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http://hdl.handle.net/1942/37805
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DC Field | Value | Language |
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dc.contributor.author | Omote, Kazunori | - |
dc.contributor.author | Sorimachi, Hidemi | - |
dc.contributor.author | Obokata, Masaru | - |
dc.contributor.author | Reddy, Yogesh N., V | - |
dc.contributor.author | VERBRUGGE, Frederik | - |
dc.contributor.author | Omar, Massar | - |
dc.contributor.author | DuBrock, Hilary M. | - |
dc.contributor.author | Redfield, Margaret M. | - |
dc.contributor.author | Borlaug, Barry A. | - |
dc.date.accessioned | 2022-07-25T10:11:11Z | - |
dc.date.available | 2022-07-25T10:11:11Z | - |
dc.date.issued | 2022 | - |
dc.date.submitted | 2022-07-19T10:36:14Z | - |
dc.identifier.citation | European heart journal, 43 (36) , p. 3417-3431 | - |
dc.identifier.uri | http://hdl.handle.net/1942/37805 | - |
dc.description.abstract | Aims Pulmonary hypertension (PH) and pulmonary vascular disease (PVD) are common and associated with adverse outcomes in left heart disease (LHD). This study sought to characterize the pathophysiology of PVD across the spectrum of PH in LHD. Methods and results Patients with PH-LHD [mean pulmonary artery (PA) pressure >20 mmHg and PA wedge pressure (PAWP) >= 15 mmHg] and controls free of PH or LHD underwent invasive haemodynamic exercise testing with simultaneous echocardiography, expired air and blood gas analysis, and lung ultrasound in a prospective study. Patients with PH-LHD were divided into isolated post-capillary PH (IpcPH) and PVD [combined post- and pre-capillary PH (CpcPH)] based upon pulmonary vascular resistance (PVR <3.0 or >= 3.0 WU). As compared with controls (n = 69) and IpcPH-LHD (n = 55), participants with CpcPH-LHD (n = 40) displayed poorer left atrial function and more severe right ventricular (RV) dysfunction at rest. With exercise, patients with CpcPH-LHD displayed similar PAWP to IpcPH-LHD, but more severe RV-PA uncoupling, greater ventricular interaction, and more severe impairments in cardiac output, O-2 delivery, and peak O-2 consumption. Despite higher PVR, participants with CpcPH developed more severe lung congestion compared with both IpcPH-LHD and controls, which was associated lower arterial O-2 tension, reduced alveolar ventilation, decreased pulmonary O-2 diffusion, and greater ventilation-perfusion mismatch. Conclusions Pulmonary vascular disease in LHD is associated with a distinct pathophysiologic signature marked by greater exercise-induced lung congestion, arterial hypoxaemia, RV-PA uncoupling, ventricular interdependence, and impairment in O-2 delivery, impairing aerobic capacity. Further study is required to identify novel treatments targeting the pulmonary vasculature in PH-LHD. | - |
dc.description.sponsorship | B.A.B. is supported by R01 HL128526 and U01 HL160226, both from the United States National Institutes of Health. H.S. is supported by a research fellowship from the Uehara Memorial Foundation, Japan. K.O. is supported by Japan Heart Foundation/Bayer Yakuhin Research Grant Abroad and the JSPS Overseas Research Fellowships from the Japan Society for the Promotion of Science. F.H.V. is supported by a Fellowship of the Belgian American Educational Foundation (B.A.E.F.) and by the Special Research Fund (BOF) of Hasselt University (BOF19PD04). The authors thank the staff of the Mayo Clinic Earl Wood Catheterization Laboratory and the patients who agreed to participate in the research, allowing for this study to be completed. | - |
