Sublingual Microcirculation in Pulmonary Arterial Hypertension

Dababneh, Luma; Cikach, Frank; Alkukhun, Laith; Dweik, Raed A.; Tonelli, Adriano R.

doi:10.1513/annalsats.201308-277oc

Cited by 31 publications

(36 citation statements)

References 47 publications

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“…Initial studies characterized idiopathic PAH (IPAH) as a disease of the pulmonary circulation; however, recent data from us (2,3) and other investigators (4)(5)(6) showed evidence of extrapulmonary vascular involvement.…”

Section: To the Editormentioning

confidence: 99%

“…However, patients with specific asthma phenotypes might benefit from FE NO monitoring. In particular, in patients with "discordant phenotypes" (high inflammation, low symptoms or high symptoms, low inflammation), an inflammation-driven strategy might be beneficial (2). The aim of our study was (1) to assess the presence and stability of concordant and discordant asthma phenotypes in children and (2) to assess whether children with a discordant phenotype were more likely to benefit from adjusting treatment to FE NO than children with a concordant phenotype.…”

Section: To the Editormentioning

confidence: 99%

See 1 more Smart Citation

Treprostinil Iontophoresis in Idiopathic Pulmonary Arterial Hypertension

Tonelli

Ahmed

Alkukhun

et al. 2015

Am J Respir Crit Care Med

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Section: To the Editormentioning

confidence: 99%

Section: To the Editormentioning

confidence: 99%

Treprostinil Iontophoresis in Idiopathic Pulmonary Arterial Hypertension

Tonelli

Ahmed

Alkukhun

et al. 2015

Am J Respir Crit Care Med

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“…Assessment of microvascular hemodynamics has been reported in non-ocular tissues, including nail fold [29], sublingual [30], and buccal mucosa [31] with the use of CapiScope, a commercially available device. Although, this device is capable of automated blood vessel diameter measurements, evaluation of blood velocity requires manual drawing of a line along a target vessel.…”

Section: Discussionmentioning

confidence: 99%

Automated assessment of hemodynamics in the conjunctival microvasculature network

Khansari

Wanek

Felder

et al. 2015

IEEE Trans. Med. Imaging

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The conjunctival microcirculation is accessible for direct visualization and quantitative assessment of microvascular hemodynamic properties. Currently available methods to assess hemodynamics in the conjunctival microvasculature use manual or semi-automated algorithms, which can be inefficient for application to a large number of microvessels within the microvascular network. We present an automated image analysis method for measurements of diameter and blood velocity in microvessels. The method was applied to conjunctival microcirculation images acquired in 15 healthy human subjects. Frangi filtering, thresholding, and morphological closing were applied to automatically segment microvessels, while variance filtering was used to detect blood flow. Diameter and blood velocity were measured in arterioles and venules within the conjunctival microvascular network, and blood flow and wall shear rate were calculated. Repeatability and validity of hemodynamic measurements were established. The automated image analysis method allows reliable, rapid and quantitative assessment of hemodynamics in the conjunctival microvascular network and can be potentially applied to microcirculation images of other tissues.

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“…We tested this noninvasive methodology in patients with PAH, a condition that with time leads to decrease cardiac output and poor peripheral perfusion. In addition, there is mounting evidence that PAH is not only a disease limited to pulmonary vasculature but also affects the systemic microcirculation [4,14]. Hofstee et al found that a reduction in nailfold capillary density was associated with PAH severity in patients with systemic sclerosis or idiopathic PAH[14].…”

Section: Discussionmentioning

confidence: 99%

Are Transcutaneous Oxygen and Carbon Dioxide Determinations of Value in Pulmonary Arterial Hypertension?

et al. 2015

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Background We hypothesized that transcutaneous gas determinations of O2 and CO2 (TcPO2 and TcPCO2) are associated with the severity of pulmonary arterial hypertension (PAH). Methods In this cross-sectional study we included consecutive patients with PAH (group 1 pulmonary hypertension (PH)) (n=34). Transcutaneous gas determinations were compared to those of age- and gender-matched healthy controls (n=14), non-group 1 PH (n=19) or patients with high estimated right ventricular systolic pressure on echocardiography but without hemodynamic evidence of PH (n=12). Results In patients with PAH, TcPO2 and TcPCO2 were significantly associated with PaO2 (R= 0.44, p=0.03) and PaCO2 (R=0.77, p<0.001), respectively. TcPO2/FiO2 (mean difference: −65.0 [95% CI: −121.3–8.7]) and TcPCO2 (mean difference: −7.4 [95% CI: −11.6–3.1]) were significantly lower in patients with PAH than healthy controls. TcPCO2 was useful in discriminating PAH patients from other individuals (AUC: 0.74 (95% CI of 0.62–0.83)). TcPO2/FiO2 ratio was significantly associated with mean PAP, TPG, PVR, CI, SVI, DLCO, 6-min walk distance and components of the CAMPHOR questionnaire. Conclusions Transcutaneous pressure of CO2 was lower in patients with PAH. Transcutaneous pressure of O2 over inspired fraction of O2 ratio was inversely associated with severity of disease in patients with pulmonary arterial hypertension.

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Sublingual Microcirculation in Pulmonary Arterial Hypertension

Cited by 31 publications

References 47 publications

Treprostinil Iontophoresis in Idiopathic Pulmonary Arterial Hypertension

Treprostinil Iontophoresis in Idiopathic Pulmonary Arterial Hypertension

Automated assessment of hemodynamics in the conjunctival microvasculature network

Are Transcutaneous Oxygen and Carbon Dioxide Determinations of Value in Pulmonary Arterial Hypertension?

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