Characteristic changes to pulsatile and steady‐state load according to pulmonary hypertension classification

Author:

Hungerford Sara123ORCID,Kearney Katherine124,Song Ning124,Kotlyar Eugene1,Bart Nicole K.124,Lau Edmund5,Jabbour Andrew124,Hayward Christopher Simon124,Muller David William Marshall124,Adji Audrey1246ORCID

Affiliation:

1. Faculty of Health and Medicine The University of New South Wales Sydney New South Wales Australia

2. Department of Cardiology St Vincent's Hospital Darlinghurst New South Wales Australia

3. Department of Cardiology Royal North Shore Hospital Sydney New South Wales Australia

4. Victor Chang Cardiac Research Institute Sydney New South Wales Australia

5. Department of Respiratory Medicine Royal Prince Alfred Hospital Camperdown New South Wales Australia

6. FMHHS Macquarie University Sydney New South Wales Australia

Abstract

AbstractIt is of increasing importance to understand and predict changes to the systemic and pulmonary circulations in pulmonary hypertension (PH). To do so, it is necessary to describe the circulation in complete quantitative terms. Characteristic impedance (Zc) expresses opposition of the circulation to pulsatile blood flow. Evaluation of systemic and pulmonary Zc relationships according to PH classification has not previously been described. Prospective study of 40 clinically indicated patients referred for CMR and RHC (56 ± 18 years; 70% females, eight mPAP ≤ 25 mmHg, 16 pre‐capillary [Pre‐cPH], eight combined pre‐ and post‐capillary [Cpc‐PH] and eight isolated left‐heart disease [Ipc‐PH]). CMR provided assessment of ascending aortic (Ao) and pulmonary arterial (PA) flow, and RHC, central Ao and PA pressure. Systemic and pulmonary Zc were expressed as the relationship of pressure to flow in the frequency domain. Baseline demographic characteristics were well‐matched across PH subclasses. In those with a mPAP ≤25mHg, systemic Zc and SVR were >2 times higher than pulmonary Zc and PVR. Only Pre‐cPH was associated with inverse pulsatile (systemic Zc 58 [45–69] vs pulmonary Zc 70 [58–85]), but not steady‐state (SVR 1101 [986–1752] vs. PVR 483 [409–557]) relationships. Patients with CpcPH and IpcPH had concordant pulsatile and steady‐state relationships (Graphical Abstract). Measurement of, and the relationship between, systemic and pulmonary Zc in patients according to PH sub‐classification has not previously been described. Systemic Zc was routinely higher than pulmonary Zc, except in patients with newly diagnosed Pre‐cPH, where inverse pulsatile but not steady‐state relationships were observed.

Publisher

Wiley

Subject

Physiology (medical),Physiology

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3