The Experts below are selected from a list of 312 Experts worldwide ranked by ideXlab platform
Michael H Picard - One of the best experts on this subject based on the ideXlab platform.
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observations from non invasive measures of right Heart Hemodynamics in left ventricular assist device patients
Journal of The American Society of Echocardiography, 2009Co-Authors: Kaitlyn Lam, Stephanie Ennis, Gerry Odriscoll, Jorge Solis, Tom Macgillivray, Michael H PicardAbstract:Background Left ventricular assist devices (LVADs) reduce pulmonary vascular resistance (PVR) in patients with severe Heart failure. The aim of this study was to noninvasively assess the effect of LVAD implantation on PVR and right-Heart function. Methods In 21 patients with HeartMate II LVADs, serial echocardiograms were reviewed prior to implantation and 1 and 6 months after implantation. Echocardiographic and Doppler indices of right-Heart structure and function were measured along with LVAD settings, Hemodynamics, and biochemistry, and the Minnesota Living With Heart Failure Questionnaire (MLHFQ) and 6-minute walk test were administered. Results Comparing values before and 1 month after implantation, there were reductions in PVR (3.51 ± 0.9 vs 2.0 ± 0.5 Wood units, P P P = .04; 6-minute walking distance, 1706 ± 71 vs 1141 ± 387 ft, P = .04). Patients with significant deteriorations in RV function had poorer clinical status (MLHFQ score, 79 ± 13 vs 51 ± 27, P = .04; 6-minute walking distance, 480 ± 275 vs 1030 ± 437 ft, P = .04). Conclusions Echocardiographically detected changes in right-Heart Hemodynamics were associated with symptomatic status after LVAD implantation.
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276: Non Invasive Measures of Right Heart Hemodynamics Associated with Clinical Improvement Post Heartmate II
The Journal of Heart and Lung Transplantation, 2008Co-Authors: Kaitlyn Lam, Stephanie Ennis, Thomas E. Macgillivray, K. Crisalli, J. Cumuso, Michael H PicardAbstract:Purpose: Left ventricular assist devices (VAD) reduce pulmonary vascular resistance (PVR) in severe Heart failure. The Heartmate II (HMII), a continuous axial flow pump improves the clinical status of patients awaiting transplantation. Our aim was to non invasively assess the HMII’s effect on PVR and right Heart function in view of the risks associated with right Heart catheterisation in VAD patients. Methods and Materials: 18 patients enrolled in the HM II trial were studied. Echocardiograms performed prior to implant and 1 month post implant were reviewed. Tricuspid regurgitation velocity (TRV), right ventricular outflow tract velocity (RVOT VTI), tricuspid inflow velocities (TEV) and right chamber areas were measured. PVR, RV stroke volume (SV) and RV ejection fraction (RVEF) were calculated from the data (PVR TRV/RVOT VTI x 10 0.16; SV RVOT TVI X RVOT area). These results were compared to Minnesota Living with Heart Failure Questionnaire (MLWHF), VAD speed and flow rate. Results: Significant reductions in PVR, RVSP, TR and MLWHF with increases in the SV and TEV occurred post implant. Patients with more than 50% reduction in their PVR (n 4) had lower MLWHF (35 19 vs 67 29, p 0.05)and higher VAD flow rates (6.1 0.5 L/min vs 5.0 0.7 L/min) without significant difference in VAD support (9350 341rpm vs 9160 227rpm). Conclusions: Doppler echo detected improvements in right Heart Hemodynamics with HMII 1 month post implant. PVR change was associated with improved symptoms. Doppler echo can measure right Heart hemodynamic changes in VAD patients and may assist with optimal timing for transplantation and maximising clinical response in DT. It enables frequent acquisition of hemodynamic data on VAD patients which can improve understanding of the recovering myocardium.
Anne Charloux - One of the best experts on this subject based on the ideXlab platform.
