• Journal of Chest Surgery
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• 제44권6호
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• pp.432-436
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• 2011

We herein present a case of a successful correction of cor triatriatum associated with thrombotic pulmonary hypertension diagnosed in an adult female patient. We confirmed diagnosis using transthoracic and transesophageal echocardiography in addition to cardiac computed tomography and magnetic resonance imaging. Surgical repair comprised excision of the fibromuscular membranous septum in the left atrium, patch closure of an atrial septal defect, and reconstruction of the pulmonary arteries with a vascular graft. Cor triatriatum complicated pulmonary thrombotic hypertension with atrial septal defect is amenable to surgical correction with satisfactory results.

• Korean Circulation Journal
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• 제48권12호
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• pp.1135-1144
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• 2018

Background and Objectives: Mitochondria play a key role in the pathophysiology of heart failure and mitochondrial permeability transition pore (MPTP) play a critical role in cell death and a critical target for cardioprotection. The aim of this study was to evaluate the protective effects of cyclosporine A (CsA), one of MPTP blockers, and morphological changes of mitochondria and MPTP related proteins in monocrotaline (MCT) induced pulmonary arterial hypertension (PAH). Methods: Eight weeks old Sprague-Dawley rats were randomized to control, MCT (60 mg/kg) and MCT plus CsA (10 mg/kg/day) treatment groups. Four weeks later, right ventricular hypertrophy (RVH) and morphological changes of right ventricle (RV) were done. Western blot and reverse transcription polymerase chain reaction (RT-PCR) for MPTP related protein were performed. Results: In electron microscopy, CsA treatment prevented MCT-induced mitochondrial disruption of RV. RVH was significantly increased in MCT group compared to that of the controls but RVH was more increased with CsA treatment. Thickened medial wall thickness of pulmonary arteriole in PAH was not changed after CsA treatment. In western blot, caspase-3 was significantly increased in MCT group, and was attenuated in CsA treatment. There were no significant differences in voltage-dependent anion channel, adenine nucleotide translocator 1 and cyclophilin D expression in western blot and RT-PCR between the 3 groups. Conclusions: CsA reduces MCT induced RV mitochondrial damage. Although, MPTP blocking does not reverse pulmonary pathology, it may reduce RV dysfunction in PAH. The results suggest that it could serve as an adjunctive therapy to PAH treatment.

• The Korean Journal of Physiology and Pharmacology
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• 제27권3호
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• pp.209-220
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• 2023

This study is to determine the regulation of nitric oxide synthase 3 (NOS3) by edaravone in mice with hypoxic pulmonary hypertension (HPH). C57BL/6J mice were reared in a hypoxic chamber. HPH mice were treated with edaravone or edaravone + L-NMMA (a NOS inhibitor). Lung tissue was collected for histological assessment, apoptosis analysis, and detection of malondialdehyde, superoxide dismutase, tumor necrosis factor (TNF)-α, interleukin (IL)-6, and NOS3. The levels of serum TNF-α and IL-6 were also measured. Immunohistochemistry was used to visualize the expression of α-smooth muscle actin (SMA) in pulmonary arterioles. Edaravone treatment improved hemodynamics, inhibited right ventricular hypertrophy, increased NOS3 expression, and reduced pathological changes, pulmonary artery wall thickness, apoptotic pulmonary cells, oxidative stress, and the expression of TNF-α, IL-6, and α-SMA in HPH mice. L-NMMA treatment counteracted the lung protective effects of edaravone. In conclusion, edaravone might reduce lung damage in HPH mice by increasing the expression of NOS3.

• 대한핵의학회지
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• 제19권2호
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• pp.87-89
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• 1985

Unresolved major pulmonary embolism (UMPE) is an uncommon condition which causes pulmonary hypertension, cor pulmonale and death. An accurate and prompt diagnosis of UMPE is very important in the management of such patients with pulmonary embolectomy. Follow-up lung scans can lead to earlier diagnosis of UMPE especially on patients who have a history of acute pulmonary embolism in the past and. present with pulmonary hypertension, respiratory insufficiency and cor pulmonale. We report a case of UMPE strongly suggested by follow-up lung scans and subsequently confirmed by pulmonary angiography and postmortem examination.

