Hydrogen Gas Inhalation (4%) could Reduce Lung Inflammation and Blood Pressure in Rats with Monocrotaline-Induced Pulmonary Hypertension | Chapter 9 | Medicine and Medical Research: New Perspectives Vol. 2

 

The aim of this study was to investigate the effects of inhaling atmospheric air containing 4% hydrogen on the symptoms and progression of PH in male Wistar rats using the MCT-induced model. Interstitial lung diseases (IPD), associated with inflammatory processes and the appearance of fibrosis, lead to impaired ventilation-perfusion ratio and hypoxia. Recently, strategies and drug approaches for the treatment of IPD-associated pulmonary hypertension have been widely discussed. Hydrogen has been shown to exhibit selective antioxidant properties against hydroxyl radicals and exert antioxidant and anti-inflammatory effects. Because monocrotaline causes oxidative stress, the monocrotaline-induced model of pulmonary hypertension is appropriate for researching compounds having antioxidant properties. On day 1, male Wistar rats were subcutaneously injected with either a water-alcohol solution of monocrotaline or control solution consisting solely of water and alcohol. One group of monocrotaline-injected animals was placed in a plastic box continuously ventilated with atmospheric air containing 4% molecular hydrogen, while the two other groups (one injected with monocrotaline and the other with vehicle) were placed in boxes ventilated with atmospheric air. After 21 days, hemodynamic parameters were measured under urethane narcosis. The results showed that, although hydrogen inhalation had no effect on the main markers of pulmonary hypertension induced by monocrotaline injection, there was a reduction in systemic blood pressure due to its systolic component, and a decrease in TGF- β expression, as well as a reduction in tryptase-containing mast cells. The results in combination with previous published results indicate that molecular hydrogen may be a useful therapeutic agent to combat pulmonary hypertension. Further research with larger sample sizes and exploring different routes of administration, concentrations and durations is needed to determine the optimal therapeutic approach. Overall, these findings suggest that molecular hydrogen may hold promise as a therapeutic agent in the treatment of pulmonary hypertension, in patients but further investigation is warranted.

 

Author(s) Details

Tatyana Kuropatkina
Faculty of Medicine, Lomonosov Moscow State University, Lomonosovsky Prospect 27-1, 119991 Moscow, Russia.

 

Dmitrii Atiakshin
Research Institute of Experimental Biology and Medicine, N.N. Burdenko Voronezh State Medical University, Moskovsky Prispect, 185, 394066, Voronezh, Russia and RUDN University, Miklukho-Maklaya St 6, 117198, Moscow, Russia.

 

 

Fedor Sychev
Faculty of Biology, Lomonosov Moscow State University, Leninskie Gory 1-12, 119234 Moscow, Russia.

 

Marina Artemieva
Faculty of Medicine, Lomonosov Moscow State University, Lomonosovsky Prospect 27-1, 119991 Moscow, Russia and Faculty of Biology, Lomonosov Moscow State University, Leninskie Gory 1-12, 119234 Moscow, Russia.

 

Tatyana Samoilenko
Research Institute of Experimental Biology and Medicine, N.N. Burdenko Voronezh State Medical University, Moskovsky Prispect, 185, 394066, Voronezh, Russia.

 

Olga Gerasimova
Research Institute of Experimental Biology and Medicine, N.N. Burdenko Voronezh State Medical University, Moskovsky Prispect, 185, 394066, Voronezh, Russia.

 

Viktoria Shishkina
Research Institute of Experimental Biology and Medicine, N.N. Burdenko Voronezh State Medical University, Moskovsky Prispect, 185, 394066, Voronezh, Russia.

 

Khaydar Gufranov
Faculty of Medicine, Lomonosov Moscow State University, Lomonosovsky Prospect 27-1, 119991 Moscow, Russia.

 

Natalia Medvedeva
Faculty of Biology, Lomonosov Moscow State University, Leninskie Gory 1-12, 119234 Moscow, Russia.

 

Tyler W. Le Baron
Department of Kinesiology and Outdoor Recreation, Southern Utah University, Cedar City, 84720, Utah, USA and Molecular Hydrogen Institute, Cedar City, Utah, 84720, USA.