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right Heart Hemodynamics in pulmonary hypertension an echocardiography and catheterization study
Circulation, 2016Co-Authors: Stéphane Doutreleau, Matthieu Canuet, Irina Enache, Paola Di Marco, Evelyne Lonsdorfer, Monique Oswaldmammoser, Anne CharlouxAbstract:BACKGROUND Echocardiography (ECHO) plays a key role in both the diagnosis and prognosis of pulmonary hypertension (PH). Many equations have been published to assess right Heart Hemodynamics using ECHO. The objective of this study was to test the accuracy and precision of different echocardiographic equations in comparison with the right Heart catheterization. METHODS AND RESULTS Complete right Heart hemodynamic assessments were prospectively obtained from 115 individuals (mean age 66±1 years; 57 males) who had known or suspected PH. Several equations were tested for the estimation of right atrial pressure, mean and systolic pulmonary artery pressure (MPAP), cardiac output, pulmonary capillary wedge pressure (PCWP), and pulmonary vascular resistance (PVR). The accuracy of ECHO was good, with a mean difference <2 mmHg for all of the pressure calculations and ±0.6 L/min for cardiac output. However, the PVR estimation was weak using any one of the formulae. For all the parameters, the precision of ECHO was moderate. The MPAP calculation detected PH with a sensibility of 97% and specificity of 83%. However, ECHO underdiagnosed post-capillary PH. CONCLUSIONS ECHO is a good method for the diagnosis of PH, with an adequate calculation of right pressures, but cannot accurately calculate PCWP and PVR. (Circ J 2016; 80: 2019-2025).
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Right Heart Hemodynamics in Pulmonary Hypertension – An Echocardiography and Catheterization Study –
Circulation journal : official journal of the Japanese Circulation Society, 2016Co-Authors: Stéphane Doutreleau, Matthieu Canuet, Irina Enache, Paola Di Marco, Evelyne Lonsdorfer, Monique Oswald-mammoser, Anne CharlouxAbstract:BACKGROUND Echocardiography (ECHO) plays a key role in both the diagnosis and prognosis of pulmonary hypertension (PH). Many equations have been published to assess right Heart Hemodynamics using ECHO. The objective of this study was to test the accuracy and precision of different echocardiographic equations in comparison with the right Heart catheterization. METHODS AND RESULTS Complete right Heart hemodynamic assessments were prospectively obtained from 115 individuals (mean age 66±1 years; 57 males) who had known or suspected PH. Several equations were tested for the estimation of right atrial pressure, mean and systolic pulmonary artery pressure (MPAP), cardiac output, pulmonary capillary wedge pressure (PCWP), and pulmonary vascular resistance (PVR). The accuracy of ECHO was good, with a mean difference
Kaitlyn Lam - One of the best experts on this subject based on the ideXlab platform.
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observations from non invasive measures of right Heart Hemodynamics in left ventricular assist device patients
Journal of The American Society of Echocardiography, 2009Co-Authors: Kaitlyn Lam, Stephanie Ennis, Gerry Odriscoll, Jorge Solis, Tom Macgillivray, Michael H PicardAbstract:Background Left ventricular assist devices (LVADs) reduce pulmonary vascular resistance (PVR) in patients with severe Heart failure. The aim of this study was to noninvasively assess the effect of LVAD implantation on PVR and right-Heart function. Methods In 21 patients with HeartMate II LVADs, serial echocardiograms were reviewed prior to implantation and 1 and 6 months after implantation. Echocardiographic and Doppler indices of right-Heart structure and function were measured along with LVAD settings, Hemodynamics, and biochemistry, and the Minnesota Living With Heart Failure Questionnaire (MLHFQ) and 6-minute walk test were administered. Results Comparing values before and 1 month after implantation, there were reductions in PVR (3.51 ± 0.9 vs 2.0 ± 0.5 Wood units, P P P = .04; 6-minute walking distance, 1706 ± 71 vs 1141 ± 387 ft, P = .04). Patients with significant deteriorations in RV function had poorer clinical status (MLHFQ score, 79 ± 13 vs 51 ± 27, P = .04; 6-minute walking distance, 480 ± 275 vs 1030 ± 437 ft, P = .04). Conclusions Echocardiographically detected changes in right-Heart Hemodynamics were associated with symptomatic status after LVAD implantation.
