Occult constrictive pericardial disease. Diagnosis by rapid volume expansion and correction by pericardiectomy.

Bush, Charles A.; Stang, John M.; Wooley, Charles F.; Kilman, James W.

doi:10.1161/01.cir.56.6.924

Cited by 153 publications

(45 citation statements)

References 13 publications

(3 reference statements)

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“…Threeyear survival in the patients with ILD was 82.5% (95% CI 78.0-87.0). Survival at 5 years was similar in patients with a mean PAP of Յ20 mm Hg and those with a mean PAP of [21][22][23][24] (Figure 4). Survival at 3 years was 90% (95% CI 72-100) in the group of patients with rapid progression.…”

Section: Resultsmentioning

confidence: 83%

Borderline Mean Pulmonary Artery Pressure in Patients With Systemic Sclerosis: Transpulmonary Gradient Predicts Risk of Developing Pulmonary Hypertension

Valerio¹,

Schreiber²,

Handler³

et al. 2013

Arthritis & Rheumatism

158

107

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Objective. To determine whether patients with systemic sclerosis (SSc) and borderline mean pulmonary artery pressure (PAP) at cardiac catheterization are more likely to develop pulmonary hypertension (PH) than those in whom pulmonary pressure is normal.Methods. Patients with SSc in whom PH and significant interstitial lung disease had been excluded at baseline were enrolled in our prospective cohort. Analysis of followup data identified patients who met prespecified criteria prompting repeat catheterization to reassess for possible PH. Using Kaplan-Meier, receiver operating characteristic, and Cox regression methods, we studied the development of PH and death.Results. Of 228 patients in this study, 86 had borderline mean PAP (21-24 mm Hg) at baseline. Following prespecified criteria, 76 patients underwent repeat catheterization, and 29 of these developed PH. Two cases were related to disease of the left side of the heart. The average mean PAP increased from baseline (20.2 mm Hg) to followup (24.3 mm Hg) (P < 0.05 by Student's t-test). Patients with borderline mean PAP were more likely to develop PH than patients with mean PAP <20 mm Hg (P < 0.001 by log rank test, hazard ratio [HR] 3.7). A transpulmonary gradient (TPG) >11 mm Hg at baseline also predicted PH (P < 0.001 by log rank test, HR 7.9). Incident development of pulmonary arterial hypertension (PAH) was not benign, with a mortality of 18% within 3 years.Conclusion. Our findings indicate that borderline mean PAP and an elevated TPG in patients with SSc predict progression to PH. These patients should be monitored closely for the development of PH. Our findings indicate that catheterization data are useful in patients considered at risk of PAH.

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Section: Resultsmentioning

confidence: 83%

Borderline Mean Pulmonary Artery Pressure in Patients With Systemic Sclerosis: Transpulmonary Gradient Predicts Risk of Developing Pulmonary Hypertension

Valerio¹,

Schreiber²,

Handler³

et al. 2013

Arthritis & Rheumatism

158

107

View full text Add to dashboard Cite

show abstract

“…This challenge is based on studies that show marked increases in PWP (Ͼ 7 mm Hg) in patients with LV dysfunction with preserved systolic function rapidly given up to 1,000 mL of saline solution. 17 We found that little additional increase in PWP was obtained with a fluid challenge of Ͼ 500 mL; therefore, 500 mL was used in our protocol. Two patients with PVH underwent RHC at outside institutions, neither of whom received inhaled nitric oxide or a fluid challenge.…”

Section: Study Patientsmentioning

confidence: 99%

Association of the Metabolic Syndrome With Pulmonary Venous Hypertension

Robbins

Newman

Johnson

et al. 2009

Chest

159

130

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Background: Pulmonary venous hypertension (PVH) is a well-described cause of pulmonary hypertension (PH) in patients with left heart disease associated with elevated left heart filling pressure. PVH results from a number of processes, including left-sided valvular disease, constrictive pericardial disease, restrictive cardiomyopathies, and left ventricular (LV) systolic dysfunction. PVH in patients with normal LV systolic function, commonly referred to as diastolic dysfunction, is not well characterized. We observed that many patients with PH due to PVH have obesity, hypertension, diabetes mellitus, and hypercholesterolemia, which are clinical features of the metabolic syndrome (MS), a previously identified cause for systemic vascular disease. Methods: We evaluated 122 consecutive patients referred for diagnosis and treatment of PH and compared the prevalence of features of the MS between patients with PVH and those with pulmonary arterial hypertension (PAH). We also compared clinical and hemodynamic characteristics between these two groups.

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“…For clinical suspicion of SSc-related occult constrictive pericarditis (dyspnea on exertion out of proportion to pulmonary function test values), right and left cardiac catheterization with a fluid challenge (1000 cc bolus of normal saline over 10 minutes) may be required for diagnosis 19 .…”

Section: Rheumatologymentioning

confidence: 99%

Hematopoietic Stem Cell Transplantation for Systemic Sclerosis: If You Are Confused, Remember: “It Is a Matter of the Heart”

Burt¹,

Shah²,

Gheorghiade³

et al. 2012

J Rheumatol

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Occult constrictive pericardial disease. Diagnosis by rapid volume expansion and correction by pericardiectomy.

Abstract: of dobutamine on regional myocardial blood flow and ventricular performance during acute and chronic myocardial ischemia in dogs.

Cited by 153 publications

References 13 publications

Borderline Mean Pulmonary Artery Pressure in Patients With Systemic Sclerosis: Transpulmonary Gradient Predicts Risk of Developing Pulmonary Hypertension

Borderline Mean Pulmonary Artery Pressure in Patients With Systemic Sclerosis: Transpulmonary Gradient Predicts Risk of Developing Pulmonary Hypertension

Association of the Metabolic Syndrome With Pulmonary Venous Hypertension

Hematopoietic Stem Cell Transplantation for Systemic Sclerosis: If You Are Confused, Remember: “It Is a Matter of the Heart”

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