 

Oleg Medvedev
Faculty of Medicine, Lomonosov Moscow State University, Lomonosovsky Prospect 27-1, 119991 Moscow, Russia and Laboratory of Experimental Pharmacology, National Medical Research Center of Cardiology, Ulitsa Akademika Chazova 15a, 121552 Moscow, Russia.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v2/1180

Noninvasive Assessment and Correlation of Cardiovascular Changes among COPD Patients with Its Prognosis | Chapter 7 | Disease and Health Research: New Insights Vol. 5

Background: Chronic obstructive pulmonary disease (COPD) often co-exists with other co-morbidities or diseases that have an enormous impact on its prognosis. A complex systemic disease with both pulmonary and extrapulmonary manifestations that are causally related or have shared risk factors. Cardiovascular changes on ECG and Echocardiography are one of the common comorbidities of COPD accounting for a 25% rise in major adverse cardiac events (like AMI, and stroke) and mortality. Hence acute cardiac abnormalities across all severity of COPD patients clearly contribute to the overall mortality and morbidity, so an understanding of their role noninvasively through this study holds potential for early intervention.

 

Objectives: This study aimed at noninvasive assessment and correlation of cardiovascular manifestation in COPD patients with its outcome.

 

Materials and Methods: A cross-sectional study was done in the Department of Respiratory Medicine of a rural tertiary care center on patients during the period from January 2015 to June 2016 visiting our OPD or IPD. A total of 350 study subjects were screened and those fulfilling the inclusion and exclusion criteria that were 200 consenting to participate were included in the study. COPD was diagnosed based on clinical history, clinical examination, X-ray chest, and spirometry. All patients were further subjected to electrocardiogram (ECG) and two- dimensional echocardiography (2D-ECHO) for cardiac evaluation. Data collection was done and analyzed.

 

Results: On ECG evaluation: arrhythmia was found in 99 (49.5%) cases, right ventricular hypertrophy (RVH) in 61(30.5%) cases, and right atrial enlargement (RAE) in 52(26%) cases. Right bundle branch blocking in 20(10%) cases poor progression of R wave in 24(12%) cases and right axis deviation was found in 30 (15%) cases.

 

On 2DECHO evaluation: Tricuspid regurgitation was found in 117(58.5%) cases, pulmonary hypertension in 116 (58%) cases, RAE in 79(39.5%) cases, RVH in74 (37%) cases, RV enlargement in 55(27.5%) cases, and left ventricular diastolic dysfunction in 113(56.05%) cases.

 

Conclusion: Cardiovascular comorbidities are highly prevalent in moderate to very severe COPD patients who need early diagnosis and treatment. Hence ECG and ECHO are simple non-invasive bedside tools for cardiac evaluation of COPD patients during acute exacerbation as well as during the follow-up of the disease.

 

 

Author (s) Details

Prashant Yadav
Department of Respiratory Medicine, U.P. University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India.

 

Somnath Bhattacharya
Department of Respiratory Medicine, U.P. University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India.

 

Adesh Kumar
Department of Respiratory Medicine, U.P. University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India.

 

Ashish Kumar Gupta
Department of Respiratory Medicine, U.P. University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India.

 

Aditya Kumar Gautam
Department of Respiratory Medicine, U.P. University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India.

 

Bal Krishna Kushwah
Department of Respiratory Medicine, U.P. University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrni/v5/2074

A Comprehensive Review of Anesthesia and Pulmonary Hypertension: Insights into Preoperative Preparation, Monitoring and Treatment | Chapter 11 | Medicine and Medical Research: New Perspectives Vol. 11

Pulmonary hypertension (PH) is a complex disease of the cardiopulmonary system. The most common causes of postoperative mortality in PH patients are acute RVF, arrhythmias (particularly atrial fibrillation [AF]), ischemia, congestive heart failure (CHF), unstable hemodynamic status, hypoxia, respiratory and renal failure, sepsis, and stroke. Perioperative management of PH is one of the most challenging issues for anesthetists. Morbidity and mortality are significantly high in PH patients undergoing surgery due to right heart failure, arrhythmia, atrial fibrillation, ischemia, hemodynamic instability, hypoxia, respiratory failure, renal failure, sepsis, and stroke. Detailed preoperative evaluation and correct anesthetic management will significantly increase the chances of a successful peri-operative outcome in these patients. In PH patients, it is important that more than one physician, including anesthesiologist, intensivist, pulmonologist, cardiologist, and surgeon, discuss the patient’s possible difficulties and complications with a multidisciplinary approach and make a decision. In order to optimize the management of PH patients, it is necessary to comprehensively evaluate the underlying cause, pathophysiology, risk factors, course, and treatment of the disease. Currently, no evidence-based information is available for choosing general, regional, or combined anesthesia as anesthetic techniques for PH patients. A balanced anesthesia technique, including inhalation or intravenous agents, appropriate regional anesthesia (RA), opioids, and α-2-adrenoceptor agonists may provide the most uniform hemodynamic profile in these patients. The basis of anesthesia management should be to prevent and treat triggering factors, provide perfusion pressures, and optimize right ventricular functions. Advanced monitoring, pulmonary vasodilator therapies, adequate anesthesia and analgesia, and appropriate ventilator settings should be performed for patients with PH. Patients with PH should be followed in the intensive care unit in the first 48–72 h postoperatively. In PH patients, advanced intraoperative and postoperative follow-up, pulmonary vasodilator treatments, adequate anesthesia, and analgesia should be considered. It is essential to optimize the patient for surgery in a nonemergency situation and to organize treatment and education of the patient for the long-term period of the disease. This book chapter aims to focus on appropriate preoperative preparation, perioperative monitoring, anesthesia and ventilator management, pain control, preventive methods, and treatment in patients with PH in light of the literature.

