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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors studied the bronchoscopic appearance of bronchial mucosa's vessel contour in pulmonary venous hypertension in 20 patients with mitral stenosis and in 20 with cardiomyopathy and/or aortic vitium. The submucous venous congestion was scored on the base of its extent and severity according to Ohmichi. They have observed a linear relation between the PPA (wedge) and PPA values in patients with mitral stenosis and the total scores indicatory of submucous venous congestion. The mean total scores of patients with mitral stenosis as well as cardiomyopathic patients showing volume-loading of the pulmonary circuit and/or aortic vitium differed to the benefit of the former. Mucosa's vessel contour of grade 3 was found in 12 patients with mitral stenosis and only in 4 cases of cardiomyopathy and/or aortic vitium, so that is more characteristic of mitral stenosis. In spite of this, condition of patients with cardiomyopathy and/or aortic vitium are considered more severe on the base of NYHA values. Taking both patient populations into consideration relation between NYHA-phase and the degree of total scores could not have been proved. Venous congestion on lower part of the left main bronchus was observed in every patient. Appearance of congestive bronchial mucosa has not occurred in pure precapillary pulmonary hypertension.
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PMID:[Bronchoscopic appearance of the bronchial mucosa in pulmonary venous hypertension]. 194 61

The direct and indirect actions of two active components of slow-reacting substance of anaphylaxis, leukotrienes C4 (LTC4) and D4 (LTD4), were studied in chronically instrumented unanesthetized sheep. Intravenous injection of 3 micrograms of LTD4 caused immediate marked pulmonary arterial hypertension which returned to baseline in 6.5 +/- 1.0 min. Dynamic compliance of the lungs (Cdyn) and left atrial (PLA) and aortic (Paorta) blood pressure fell concomitantly with the increases in pulmonary artery pressure (PPA). PLA and Paorta then increased above baseline and heart rate deceased significantly. LTD4 caused only small increases in lung lymph flow but did increase lung lymph concentrations of thromboxane B2. Lung lymph concentrations of 6-keto-prostaglandin F1 alpha did not increase following LTD4 infusion. The increase in PPA after 3-micrograms injections of LTD4 was greater than that caused by 10-micrograms injections of prostaglandin H2-analog. Injections of 10-30 micrograms of LTC4 caused only minor increases in PPA but did cause bradycardia and delayed increases in PLA and Paorta. The cyclooxygenase inhibitors meclofenamate and ibuprofen inhibited the increases in PPA caused by LTD4 but not the later bradycardia or increases in PLA and Paorta. The thromboxane synthetase inhibitor UK-38485 attenuated the early increase in PPA and moderated the later increases in PLA and Paorta and bradycardia caused by LTD4 injection. The response of unanesthetized sheep to LTD4 is mediated, at least in part, indirectly by stimulation of the cyclooxygenase pathway of arachidonate metabolism.
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PMID:Direct and indirect effects of leukotriene D4 on the lungs of unanesthetized sheep. 311 26

Intravenous administration of contrast material is a prerequisite for the imaging of the cardiovascular system with computed tomography and digital subtraction techniques. Fatal side effects after intravenous contrast injection, particularly in patients with pulmonary hypertension, have been reported repeatedly. The object of this study was to compare hemodynamic side effects of a conventional, ionic contrast medium (amidotrizoate; 2.1 osmol/kg) and a modern, non-ionic compound (iopamidol; 0.8 osmol/kg) after intravenous bolus injection (1.5 ml/kg). Experiments were carried out in 10 open-chest dogs with pulmonary normotension and hypertension induced by embolisation. Under control conditions (PPA = 19.9 mm Hg) both contrast media produced marked pulmonary and peripheral vasodilation. Major effects were seen after amidotrizoate (RPULM 60.3%, RPERI 32.1% vs 72.5% and 70.4% of controls). In pulmonary hypertension (PPA = 44.2 mmHg), iopamidol had similar hemodynamic effects compared to control conditions. In contrast, amidotrizoate initially led to a significant increase in pulmonary pressure and resistance (PPA = 118.6%; RPULM = 141.7%) followed by a delayed depression of right ventricular function (dP/dt = 65.3%; PRVED = 180.9%). Resuscitation was required in 3 dogs with pulmonary hypertension after amidotrizoate injection. Because of these unfavorable hemodynamic side effects of the conventional high osmolality contrast medium in animal experiments, it can be expected that modern compounds with low osmolality pruduce smaller side effects during diognostic interventions in patients with pulmonary hypertension.
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PMID:[Central venous injection of large amounts of contrast media--advantages of a low osmolar contrast medium in experimentally-induced pulmonary hypertension]. 648 70

