Pulmonary Hypertension in Chronic Lung Diseases and/or Hypoxia

Sajkov, Dimitar; Mupunga, Bliegh; Bowden, Jeffrey J.; Petrovsky, Nikolai

doi:10.5772/55681

Cited by 3 publications

(2 citation statements)

References 134 publications

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“…Pulmonary hypertension is a common complication encountered in chronic lung diseases [ 20 ]. It might be expected in severe and long-term bronchiectasis cases due to hypoxic pulmonary vasoconstriction or remodeling of the vascular bed.…”

Section: Discussionmentioning

confidence: 99%

Bronchiectasis: Retrospective Analysis of Clinical and Pathological Findings in a Tertiary-Care Hospital

Akatlı

Ulutaş

Şamdancı

et al. 2022

International Journal of Clinical Practice

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Background. Bronchiectasis is still a challenging chronic lung disease in developing countries. Patients with bronchiectasis can also have pulmonary hypertension. There are sparse data on the prevalence of pulmonary hypertension in patients with bronchiectasis. Materials and methods. Archived H&E-stained slides of 141 patients histopathologically diagnosed with bronchiectasis were reevaluated. Cases were categorized into 4 subgroups based on histology: tubular, varicose, follicular, and cystic. In addition, concomitant histopathological changes were also reevaluated. For patients with available CT sections, main, right, and left pulmonary artery (PA) diameters and PA/aorta ratio were measured with regard to pulmonary hypertension. Results. Of the cases, 70% (n = 89) were female and 30% (n = 52) were male, with a mean age of 36.58 in females and 33.84 in males. Histopathologically, 43% (n = 68) of the cases showed follicular, 37% (n = 59) showed varicose, 35% (n = 56) showed tubular, and 28% (n = 45) showed cystic bronchiectasis morphology. All cases showed chronic inflammation, fibrosis, muscle destruction, and cartilage destruction. Aspergillus were present in 11% of the cases showing cystic morphology. Approximately 17% of the cases (n = 24) were found to have neuroendocrine cell proliferations. In cases with medial hypertrophy, a statistically significant increase in the left pulmonary artery diameter was radiologically determined. Conclusions. Medial hypertrophy was found to be significant with regard to indicating a radiological increase in left pulmonary artery diameter. Vascular changes observed in bronchiectasis cases and the presence of neuroendocrine cell proliferations should be specified in pathology reports, and aspergilloma should be carefully investigated in cases with predominant cystic morphology.

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Section: Discussionmentioning

confidence: 99%

Bronchiectasis: Retrospective Analysis of Clinical and Pathological Findings in a Tertiary-Care Hospital

Akatlı

Ulutaş

Şamdancı

et al. 2022

International Journal of Clinical Practice

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“…Transpulmonary gradient (TPG) is defined as the difference between mean pulmonary arterial pressure (mPAP) and left atrial pressure (Pla), which is usually estimated by mean pulmonary capillary wedge pressure (mPCWP) (13). PHTN due to ESLD is precipitated by alveolar hypoxia leading to pulmonary vasoconstriction and intrinsic vascular remodeling, thus TPG was chosen as it is highly dependent on vascular resistance (14,15). Furthermore, TPG measures are more suitable than the traditional pulmonary artery pressures to characterize PHTN secondary to ESLD due to their independence from factors such as flow, inertia, vascular compliance, and alveolar pressures (16).…”

Section: Original Articlementioning

confidence: 99%

Transpulmonary gradient as a predictor for outcomes after lung transplantation

Chan¹,

Madde²,

Furukawa³

et al. 2022

Shanghai Chest

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Background: End stage lung disease (ESLD) is commonly associated with pulmonary hypertension (PHTN). In a donor restrictive environment, offering patients single over double lung transplants could increase organ utilization. However, there isn't a clinical consensus on how severe PHTN must be to preclude single lung transplant (SLT) due to poor outcomes. We sought to investigate the predictive value of the transpulmonary gradient (TPG) in SLT in patients with ESLD and PHTN. Methods: We performed a retrospective analysis of the United Network for Organ Sharing database and identified all patients who underwent lung transplantation (LT) from May 2005 to March 2021. Patients were stratified based on their TPG score above or below 25 mmHg. Primary outcomes include 1-year survival assessed by generalized linear mixed modeling.Results: Our analysis showed TPG was associated with 1-year survival but this relationship depended on transplant type (P=0.002) with TPG ≥25 being associated with higher mortality in single (P=0.004), but not double LT (P=0.95). This association was maintained when covarying for numerous clinical factors, as well as when excluding deaths within 90 days of LT (P=0.04).Conclusions: A preoperative TPG >25 was associated with decreased 1-year survival in SLT recipients.The use of preoperative TPG combined with other marks of clinical status can help transplant centers in their decision of offering single vs. double lung transplant in patients with ESLD and PHTN.

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Improvement of pulmonary arterial hypertension, inflammatory response, and epithelium injury by dual activation of cAMP/cGMP pathway in a rat model of monocrotaline-induced pulmonary hypertension

Muraki

Naito

Tohyama

et al. 2019

Bioscience, Biotechnology, and Biochemistry

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Pulmonary hypertension (PH) is a life-threatening lung disease. PH with concomitant lung diseases, e.g., idiopathic pulmonary fibrosis, is associated with poor prognosis. Development of novel therapeutic vasodilators for treatment of these patients is a key imperative. We evaluated the efficacy of dual activation of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) using an active, small-molecule phosphodiesterase (PDE4)/PDE5 dual inhibitor (Compound A). Compound A increased both cAMP and cGMP levels in WI-38 lung fibroblasts and suppressed the expressions of type-1 collagen α1 chain and fibronectin. Additionally, compound A reduced right ventricular weight/left ventricular weight+septal weight ratio, brain natriuretic peptide expression levels in right ventricle, C─C motif chemokine ligand 2 expression levels in lung, and plasma surfactant protein D. Our data indicate that dual activation of cAMP/cGMP pathways may be a novel treatment strategy for PH.

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Pulmonary Hypertension in Chronic Lung Diseases and/or Hypoxia

Cited by 3 publications

References 134 publications

Bronchiectasis: Retrospective Analysis of Clinical and Pathological Findings in a Tertiary-Care Hospital

Bronchiectasis: Retrospective Analysis of Clinical and Pathological Findings in a Tertiary-Care Hospital

Transpulmonary gradient as a predictor for outcomes after lung transplantation

Improvement of pulmonary arterial hypertension, inflammatory response, and epithelium injury by dual activation of cAMP/cGMP pathway in a rat model of monocrotaline-induced pulmonary hypertension

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