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276: Non Invasive Measures of Right Heart Hemodynamics Associated with Clinical Improvement Post Heartmate II
The Journal of Heart and Lung Transplantation, 2008Co-Authors: Kaitlyn Lam, Stephanie Ennis, Thomas E. Macgillivray, K. Crisalli, J. Cumuso, Michael H PicardAbstract:Purpose: Left ventricular assist devices (VAD) reduce pulmonary vascular resistance (PVR) in severe Heart failure. The Heartmate II (HMII), a continuous axial flow pump improves the clinical status of patients awaiting transplantation. Our aim was to non invasively assess the HMII’s effect on PVR and right Heart function in view of the risks associated with right Heart catheterisation in VAD patients. Methods and Materials: 18 patients enrolled in the HM II trial were studied. Echocardiograms performed prior to implant and 1 month post implant were reviewed. Tricuspid regurgitation velocity (TRV), right ventricular outflow tract velocity (RVOT VTI), tricuspid inflow velocities (TEV) and right chamber areas were measured. PVR, RV stroke volume (SV) and RV ejection fraction (RVEF) were calculated from the data (PVR TRV/RVOT VTI x 10 0.16; SV RVOT TVI X RVOT area). These results were compared to Minnesota Living with Heart Failure Questionnaire (MLWHF), VAD speed and flow rate. Results: Significant reductions in PVR, RVSP, TR and MLWHF with increases in the SV and TEV occurred post implant. Patients with more than 50% reduction in their PVR (n 4) had lower MLWHF (35 19 vs 67 29, p 0.05)and higher VAD flow rates (6.1 0.5 L/min vs 5.0 0.7 L/min) without significant difference in VAD support (9350 341rpm vs 9160 227rpm). Conclusions: Doppler echo detected improvements in right Heart Hemodynamics with HMII 1 month post implant. PVR change was associated with improved symptoms. Doppler echo can measure right Heart hemodynamic changes in VAD patients and may assist with optimal timing for transplantation and maximising clinical response in DT. It enables frequent acquisition of hemodynamic data on VAD patients which can improve understanding of the recovering myocardium.
Beth Gulyasy - One of the best experts on this subject based on the ideXlab platform.
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Constrictive pericarditis: An unusual clinical entity suggested during dobutamine stress echocardiography
International journal of cardiology, 2006Co-Authors: Vishal Gujral, Angel López-candales, Raed Abdelhadi, Frederick W. Crock, Beth GulyasyAbstract:A 44-year-old female presents with disabling dyspnea and is unable to perform a regular treadmill stress test; instead a dobutamine stress echocardiogram is performed and although negative for ischemia reveals a vigorous paradoxical motion of the interventricular septum with dilatation of the inferior vena cava without respiratory variation and an increased diastolic flow signal in the hepatic veins after expiration with the infusion of dobutamine. The diagnosis of constrictive physiology is confirmed with cardiac magnetic resonance imaging (MRI) and right Heart Hemodynamics and the patient underwent pericardiectomy without complications with resolution of symptoms.
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Letter to the Editor Constrictive pericarditis: An unusual clinical entity suggested during dobutamine stress echocardiography
2006Co-Authors: Vishal Gujral, Angel López-candales, Raed Abdelhadi, Frederick W. Crock, Beth GulyasyAbstract:A 44-year-old female presents with disabling dyspnea and is unable to perform a regular treadmill stress test; instead a dobutamine stress echocardiogram is performed and although negative for ischemia reveals a vigorous paradoxical motion of the interventricular septum with dilatation of the inferior vena cava without respiratory variation and an increased diastolic flow signal in the hepatic veins after expiration with the infusion of dobutamine. The diagnosis of constrictive physiology is confirmed with cardiac magnetic resonance imaging (MRI) and right Heart Hemodynamics and the patient underwent pericardiectomy without complications with resolution of symptoms.
Olivier C. Manintveld - One of the best experts on this subject based on the ideXlab platform.