 

Author (s) Details

Nedim Çekmen
Department of Anesthesiology, Faculty of Medicine, Baskent University, Intensive Care Unit Fevzi Cakmak Caddesi 10, Sokak No: 45 Bahcelievler, 06490 Ankara, Turkey.

 

Begüm Nemika Gökdemir
Department of Anesthesiology, Faculty of Medicine, Baskent University, Intensive Care Unit Fevzi Cakmak Caddesi 10, Sokak No: 45 Bahcelievler, 06490 Ankara, Turkey.

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v11/3154

Unveiling an Unanticipated Cause of Pulmonary Hypertension: Partial Anomalous Pulmonary Venous Connection in a Hypersensitivity Pneumonitis Patient | Chapter 4 | Current Progress in Medicine and Medical Research Vol. 6

 This episode describes a case of non-fibrotic Hypersensitivity Pneumonitis (HP), doubtful to have hypoxia-related Class III pulmonary hypertension, that on further evaluation, was establish to have PAPVC-causing PAH. Any pulmonary tone, but not all of them, can drain into the right entrance or one of allure venous tributaries straightforwardly, leading to a condition famous as partial unnatural pulmonary venous connection (PAPVC). Rarely can PAPVC be the only determinant contributing to pulmonary arterial hypertension. However, the incident and clinical meaning of PAPVC as a cause of pulmonary artery hypertension in sufferers with sensitivity pneumonitis has never been recorded. A 41-year-traditional male farmer bestowed with exertional dyspnoea - Modified Medical Research Council (mMRC) functional class II, and dry cough for 3 age, exacerbated over six months (mMRC class IV).   Chest High-Resolution Computed Tomography (HRCT) was vulgar of non-fibrotic hypersensitivity pneumonitis. In our patient, established his pertaining to work history, dispassionate presentation, HRCT judgments, and BAL reports, a diagnosis of non-fibrotic HP was fashioned. Hence the patient was started on integral steroids, with that the patient’s oxygen saturation revised. Still, as moderate PH was unexplained, he was judged further, leading to the acknowledgment of PAPVC-associated PAH. On 2D-ECHO, the right ventricle systolic pressure was 48+RAP. Right courage catheterisation showed mean pulmonary channel pressure of 73 mmHG, PVR 8.7.The left superior pulmonary tone was found to leak into the abandoned brachiocephalic vein all along the subsequent study with CTPA.

Author(s) Details:

Shivam Garg,
Department of Pulmonary Medicine, JIPMER, Puducherry, India.

Pratap Upadhya,
Department of Pulmonary Medicine, JIPMER, Puducherry, India.

A. Jeevanandham,
Department of Pulmonary Medicine, JIPMER, Puducherry, India.

Harshith Rao,
Consultant, Pulmonary and Critical Care Medicine, Ramaiah Memorial Hospital, India.

Please see the link here: https://stm.bookpi.org/CPMMR-V6/article/view/11475

Determining the Role of Tissue Doppler, Strain and 3D Echocardiographic Parameters in Pulmonary Hypertension | Chapter 16 | New Horizons in Medicine and Medical Research Vol. 3

 Introduction: A variety of echocardiographic parameters are used to investigate right ventricular (RV) function, which has a prognostic impact on pulmonary hypertension (PH). Other cardiac imaging techniques, such as cardiac magnetic resonance imaging, are likewise more expensive for serial testing and less widely available than echocardiography (MRI).

Our goal was to see how well known prognostic markers correlated with standard and advanced echocardiographic parameters like Tissue Doppler Imaging (TDI), strain imaging, and three-dimensional (3D) echocardiography.

