Right and Left Ventricular Function and Pulmonary Artery Pressure in Patients With Bronchiectasis

Alzeer, Abdulaziz H.; Al-Mobeirek, Abdulellah F.; Al-Otair, Hadil A.; Elzamzamy, Usama A.F.; Joherjy, Ismail A.; Shaffi, Ahmed S.

doi:10.1378/chest.07-1639

Cited by 52 publications

(43 citation statements)

References 29 publications

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Section: Discussionmentioning

confidence: 99%

“…PH is commonly seen in advanced bronchiectasis, particularly with cystic disease [9]. It was reported that 32.9% of stable patients with bronchiectasis had PH and SPAP was higher in cystic bronchiectasis with concomitant right and left ventricular dysfunction [9]. The pathogenesis of PH in these patients is related to impairment of pulmonary physiology Figure 2 Correlations between global HRCT score and FEV1 in cystic bronchiectasis.…”

Section: Discussionmentioning

confidence: 99%

“…The ECHO study was read by a cardiologist without information about patient status. Pulmonary hypertension (PH) was defined in this study as SPAP P40 mmHg based on criteria established by the World Health Organization Symposium on Primary Pulmonary Hypertension [9]. SPAP was calculated based on the modified Bernoulli equation, and right atrial pressure was estimated as 5, 10, 15, or 20 mmHg on the basis of size and respiratory changes of the inferior vena cava using previously described techniques [10].…”

Section: Echocardiographymentioning

confidence: 99%

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Role of a diagnostic triad in bronchiectasis

Hassan

Shalan

Allah

et al. 2015

Egyptian Journal of Chest Diseases and Tuberculosis

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Objective: To differentiate cystic and cylindrical bronchiectasis utilizing a diagnostic triad of HRCT score, PFTs, and echocardiography.Design: A prospective observational cross sectional study. Setting: All bronchiectasis patients admitted to the chest department of Assiut and Al-Azhar Universities from May 2012 to June 2014 were enrolled in this study.Main outcome measures: HRCT score, pulmonary function tests parameters (FEV1, FEV1/ FVC, FVC, PaO 2 , PaCO 2 and DLCO) and complete echocardiographic assessment were done for all patients.Results: Obstructive pulmonary defect was observed in a majority of patients (56%). FVC%, FEV1 and FEV1/FVC were lower in patients with cylindrical as compared to cystic bronchiectasis. RV diameter was significantly greater in cystic bronchiectasis, and was positively correlated with pulmonary hypertension and negatively correlated with PaO 2 . PH was significantly greater in patients with cystic bronchiectasis and was positively correlated with PaCO 2 , and inversely correlated with PaO 2 , and FEV1. Global HRCT scores for cystic bronchiectasis were significantly correlated with the values of FEV1% and with SPAP.Conclusions: Cystic bronchiectasis is associated with more severe lung function impairment and worse HRCT scores as compared with cylindrical bronchiectasis. In cystic bronchiectasis, HRCT scores correlated with FEV1% and SPAP and could be a predictor of future PH. HRCT depicts these pathological changes, moreover, high HRCT score not only reflects lung damage in those patients, but it can also be correlated with PH. PH; therefore can be a marker of lung damage in bronchiectatic patients. ª 2015 Production and hosting by Elsevier B.V. on behalf of The Egyptian Society of Chest Diseases and Tuberculosis. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Echocardiographymentioning

confidence: 99%

See 1 more Smart Citation

Role of a diagnostic triad in bronchiectasis

Hassan

Shalan

Allah

et al. 2015

Egyptian Journal of Chest Diseases and Tuberculosis

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“…The ECHO study was read by a cardiologist without information about patient status. Pulmonary hypertension (PH) was defined in this study as SPAP ≥ 40 mm Hg based on criteria established by the World Health Organization Symposium on Primary Pulmonary Hypertension [9]. SPAP was calculated based on the modified Bernoulli equation, and right atrial pressure was estimated as 5, 10, 15, or 20 mm Hg on the basis of size and respiratory changes of the inferior vena cava using previously described techniques [3].…”

Section: Echocardiographymentioning

confidence: 99%

Impact of Cystic versus Cylindrical Types of Bronchiectasis on Pulmonary and Cardiac Functions

Hassan¹,

Ziada²,

El-hamd³

2014

OJRD

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Background: The combination of the clinical features, HRCT score and echocardiographic evidence of pulmonary hypertension help assess the prognosis in bronchiectasis. Aim: To test whether pulmonary and cardiac functions associated with bronchiectasis would differ according to its type (cystic versus cylindrical) utilizing HRCT score, PFTs and echocardiography. Patients and Methods: A cross-sectional study of patients with bronchiectasis was conducted at Chest and Internal Medicine Departments at Assiut University Hospital, Egypt. The diagnosis of bronchiectasis type was based on HRCT findings. PFTs, HRCT score and echocardiography were assessed in all cases. Results: We studied 56 patients with bronchiectasis; 31 were cystic (group A) and 25 were cylindrical (group B). Forced vital capacity (FVC%) and Dlco% were significantly lower in group A (P < 0.0001) as compared with group B; whereas FEF 25% -75% and FEV1 (0.04) were lower in group B. Global HRCT score, RVD and SPAP were significantly higher in group A (P = 0.002) and correlated with FEV1% (r = −0.51), and with SPAP (r = 0.16). Conclusions: Airway obstruction and small airway dysfunction were more significantly seen in cylindrical bronchiectasis. Patients with cystic bronchiectasis had significantly, higher global HRCT scores, RVD and SPAP. HRCT scores correlate with FEV 1% and SPAP and could be a predictor of future PH. Routine echocardiographic assessment of patients with bronchiectasis, particularly in those with cystic disease is highly recommended.

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“…This indicates the often underestimated role that GERD with aspiration plays in neonatal lung disease. Pulmonary hypertension beyond the neonatal period may be associated with the development of bronchiectasis as in cystic fibrosis [1,9]. In sickle cell disease, the prevalence of PH has been reported in various studies to be between 26% and 46% when calculated by tricuspid regurgitant jet [2,15].…”

Section: Neonatal Lung Diseasementioning

confidence: 99%

Clinical practice

Healy

Hanna²,

Zinman

2009

Eur J Pediatr

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Pathologies in both the respiratory and cardiovascular systems frequently coexist and impact on each other. This manuscript introduces an approach to the interpretation of this complex relationship. Pulmonary hypertension can be a significant consequence of many respiratory diseases. This in turn can lead to right ventricular dysfunction and cor pulmonale. Many childhood illnesses can result in cor pulmonale and can be conveniently grouped into three categories: idiopathic pulmonary hypertension, neonatal lung diseases, and lung disease beyond the neonatal period. When considering the impact of cardiac disease on the lung, one must consider two main pathologies: compression of the pediatric airway and increased lung water. In conclusion, thorough attention must be given to the interpretation of the complex relationship between cardiac and respiratory diseases. Pulmonary hypertension is a complication to consider in respiratory illness at all ages. In addition, when dealing with the complexities of congenital heart disease, one must always be aware of the risks of pulmonary complications whether parenchymal or airway. Ongoing improvements in ventilation strategies, vasodilator therapy, and surgical interventions continue to improve the outlook for these complex cases.

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Right and Left Ventricular Function and Pulmonary Artery Pressure in Patients With Bronchiectasis

Cited by 52 publications

References 29 publications

Role of a diagnostic triad in bronchiectasis

Role of a diagnostic triad in bronchiectasis

Impact of Cystic versus Cylindrical Types of Bronchiectasis on Pulmonary and Cardiac Functions

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