• 한국임상수의학회지
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• 제24권4호
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• pp.613-617
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• 2007

중성화된 1년령 말티즈 개(2.4kg)가 간헐적인 기침, 호흡곤란, 운동 불내성을 주요 증상으로 내원하였다. 신체검사 시 제 2음 모순 분열, 확장기 역류성 잡음이 관찰되었으며, 심장초음파에서 주폐동맥의 확장, 심실 중격 비대를 동반한 우심실 편심성 비대, 심각한 삼첨판 역류증과 폐동맥 역류증(5.4m/sec, 3.4m/sec)이 관찰되었다. 이러한 진단 검사 결과를 바탕으로, 본 증례를 선천성 심장 내 단락, 폐쇄성 폐질환, 그리고 우심계의 압력 과부하 또는 폐혈관계과관류와 관련된 전신질환과 감별하여 원발성 폐동맥 고혈압증으로 잠정진단 하였다. 환자는 furosemide와 aspirin을 투여하여, 산소요법을 실시하였다. 본 증례는 드물게 발생하는 개의 원발성 폐동맥 고혈압이다.

• Journal of Yeungnam Medical Science
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• 제37권2호
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• pp.122-127
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• 2020

Pulmonary tumor thrombotic microangiopathy (PTTM) is a rare but fatal complication of cancer and causes pulmonary hypertension and acute/subacute right heart failure. PTTM is most commonly associated with gastric cancer and more rarely associated with pancreatic cancer. We report a case of progressive right heart failure associated with clinically diagnosed pancreatic cancer, suggesting PTTM.

• Tuberculosis and Respiratory Diseases
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• 제46권6호
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• pp.846-855
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• 1999

연구배경 : 만성 저산소성 폐질환 환자의 폐동맥고혈압은 폐혈류 장애에 따른 악화에 이르는 주요 합병증이다. 폐동맥 고혈압과 이에 수반되는 폐성심의 임상적 진단은 때로 모호하여 폐동맥압의 비관혈적인 심초음파 검사의 중요성이 대두되고 있다. 최근 도플러 심초음파는 기존의 M모드 검사법에 비해 측정치의 정확도, 재생산성과 좋은 창을 얻을 수 있는 상대적인 장점이 있어 폐기종성 환자에서 보다 적용하기 용이한 검사법이다. 본 연구는 만성 저산소성 폐질환의 폐동맥 고혈압 예상 환자에서 도플러 검사법이 갖는 유의한 지표를 확인함에 목적이 있다. 방 법 : 대상환자는 만성 저산소성 폐질환을 보이며 임상소견상 폐동맥 고혈압이 예상되어 심초음파 검사를 시행받은 19명의 환자들을 대상으로 의의있는 폐동맥 고혈압 지표에 대해 조사하였다. 대상 환자들은 와위에서 좌흉골연이나 늑골하에 2.5MHz 진동자를 두고 도플러 및 M모드 심초음파를 시행하였고 특히, 삼첨판 역류시는 도플러 모드로 예측되는 우심실 수축기압(RVSP)이 40mmHg 이상인 군을 그 미만이거나 삼첨판 역류가 없었던 경우와 구분하여 다른 임상지표들에 대하여 비교, 분석하였다. 결 과 : 1) M모드 심초음파의 늑골하 사방관찰에서 RVSP 상승군이 대조군에 비해 수축기말 우심실 직경은 증가하였지만 그외 이완기말 우심실 직경, 수축기 및 이완기말 면적, 우심실 지유벽의 두께, 우심실 출구의 직경과 심실 중벽 두께 등은 두군간 차이가 없었다. 2) 도플러 모드에서 RVSP 상승군의 우심실 출구 수축기 가속기간(AT)은 $82{\pm}9msec$로 대조군 $96{\pm}16msec$에 비해 유의하게 단축되어 있었다. 3) 동맥혈 검사상 RVSP 상승군은 대조군에 비해 산소분압이 감소되어 있었으나 유의한 차이는 없었고 폐기능검사의 노력성 폐활량 및 1초 노력성호기량도 상승군에서 저하되었으나 두군간 유의한 차이는 없었다. 4) AT는 RVSP와 통계학적으로 유의한 역상관관계를 보여주었다. 결 론 : 만성 저산소성 폐질환에서 임상소견상 폐동맥 고혈압이 예상되는 경우 이를 규명하기 위해 심초음파 검사를 하여 컬러도플러로 삼첨판 역류가 확인되면 연속파 도플러로 RVSP를 예측할 수 있으며 이는 간헐파 도플러의 AT의 단축과 관련되어 있음을 확인하였다. 도플러 모드하의 RVSP 및 AT의 측정은 폐동맥 고혈압의 좋은 지표가 될 수 있을 것으로 예상된다.