Methods: The following variables (among others) were examined in 51 patients with PH: Right Atrial Area/Volume and Global Longitudinal Strain (GLS), Tricuspid Annular Plane Systolic Excursion (TAPSE), RV Fractional Area Change, RV GLS, RV Tei Index, Pulmonary Artery Systolic Pressure (PASP), Pulmonary Acceleration Time (PAcT), Tricuspid s' RV end-systolic (ES), end-diastolic (ED) volumes (V), and ejection fraction (EF) were calculated in 42 patients (EF). Clinical and demographic information, as well as data on the six-minute walk test (6MWT) and brain natriuretic peptide (BNP), were gathered.

Results: There was a statistically significant (p 0.05) association between 6MWT and RV Tei Index (r = -0.336), PASP (r = -0.388), PAcT (r = 0.661), RVESV (r = -0.380), RVEF (r = 0.381), as well as BNP and TAPSE (r = -0.332),ytu5 Tricuspid s' (r = -0.29), PAcT (r

Conclusions: In this PH population, traditional echocardiographic parameters, which have several limitations, as well as advanced parameters obtained by 3D echocardiography, particularly RV GLS and EDV/EF, showed a significant correlation with well-studied prognostic markers, reinforcing the need for a more comprehensive study of RV function.

Author(S) Details

Marta Afonso Nogueira
Department of Cardiology, Currently at Cascais Hospital, Portugal.

Luísa Moura Branco
Department of Cardiology, Santa Marta’s Hospital, Portugal.

Ana Agapito
Department of Cardiology, Santa Marta’s Hospital, Portugal.

Ana Galrinho
Department of Cardiology, Santa Marta’s Hospital, Portugal.

Alexandra Borba
Department of Pulmonology, Santa Marta’s Hospital, Portugal.

Ruben Ramos
Department of Cardiology, Santa Marta’s Hospital, Portugal

Duarte Cacela
Department of Cardiology, Santa Marta’s Hospital, Portugal.

Rui Cruz Ferreira
Department of Cardiology, Santa Marta’s Hospital, Portugal.

View Book:- https://stm.bookpi.org/NHMMR-V3/article/view/6345

Determination of Clinical and Laboratory Predictors of Elevated TRV in Sickle Cell Anaemia | Chapter 4 | Recent Developments in Medicine and Medical Research Vol. 5

 Pulmonary hypertension (PH) has become a well-known consequence of sickle cell anaemia (SCA) and is a significant cause of morbidity and mortality. Despite the high prevalence of SCA in Sub-Saharan Africa, there is a scarcity of data on SCA-associated PH, and it receives little or no attention in regular patient care. In the early stages, pulmonary hypertension is usually asymptomatic, but it can cause dyspnea on exertion, hypoxemia, progressive worsening of pulmonary function tests (PFTs), and right heart failure if it is severe. The goal of this study was to assess the prevalence of PH in a group of adult SCA patients, as well as the risk variables that could lead to an early diagnosis of the condition. A total of 76 clinically stable, hydroxyurea-naive patients took part in this cross-sectional investigation. We gathered information on the patient's socioeconomic status and medical history. Transthoracic echocardiography was used to measure Tricuspid Regurgitant Jet Velocity (TRV), while spirometry and pulse oximetry were used to assess lung function. Complete blood counts, free plasma haemoglobin, serum urea, and creatinine were among the other tests performed. On Doppler echocardiography, twenty-five (32.9%) of study participants had elevated TRV (2.5m/s), which was indicative of elevated pulmonary artery systolic pressure. There were significant associations between elevated TRV and steady-state haemoglobin (p 0.001), blood urea level (p = 0.030), chronic leg ulcers (p = 0.043), and oxygen saturation (p 0.001), suggesting that these may be identifiable and modifiable risk factors for selective echocardiography screening in a resource-limited setting.

Author (S) Details

Jane S. Afriyie-Mensah

Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences University of Ghana, Accra, Ghana.

Yvonne A. Dei-Adomakoh

Department of Hematology, School of Biomedical and Allied Health Sciences, College of Health Sciences University of Ghana, Accra, Ghana.

Audrey Forson

Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences University of Ghana, Accra, Ghana.

Martin Adadey

Department of Medicine and Therapeutics, School of Medicine and Dentistry, College of Health Sciences University of Ghana, Accra, Ghana.

Thomas A. Ndanu

Department of Community and Preventive Dentistry, School of Medicine and Dentistry, College of Health Sciences University of Ghana, Accra, Ghana.

Joseph K. Acquaye

Department of Hematology, School of Biomedical and Allied Health Sciences, College of Health Sciences University of Ghana, Accra, Ghana

View Book :- https://stm.bookpi.org/RDMMR-V5/article/view/4189