A5017257299- Pulmonary Hypertension Research and Treatments
- Cardiovascular Function and Risk Factors
- Systemic Sclerosis and Related Diseases
- Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
- Vascular Anomalies and Treatments
- Cardiovascular Issues in Pregnancy
- Congenital Heart Disease Studies
- Respiratory Support and Mechanisms
- Liver Disease and Transplantation
- Medical Imaging and Pathology Studies
- Heart Failure Treatment and Management
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Gout, Hyperuricemia, Uric Acid
- Nitric Oxide and Endothelin Effects
- Cardiovascular Effects of Exercise
- Cardiovascular Disease and Adiposity
- Cardiac Valve Diseases and Treatments
- Macrophage Migration Inhibitory Factor
- Eicosanoids and Hypertension Pharmacology
- Renin-Angiotensin System Studies
- Cardiac Imaging and Diagnostics
- Neonatal Respiratory Health Research
- Protease and Inhibitor Mechanisms
- Connective Tissue Growth Factor Research
- Heme Oxygenase-1 and Carbon Monoxide
Johns Hopkins University
2016-2025
Johns Hopkins Medicine
2016-2025
Pulmonary and Critical Care Associates
2012-2025
Johns Hopkins Hospital
2010-2025
Johns Hopkins Bayview Medical Center
2010-2023
Cleveland Clinic
2023
University of Baltimore
2006-2022
American Thoracic Society
2018
Legacy Health
2018
Northwestern University
2018
Right ventricular (RV) function is an important determinant of prognosis in pulmonary hypertension. However, noninvasive assessment the RV often limited by complex geometry and poor endocardial definition.To test whether degree tricuspid annular displacement (tricuspid plane systolic excursion [TAPSE]) a useful echo-derived measure with prognostic significance hypertension.We prospectively studied 63 consecutive patients hypertension who were referred for clinically indicated right heart...
Transthoracic Doppler echocardiography is recommended for screening the presence of pulmonary hypertension (PH). However, some recent studies have suggested that echocardiographic artery pressure estimates may frequently be inaccurate.
By its inhibitory effect on platelet-derived growth factor signaling, imatinib could be efficacious in treating patients with pulmonary arterial hypertension (PAH).Imatinib Pulmonary Arterial Hypertension, a Randomized, Efficacy Study (IMPRES), randomized, double-blind, placebo-controlled 24-week trial, evaluated vascular resistance ≥ 800 dyne·s·cm(-5) symptomatic 2 PAH therapies. The primary outcome was change 6-minute walk distance. Secondary outcomes included changes hemodynamics,...
Our prior in vitro studies indicate that sphingosine 1-phosphate (S1P), a phospholipid angiogenic factor, produces endothelial cell barrier enhancement through ligation of differentiation gene family receptors. We hypothesized S1P may reduce the vascular leak associated with acute lung injury and found infusion produced rapid significant reduction weight gain (more than 50%) isolated perfused murine lung. The effect was next assessed model LPS-mediated microvascular permeability inflammation...
Background— Right ventricular failure from increased pulmonary vascular loading is a major cause of morbidity and mortality, yet its modulation by disease remains poorly understood. We tested the hypotheses that, unlike systemic circulation, resistance (R PA ) compliance (C are consistently inversely related regardless age, hypertension, or interstitial fibrosis that this relation may be changed elevated capillary wedge pressure, augmenting right pulsatile load. Methods Results— Several...
Abstract Objective Pulmonary arterial hypertension related to scleroderma (PAH‐Scl) is associated with high morbidity and mortality as well poorer response therapy worse outcomes compared the idiopathic form of PAH (IPAH). Scleroderma an autoimmune disease that can affect left right heart function directly through inflammation fibrosis indirectly systemic pulmonary hypertension. This study tested hypothesis increased prevalence might explain higher in patients PAH‐Scl IPAH. Methods The was...
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Background— Systemic sclerosis–associated pulmonary artery hypertension (SScPAH) has a worse prognosis compared with idiopathic arterial (IPAH), median survival of 3 years after diagnosis often caused by right ventricular (RV) failure. We tested whether SScPAH or systemic sclerosis–related interstitial lung disease imposes greater vascular load than IPAH and leads to RV contractile function. Methods Results— analyzed pressures mean flow in 282 patients (166 SScPAH, 49 disease, 67 IPAH). An...
Right ventricular (RV) functional reserve affects capacity and prognosis in patients with pulmonary arterial hypertension (PAH). PAH associated systemic sclerosis (SSc-PAH) has a substantially worse than idiopathic (IPAH), even though many measures of resting RV function vascular load are similar. We therefore tested the hypothesis that is depressed SSc-PAH patients.RV pressure-volume relations were prospectively measured IPAH (n=9) (n=15) at rest during incremental atrial pacing or supine...
Rationale: Systemic sclerosis (SSc)-pulmonary arterial hypertension (PAH) is one of the most prevalent and deadly forms PAH. B cells may contribute to SSc pathogenesis. Objectives: We investigated safety efficacy B-cell depletion for SSc-PAH. Methods: In an NIH-sponsored, multicenter, double-blinded, randomized, placebo-controlled, proof-of-concept trial, 57 patients with SSc-PAH on stable-dose standard medical therapy received two infusions 1,000 mg rituximab or placebo administered 2 weeks...
Pulmonary hypertension (PH) is an important cause of mortality in systemic sclerosis (SSc), where it can be isolated (pulmonary arterial [PAH]) or associated with interstitial lung disease (ILD). This study was undertaken to characterize determinants survival among SSc patients either type PH who received PAH-specific therapy.Consecutive PAH ILD-associated confirmed by right heart catheterization were included the study. Kaplan-Meier and Cox proportional hazards models used compare between...
Rationale: Pulmonary arterial hypertension (PAH) related to systemic sclerosis (SSc) has a poorer prognosis compared with other forms of PAH for reasons that remain unexplained.Objectives: To identify risk factors mortality in well-characterized cohort patients (SSc-PAH).Methods: Seventy-six consecutive SSc (64 women and 12 men; mean age 61 ± 11 yr) were diagnosed by heart catheterization single center, starting January 2000, followed over time. Kaplan-Meier estimates calculated...
Excessive mechanical stress is a key component of ventilator-associated lung injury, resulting in profound vascular leak and an intense inflammatory response. To extend our vitro observations concerning the barrier-protective effects lipid growth factor sphingosine 1-phosphate (Sph 1-P), we assessed ability Sph 1-P to prevent regional pulmonary edema accumulation clinically relevant rodent canine models acute injury induced by combined intrabronchial endotoxin administration high tidal...
In patients with emphysema being evaluated for lung volume reduction surgery, Doppler echocardiography has been used to screen pulmonary hypertension as an indicator of increased peri-operative risk. To determine the accuracy this test, present authors compared results right heart catheterisations and echocardiograms in 163 participating cardiovascular substudy National Emphysema Treatment Trial. Substudy had both catheterisation performed before after randomisation. 74 paired carried out on...
Oxygen (O2) may regulate pulmonary vascular resistance through changes in endothelial nitric oxide (NO) production. To determine whether constitutive NO synthase (cNOS) is regulated by O2, we assessed cNOS expression and activity bovine artery cells exposed to different concentrations of O2. In a time-dependent manner, O2 concentration from 95 3% produced progressive decrease mRNA protein levels resulting 4.8- 4.3-fold reductions after 24h, respectively. This correlated with as determined...