The relationship between mean pulmonary artery pressure (PPA) and the regional distribution of perfusion, investigated with 133Xe, was studied in 67 patients with chronic respiratory diseases, including 57 patients with chronic obstructive pulmonary disease. The vertical gradient of perfusion, assessed by the ratio upper/lower perfusion (RQ), was considered as normal when RQ was less than or equal to 0.85. Patients were divided into three groups: no pulmonary hypertension, mild hypertension, moderate to severe hypertension. RQ was normal in the majority of patients, even in the group with PPA greater than 30 mm Hg. The average values of RQ did not significantly differ from one group to another. There was no correlation between PPA or pulmonary vascular resistance and RQ. These results suggest that the vertical gradient of perfusion is generally conserved and that the distribution of perfusion cannot provide any reliable prediction of pulmonary hypertension in chronic obstructive pulmonary disease.
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PMID:Relationship between pulmonary artery mean pressure and the vertical gradient of perfusion in chronic respiratory diseases. 652 40

The diagnostic value of thallium 201 (201Tl) myocardial imaging was studied in 57 patients with chronic respiratory diseases, most with COPD (n = 46), by comparing the results to hemodynamic findings. In healthy subjects, the right ventricle (RV) is not visualized; therefore, any recorded activity of the RV was considered as indicating RV hypertrophy due to RV pressure overloading (RVPO). RV activity was graded from 0 (no activity) to 3 (activity greater than or equal to that of the left ventricle). Patients were divided into three groups according to the level of the pulmonary artery mean pressure (PPA): PPA less than or equal to 20 mm Hg (no pulmonary arterial hypertension [PAH] ) = group 1, n = 20; PPA ranging from 21 to 30 mm Hg (mild to moderate PAH) = group 2, n = 20; PPA greater than 30 mm Hg (marked PAH) = group 3, n = 17. RV was visualized in 14 patients in group 3 (82 percent) and in 13 patients in group 2 (65 percent). For all patients with PAH (2 + 3) the sensitivity of 201Tl imaging for the diagnosis of RVPO was of 73 percent, higher than that of ECG and echocardiography (both 51 percent). The sensitivity of 201Tl, even if moderate (65 percent) was better than that of ECG (30 percent) or echo (40 percent) in patients with mild-to-moderate PAH (group 2). A high RV activity (grade 3) was observed in only three patients. The specificity of this method (obtained from results in group 1) was of 80 percent vs 89 percent for echo and 100 percent for ECG. These results suggest that 201Tl myocardial imaging is a rather sensitive method and could be of interest for the noninvasive diagnosis of RVPO in COPD patients.
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PMID:Detection of right ventricular pressure overloading by thallium-201 myocardial scintigraphy. Results in 57 patients with chronic respiratory diseases. 669 96

65 patients with interstitial lung diseases were subdivided into two groups: idiopathic pulmonary fibrosis (IPF) and other interstitial pulmonary diseases (OIP) according to histopathological, immunological and follow-up findings. Arterial blood gases and pulmonary hemodynamics at rest and during steady-state exercise were compared in these two groups (IPF = 31 patients, OIP = 34 patients). The resting PaO2 was significantly lower in the IPF group (p less than 0.001) and regularly worsened during exercise in this group (from 69.6 +/- 11.6 to 56.0 +/- 9.4 mm Hg, p less than 0.001) whereas it did not vary significantly in the OIP group (from 79.2 +/- 13.1 to 75.3 +/- 14.1 mm Hg, NS). Pulmonary artery mean pressure (PPA) was higher in the IPF group (p less than 0.001) as were all indices of pulmonary vascular resistance (PVR). During exercise, PPA markedly increased in the IPF group (from 21.7 +/- 7.8 to 45.3 +/- 16.2 mm Hg) but modestly in the OIP group (from 15.5 +/- 3.7 to 28.3 +/- 9.8 mm Hg). The best relationships were found between PPA, PVR and PaO2, which suggests that pulmonary arterial hypertension in these diseases is not only due to anatomical factors but also to alveolar and arterial hypoxia. Arterial blood gases and pulmonary hemodynamics at rest and during exercise may be of interest for the discrimination of 'true' interstitial fibrosis (IPF) from other interstitial lung diseases (OIP).
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PMID:Pulmonary hemodynamics in idiopathic pulmonary fibrosis and other interstitial pulmonary diseases. 683 87