• 약학회지
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• 제43권4호
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• pp.487-493
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• 1999

Effects of Ginkgo biloba extract (EGb 761) on the anti-pulmonary hypertensive action of enalapril were evaluated in rats. Pulmonary hypertension was induced by monocrotaline treatment (60mg/kg, i.p.) in normotensive rats. In the systolic pulmonary artery pressure, the control group was 33$\pm$2 mmHg, comparing to the normal group of 19$\pm$1 mmHg. That of enalapril group(20mg/kg/day, p.o.) was 26$\pm$2 mmHg. In the isolated lung preparation, acetylcholine, which was endothelium dependent vasodilator, induced the decrease of pulmonary artery perfusion pressure(-2.0$\pm$0.7 mmHg) in normal group, but the increase of that of 3.4$\pm$0.6 and 3.0$\pm$0.9 mmHg in control and enalapril group, respectively. And that of the combined group was -0.5$\pm$0.2 mmHg. In the isolated pulmonary artery, acetylcholine(10-5M) induced the relaxation of 65$\pm$6% in normal group, but 15 and 8% in control and enalapril group, respectively. And that of the combined group was resulted 55$\pm$2%. These results suggested that co-administration of Ginkgo biloba extract(EGb 761) potentiated the anti-pulmonary hypertensive effects of enalapril through the increase of pulmonary vasodilation due to the protection of endothelial cell by antioxidant action of Ginkgo biloba extract (EGb 761).

• Tuberculosis and Respiratory Diseases
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• 제60권2호
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• pp.142-150
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• 2006

Pulmonary arterial hypertension (PAH) is often difficult to diagnose and challenging to treat. Untreated, it is characterized by a progressive increase in pulmonary vascular resistance leading to right ventricular failure and death. The past decade has seen remarkable improvements in therapy, driven largely by the conduct of randomized controlled trials. Still, the selection of most appropriate therapy is complex, and requires familiarity with the disease process, evidence from treatment trials, complicated drug delivery systems, dosing regimens, side effects, and complications. We tried to provide evidence-based treatment recommendations for physicians involved in the care of these complex patients. Due to the complexity of the diagnostic evaluation required, and the treatment options available, it is strongly recommended that consideration be given to referral of patients with PAH to a specialized center.

• Journal of Chest Surgery
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• 제23권4호
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• pp.659-666
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• 1990

We evaluated 68 patients with mitral valve disease who underwent mitral valve replacement from April, 1986, to December, 1988. Among them 20 patients showed increased systolic pulmonary arterial pressure greater than 60 mmHg and postoperative hemodynamic data were obtained in 19 patients average 13 months after mitral valve replacement. The results were as followings. 1. Average pulmonary systolic pressure decreased from 84.8$\pm$4.5 preoperatively to 33. 0$\pm$1.9mmHg postoperatively[P<0.001]. 2. Average pulmonary vascular resistance index decreased from 1425$\pm$148 preoperatively to 287+35.8 dyne * sec * cm2 * m postoperatively[P<0.001]. 3. Average cardiac index rose from 1.927$\pm$0.169 preoperatively to 2.625$\pm$0.159 L/min/m2 postoperatively [P <0.005]. This study shows that pulmonary hypertension and the increased pulmonary vascular resistance index due to mitral valve disease can regress significantly after mitral valve replacement.