Pulmonary Artery Pressure, Gender, Menopause, and Pregnancy in Schistosomiasis-Associated Pulmonary Hypertension

Armstrong, Anderson C.; Bandeira, Angela; Correia, Luís Cláudio Lemos; Melo, Humberto C. O.; Silveira, Carlos Antônio da Mota; Albuquerque, Eugenio Soares de; Moraes, Jeová C.; Silva, Antônio M. L.; Lima, João A.C.; Filho, Dário Celestino Sobral

doi:10.5935/abc.20130130

Cited by 4 publications

(5 citation statements)

References 36 publications

(33 reference statements)

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“…We estimated PASP by Doppler Echocardiogram. It is usually used to screen patients suspected of PH (19) as a useful substitute for invasive means to measure mean pulmonary artery pressure as shown in some studies. (20) The results of this study show that PASP within our pregnant population ranges between 14mmHg and 45mmHg.…”

Section: Discussionmentioning

confidence: 99%

The Estimation of Pulmonary Artery Systolic Pressure in Normal Pregnancy

Gharaibeh¹,

Sharo²,

Atyyat³

et al. 2015

JRMS

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Objective: To assess the effects of various stages of pregnancy as well as pregnant women age on the level of pulmonary artery systolic pressure. Methods: One hundred and thirty five healthy pregnant women, aged 18 to 42 years, were included in this study. They underwent voluntary transthoracic echocardiogram measurements of pulmonary artery systolic pressure at rest. Three groups of pregnant women were designed according to gestational age; Group 1 included pregnancies less than 13 weeks of gestation and considered as control group. Group II included pregnancies equal to 13 weeks gestation and less than 28 weeks. Group III included those pregnancies with 28 weeks of gestation up to term. Each group included 45 women. The mean pulmonary artery systolic pressure was calculated for each group. Results for groups two and three were compared separately to the control group. The study population was then regrouped according to women's age; Group A included women aged less than 35 years (n=95), Group B included women aged 35 years and above (n=40). Difference in mean pulmonary artery systolic pressure between groups A and B were studied. Results: Lower and upper limits of pulmonary artery systolic pressure during pregnancy were found to be 14 and 45 mmHg. Pulmonary artery systolic pressure during pregnancy showed an increase with maternal age after 35. Marginal change was also noted with gestational age; however that was of no statistical significance. Conclusion: During the different stages of pregnancy, mean pulmonary artery systolic pressure does not alter; however, it may reach high values in healthy asymptomatic women. When interpreting pulmonary artery systolic pressure in pregnancy, age correction may be required since pulmonary artery systolic pressure is found to physiologically increase with increasing pregnant women's age.

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Section: Discussionmentioning

confidence: 99%

The Estimation of Pulmonary Artery Systolic Pressure in Normal Pregnancy

Gharaibeh¹,

Sharo²,

Atyyat³

et al. 2015

JRMS

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“…14 Overall approximately 1% of individuals chronically infected develop PH. 14 Overall approximately 1% of individuals chronically infected develop PH.…”

Section: Schistosomiasismentioning

confidence: 99%

Pulmonary Hypertension and Pregnancy

Gei

Montúfar-Rueda

2014

Clinical Obstetrics &Amp; Gynecology

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Pulmonary hypertension is a syndrome infrequently associated with pregnancy. Despite advancements in therapy during the past 25 years and encouraging reports of improved outcomes, pulmonary arterial hypertension remains a devastating disease with a significantly reduced lifespan. This disorder should still be considered a contraindication to pregnancy. The decision of a patient to continue the pregnancy should be supported by an empathetic group of health care professionals who would optimize their treatment and hopefully their pregnancy outcomes and survival after delivery. We overview here different aspects of the diagnosis, evaluation, management, and counseling of patients suffering from pulmonary hypertension during pregnancy.

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“…Eleventh, the male bias in disease worsening in SSc-associated PH (11,12), the lack of sex bias in schistosomiasis-associated PH (13) and the small male bias in development of HIV-associated PH (14) are likely due to localized pulmonary vascular-level activation of immune processes that include STAT5 activation (112)(113)(114)(115)(116)(117).…”

Section: Synthesis Of the Literature On Sex Bias Mediated By The Neurmentioning

confidence: 99%

“…However, after excluding PH diagnosed at baseline, male SSc patients have a higher likelihood of developing PH and a worse outcome (11,12). Schistosomiasisinduced PH shows no sex bias (13), whereas HIV-induced PH shows a small (1.2-fold) male bias (14). The mechanisms that underlie these sexual dimorphisms in humans, especially the female bias in disease prevalence in IPAH and HPAH, are incompletely understood (8,15).…”

Section: Introductionmentioning

confidence: 99%

Hypothesis: Neuroendocrine Mechanisms (Hypothalamus-Growth Hormone-STAT5 Axis) Contribute to Sex Bias in Pulmonary Hypertension

Sehgal

Yang

Miller

2015

Mol Med

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Pulmonary hypertension (PH) is a disease with high morbidity and mortality. The prevalence of idiopathic pulmonary arterial hypertension (IPAH) and hereditary pulmonary arterial hypertension (HPAH) is approximately two-to four-fold higher in women than in men. Paradoxically, there is an opposite male bias in typical rodent models of PH (chronic hypoxia or monocrotaline); in these models, administration of estrogenic compounds (for example, estradiol-17β [E2]) is protective. Further complexities are observed in humans ingesting anorexigens (female bias) and in rodent models, such as after hypoxia plus SU5416/Sugen (little sex bias) or involving serotonin transporter overexpression or dexfenfluramine administration (female bias). These complexities in sex bias in PH remain incompletely understood. We recently discovered that conditional deletion of signal transducer and activator of transcription 5a/b (STAT5a/b) in vascular smooth muscle cells abrogated the male bias in PH in hypoxic mice and that late-stage obliterative lesions in patients of both sexes with IPAH and HPAH showed reduced STAT5a/b, reduced Tyr-P-STAT5 and reduced B-cell lymphoma 6 protein (BCL6). In trying to understand the significance of these observations, we realized that there existed a wellcharacterized E2-sensitive central neuroendocrine mechanism of sex bias, studied over the last 40 years, that, at its peripheral end, culminated in species-specific male ("pulsatile") versus female ("more continuous") temporal patterns of circulating growth hormone (GH) levels leading to male versus female patterned activation of STAT5a/b in peripheral tissues and thus sex-biased expression of hundreds of genes. In this report, we consider the contribution of this neuroendocrine mechanism (hypothalamus-GH-STAT5) in the generation of sex bias in different PH situations.

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Pulmonary Artery Pressure, Gender, Menopause, and Pregnancy in Schistosomiasis-Associated Pulmonary Hypertension

Cited by 4 publications

References 36 publications

The Estimation of Pulmonary Artery Systolic Pressure in Normal Pregnancy

The Estimation of Pulmonary Artery Systolic Pressure in Normal Pregnancy

Pulmonary Hypertension and Pregnancy

Hypothesis: Neuroendocrine Mechanisms (Hypothalamus-Growth Hormone-STAT5 Axis) Contribute to Sex Bias in Pulmonary Hypertension

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