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Preoperative right Heart Hemodynamics predict postoperative acute kidney injury after Heart transplantation
Intensive Care Medicine, 2018Co-Authors: Goksel Guven, Milos Brankovic, Alina A. Constantinescu, Jasper J. Brugts, Dennis A. Hesselink, Sakir Akin, Ard Struijs, Ozcan Birim, Can Ince, Olivier C. ManintveldAbstract:Purpose Acute kidney injury ( AKI) frequently occurs after Heart transplantation (HTx), but its relation to preoperative right Heart hemodynamic (RHH) parameters remains unknown. Therefore, we aimed to determine their predictive properties for postoperative AKI severity within 30 days after HTx. Methods From 1984 to 2016, all consecutive HTx recipients ( n = 595) in our tertiary referral center were included and analyzed for the occurrence of postoperative AKI staged by the kidney disease improving global outcome criteria. The effects of preoperative RHH parameters on postoperative AKI were calculated using logistic regression, and predictive accuracy was assessed using integrated discrimination improvement (IDI), net reclassification improvement (NRI), and area under the receiver operating characteristic curves (AUC). Results Postoperative AKI occurred in 430 (72%) patients including 278 (47%) stage 1, 66 (11%) stage 2, and 86 (14%) stage 3 cases. Renal replacement therapy (RRT) was administered in 41 (7%) patients. Patients with higher AKI stages had also higher baseline right atrial pressure (RAP; median 7, 7, 8, and in RRT 11 mmHg, p trend = 0.021), RAP-to-pulmonary capillary wedge pressure ratio (median 0.37, 0.36, 0.40, 0.47, p trend = 0.009), and lower pulmonary artery pulsatility index (PAPi) values (median 2.83, 3.17, 2.54, 2.31, p trend = 0.012). Higher RAP and lower PAPi values independently predicted AKI severity [adjusted odds ratio (OR) per doubling of RAP 1.16 (1.02–1.32), p = 0.029; of PAPi 0.85 (0.75–0.96), p = 0.008]. Based on IDI, NRI, and delta AUC, inclusion of these parameters improved the models’ predictive accuracy. Conclusions Preoperative PAPi and RAP strongly predict the development of AKI early after HTx and can be used as early AKI predictors.
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Preoperative right Heart Hemodynamics predict postoperative acute kidney injury after Heart transplantation.
Intensive care medicine, 2018Co-Authors: Goksel Guven, Milos Brankovic, Alina A. Constantinescu, Jasper J. Brugts, Dennis A. Hesselink, Sakir Akin, Ard Struijs, Ozcan Birim, Can Ince, Olivier C. ManintveldAbstract:Acute kidney injury (AKI) frequently occurs after Heart transplantation (HTx), but its relation to preoperative right Heart hemodynamic (RHH) parameters remains unknown. Therefore, we aimed to determine their predictive properties for postoperative AKI severity within 30 days after HTx. From 1984 to 2016, all consecutive HTx recipients (n = 595) in our tertiary referral center were included and analyzed for the occurrence of postoperative AKI staged by the kidney disease improving global outcome criteria. The effects of preoperative RHH parameters on postoperative AKI were calculated using logistic regression, and predictive accuracy was assessed using integrated discrimination improvement (IDI), net reclassification improvement (NRI), and area under the receiver operating characteristic curves (AUC). Postoperative AKI occurred in 430 (72%) patients including 278 (47%) stage 1, 66 (11%) stage 2, and 86 (14%) stage 3 cases. Renal replacement therapy (RRT) was administered in 41 (7%) patients. Patients with higher AKI stages had also higher baseline right atrial pressure (RAP; median 7, 7, 8, and in RRT 11 mmHg, p trend = 0.021), RAP-to-pulmonary capillary wedge pressure ratio (median 0.37, 0.36, 0.40, 0.47, p trend = 0.009), and lower pulmonary artery pulsatility index (PAPi) values (median 2.83, 3.17, 2.54, 2.31, p trend = 0.012). Higher RAP and lower PAPi values independently predicted AKI severity [adjusted odds ratio (OR) per doubling of RAP 1.16 (1.02–1.32), p = 0.029; of PAPi 0.85 (0.75–0.96), p = 0.008]. Based on IDI, NRI, and delta AUC, inclusion of these parameters improved the models’ predictive accuracy. Preoperative PAPi and RAP strongly predict the development of AKI early after HTx and can be used as early AKI predictors.
