44%) had a pre-capillary haemodynamic pattern. The patients with pre-capillary pulmonary hypertension had lower forced vital capacity (mean¡SD 50¡17% versus 69¡22% predicted, p,0.01), carbon monoxide diffusing capacity (37¡12% versus 47¡14% predicted, p,0.01), arterial oxygen tension (median (interquartile range) 59.0 (47.8-69.3) versus 73.0 (62.2-78.5) mmHg, p,0.01) and saturation after the 6-min walk test (78¡8% versus 86¡7%, p,0.01). In pre-capillary pulmonary hypertension, oxygen uptake was also lower at the anaerobic threshold (41¡11% versus 50¡8% predicted, p50.04) and at peak exercise (12.8¡1.6 versus 15.0¡2.5 mL?kg -1 ?min -1 , p50.02). Pre-capillary pulmonary hypertension is common in symptomatic chronic hypersensitivity pneumonitis and is related to interstitial lung disease severity. Additionally, pulmonary hypertension is more prevalent in hypoxaemic patients with impaired lung function and exercise capacity. @ERSpublications PH is common in chronic hypersensitivity pneumonitis and is related to interstitial lung disease severity
Echocardiography is a sensitive method to detect valvar abnormalities in patients with acute rheumatic fever and carditis. Additionally, by using regular standardized criterions, abnormalities that lead to a diagnosis of subclinical carditis are found in those patients with acute rheumatic fever in the apparent absence of cardiac involvement.
Infracardiac total anomalous pulmonary venous drainage can be erroneously diagnosed as respiratory distress of several different etiologies during the neonatal period. A cross-sectional echocardiography study with Doppler color flow mapping can preoperatively determine the precise drainage site and pulmonary venous return pattern, thereby allowing cardiac surgery to be performed promptly, prior to any clinical deterioration.
As cardiopatias congênitas (CC) são anormalidades estruturais que ocorrem no coração e/ou nos grandes vasos, ainda no período intrauterino, que podem causar alterações na fisiologia e anatomia cardiovasculares no indivíduo. Os indivíduos que sobrevivem à fase adulta muitas vezes desenvolvem outros problemas secundários à doença de base, sendo um deles a hipertensão arterial pulmonar, atingindo de 5 a 10% do total de adultos portadores de CC. No Brasil, cerca de 28 mil novos casos de CC surgem por ano, sendo que desses, 20% têm resolução espontânea e 50% precisam ser operados ainda no primeiro ano de vida. Os avanços da medicina quanto ao diagnóstico, técnicas cirúrgicas e opções de terapias têm aumentado o índice de sobrevivência dos portadores de CC. Nas últimas décadas, o aumento da expectativa de vida explica o maior número de pacientes tratados que requerem acompanhamento e novas intervenções na vida adulta por problemas secundários, além daqueles não tratados. Pacientes com CC com ou sem hipertensão pulmonar apresentam marcada diminuição da capacidade de exercício com deterioração da qualidade de vida. O ob-jetivo dessa revisão foi abordar atualizações em cardiopatias congênitas no adulto, em relação ao diagnóstico, tratamento e recomendações para reabilitação cardiovascular baseada em exercício físico.
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