dc.language.iso | en | - |
dc.publisher | OXFORD UNIV PRESS | - |
dc.rights | The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com Free access | - |
dc.subject.other | Heart failure | - |
dc.subject.other | Left heart disease | - |
dc.subject.other | Pulmonary hypertension | - |
dc.subject.other | Combined post- and pre-capillary pulmonary hypertension | - |
dc.subject.other | Pulmonary vascular resistance | - |
dc.subject.other | Exercise haemodynamics | - |
dc.title | Pulmonary vascular disease in pulmonary hypertension due to left heart disease: pathophysiologic implications | - |
dc.type | Journal Contribution | - |
dc.identifier.epage | 3431 | - |
dc.identifier.issue | 36 | - |
dc.identifier.spage | 3417 | - |
dc.identifier.volume | 43 | - |
local.bibliographicCitation.jcat | A1 | - |
dc.description.notes | Borlaug, BA (corresponding author), Mayo Clin & Mayo Fdn, Dept Cardiovasc Med, 200 First St SW, Rochester, MN 55905 USA. | - |
dc.description.notes | borlaug.barry@mayo.edu | - |
local.publisher.place | GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND | - |
local.type.refereed | Refereed | - |
local.type.specified | Article | - |
dc.identifier.doi | 10.1093/eurheartj/ehac184 | - |
dc.identifier.pmid | 35796488 | - |
dc.identifier.isi | 000821569600001 | - |
dc.contributor.orcid | Verbrugge, Frederik Hendrik/0000-0003-0599-9290; Borlaug, | - |
dc.contributor.orcid | Barry/0000-0001-9375-0596; Omote, Kazunori/0000-0002-8132-7173; Obokata, | - |
dc.contributor.orcid | Masaru/0000-0002-5473-0688 | - |
local.provider.type | wosris | - |
local.description.affiliation | [Omote, Kazunori; Sorimachi, Hidemi; Obokata, Masaru; Reddy, Yogesh N., V; Verbrugge, Frederik H.; Omar, Massar; Redfield, Margaret M.; Borlaug, Barry A.] Mayo Clin & Mayo Fdn, Dept Cardiovasc Med, 200 First St SW, Rochester, MN 55905 USA. | - |
local.description.affiliation | [Verbrugge, Frederik H.] Univ Hosp Brussels, Ctr Cardiovasc Dis, Jette, Belgium. | - |
local.description.affiliation | [Verbrugge, Frederik H.] Hasselt Univ, Fac Med & Life Sci, Biomed Res Inst, Hasselt, Belgium. | - |
local.description.affiliation | [DuBrock, Hilary M.] Mayo Clin, Div Pulm & Crit Care Med, Rochester, MN USA. | - |
local.uhasselt.international | yes | - |
item.validation | ecoom 2023 | - |
item.fulltext | With Fulltext | - |
item.accessRights | Open Access | - |
item.fullcitation | Omote, Kazunori; Sorimachi, Hidemi; Obokata, Masaru; Reddy, Yogesh N., V; VERBRUGGE, Frederik; Omar, Massar; DuBrock, Hilary M.; Redfield, Margaret M. & Borlaug, Barry A. (2022) Pulmonary vascular disease in pulmonary hypertension due to left heart disease: pathophysiologic implications. In: European heart journal, 43 (36) , p. 3417-3431. | - |
item.contributor | Omote, Kazunori | - |
item.contributor | Sorimachi, Hidemi | - |
item.contributor | Obokata, Masaru | - |
item.contributor | Reddy, Yogesh N., V | - |
item.contributor | VERBRUGGE, Frederik | - |
item.contributor | Omar, Massar | - |
item.contributor | DuBrock, Hilary M. | - |
item.contributor | Redfield, Margaret M. | - |
item.contributor | Borlaug, Barry A. | - |
crisitem.journal.issn | 0195-668X | - |
crisitem.journal.eissn | 1522-9645 | - |
Appears in Collections: | Research publications |
Files in This Item:
File | Description | Size | Format | |
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ehac184 3417..3431.pdf | Published version | 1.2 MB | Adobe PDF | View/Open |
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