Studies performed since 1968 have shown that in patients with chronic obstructive pulmonary disease (COPD) the prognosis is worse in cases with pulmonary artery hypertension (PAH), especially when the mean pulmonary artery pressure (PPA) is greater than 30 mmHg. Author's data are based on the study of a group of 175 patients with COPD, catheterized between 1968 and 1972. The fate of the patients, at least five years after the initial catheterization, was known in all the cases. The survival rate was calculated according to the "actuarial method". The results suggest that PPA has a good prognostic value, but that FEV1 and PaCO2 are as good predictors of mortality as PPA. Furthermore the influence of age is to be taken into account: prognosis is worse in patients older than 65 years. Longitudinal studies of pulmonary haemodynamics was made in 85 patients who underwent two right heart catheterizations with an interval of greater than 3 years (mean = 5 years) between them. The results indicate that PPA varies very slightly: the average increase for the whole group is 3.1 mmHg, that is less than 1 mmHg per year. There was a good negative correlation between chronological variations of PaO2 and PPA. A long survival time could be observed after the first heart failure episode or after ascertaining pulmonary hypertension.
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PMID:Prognosis of pulmonary hypertension in chronic obstructive pulmonary disease. 747 56

The purpose of investigation was the assessment of the effect of captopril on both systemic (Pa) and pulmonary arterial pressures (PPA) in patients with high-altitude pulmonary hypertension (HAPH). Seventeen patients (mean age 44 +/- 6.8 years) with HAPH and mild-to-moderate systemic arterial hypertension were included in the study. All the patients underwent right heart catheterization with measurements of systolic PPA (PPA,syst), mean PPA (PPA) and diastolic PPA (PPA,diast). After a 4 week placebo phase, patients with PPA,syst > 25 mm Hg, PPA > 15 mm Hg and systemic diastolic blood pressure (Pa,diast) > 100 mm Hg received captopril (50-75 mg at 08.00) for a period of 12 weeks. The statistical evaluation of the results were made using the Student's t-test. It was found that captopril significantly decreases PPA and Pa.
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PMID:High-altitude pulmonary hypertension: effects of captopril on pulmonary and systemic arterial pressures. 887 46

We studied pulmonary haemodynamics in 19 male patients, mean age 45 +/- 5 years, suffering from severe OSA, mean apnea/hypopnea index (AHI) 68 +/- 17. Pulmonary haemodynamisc were studied using Swan-Ganz thermodilution catheter in the supine position at rest, and at the end of the 7th minute of steady-state exercise (40 W). Investigations were repeated after one year of treatment with nasal CPAP. At rest mean pulmonary artery pressure (PPA), pulmonary wedge pressure (PW) and cardiac output (CO) were normal, PPA = 16.6 +/- 5.7 mmHg, PW = 5.2 +/- 1.8 l/min. Pulmonary vascular resistance (PVR) was slightly elevated = 155 +/- 65 d.sec.cm-5. On exercise only PVR remained unchanged. After a year of treatment PPA changed to 15.8 +/- 4.0 mmHg (NS), Pw-7.5 +/- 3.1 mmHg (NS), CO-4.9 +/- 1.6 L/min (NS), PVR - 145 +/- 35 d.sec.cm-5 (NS). In two patients with resting hypertension PPA dropped from 33 mmHg to 25 mmHg and 28 mmHg to 18 mmHg respectively. Statistical analysis showed no significant change in any of the studied variables after one year of the CPAP therapy.
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PMID:[Pulmonary circulation at rest and during exercise in patients with obstructive sleep apnea before and after one year of treatment with CPAP]. 899 59

This study is the first approach to evaluate whether human atrial natriuretic peptide (hANP) is involved in the pathophysiology in transient puerperal hypertension (TPH). Five women who were normotensive throughout pregnancy, labor, and delivery developed hypertension between the first and sixth postpartum day. hANP (pg/ml) and plasma renin activity (PRA, ng/ml/h), angiotensin I, II (AI, II, pg/ml), and aldosterone (Aldo, pg/ml) in plasma were quantified by radioimmunoassay. Ten women without hypertension were also studied on hANP, PRA, AI, AII, and Aldo sequentially as the control group. hANP was apparently lower in women with TPH than in normotensive women. The levels of PRA, AI, AII, and Aldo were also clearly decreased in women with TPH, whereas those values in normotensive women were not altered from nonpregnant levels. Maternal natriuresis usually reaches the peak at 3-5 days postpartum. The decrease of hANP and PPA, AI, AII, and Aldo in TPH coincides with this natriuretic period. This observation suggests that hANP may serve an important role in the pathogenesis of TPH.
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PMID:Atrial natriuretic peptide in transient puerperal hypertension. 943 15


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