• 제목/요약/키워드: Pulmonary arterial hypertension

검색결과 93건 처리시간 0.024초

Decreased inward rectifier and voltage-gated K+ currents of the right septal coronary artery smooth muscle cells in pulmonary arterial hypertensive rats

  • Kim, Sung Eun;Yin, Ming Zhe;Kim, Hae Jin;Vorn, Rany;Yoo, Hae Young;Kim, Sung Joon
    • The Korean Journal of Physiology and Pharmacology
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    • 제24권1호
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    • pp.111-119
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    • 2020
  • In vascular smooth muscle, K+ channels, such as voltage-gated K+ channels (Kv), inward-rectifier K+ channels (Kir), and big-conductance Ca2+-activated K+ channels (BKCa), establish a hyperpolarized membrane potential and counterbalance the depolarizing vasoactive stimuli. Additionally, Kir mediates endothelium-dependent hyperpolarization and the active hyperemia response in various vessels, including the coronary artery. Pulmonary arterial hypertension (PAH) induces right ventricular hypertrophy (RVH), thereby elevating the risk of ischemia and right heart failure. Here, using the whole-cell patch-clamp technique, we compared Kv and Kir current densities (IKv and IKir) in the left (LCSMCs), right (RCSMCs), and septal branches of coronary smooth muscle cells (SCSMCs) from control and monocrotaline (MCT)-induced PAH rats exhibiting RVH. In control rats, (1) IKv was larger in RCSMCs than that in SCSMCs and LCSMCs, (2) IKv inactivation occurred at more negative voltages in SCSMCs than those in RCSMCs and LCSMCs, (3) IKir was smaller in SCSMCs than that in RCSMCs and LCSMCs, and (4) IBKCa did not differ between branches. Moreover, in PAH rats, IKir and IKv decreased in SCSMCs, but not in RCSMCs or LCSMCs, and IBKCa did not change in any of the branches. These results demonstrated that SCSMC-specific decreases in IKv and IKir occur in an MCT-induced PAH model, thereby offering insights into the potential pathophysiological implications of coronary blood flow regulation in right heart disease. Furthermore, the relatively smaller IKir in SCSMCs suggested a less effective vasodilatory response in the septal region to the moderate increase in extracellular K+ concentration under increased activity of the myocardium.

The effect of sildenafil on right ventricular remodeling in a rat model of monocrotaline-induced right ventricular failure

  • Bae, Hyun Kyung;Lee, Hyeryon;Kim, Kwan Chang;Hong, Young Mi
    • Clinical and Experimental Pediatrics
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    • 제59권6호
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    • pp.262-270
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    • 2016
  • Purpose: Pulmonary arterial hypertension (PAH) leads to right ventricular failure (RVF) as well as an increase in pulmonary vascular resistance. Our purpose was to study the effect of sildenafil on right ventricular remodeling in a rat model of monocrotaline (MCT)-induced RVF. Methods: The rats were distributed randomly into 3 groups. The control (C) group, the monocrotaline (M) group (MCT 60 mg/kg) and the sildenafil (S) group (MCT 60 mg/kg+ sildenafil 30 mg/kg/day for 28 days). Masson Trichrome staining was used for heart tissues. Western blot analysis and immunohistochemical staining were performed. Results: The mean right ventricular pressure (RVP) was significantly lower in the S group at weeks 1, 2, and 4. The number of intra-acinar arteries and the medial wall thickness of the pulmonary arterioles significantly lessened in the S group at week 4. The collagen content also decreased in heart tissues in the S group at week 4. Protein expression levels of B-cell lymphoma-2 (Bcl-2)-associated X, caspase-3, Bcl-2, interleukin (IL)-6, matrix metalloproteinase (MMP)-2, endothelial nitric oxide synthase (eNOS), endothelin (ET)-1 and ET receptor A (ERA) in lung tissues greatly decreased in the S group at week 4 according to immunohistochemical staining. According to Western blotting, protein expression levels of troponin I, brain natriuretic peptide, caspase-3, Bcl-2, tumor necrosis factor-${\alpha}$, IL-6, MMP-2, eNOS, ET-1, and ERA in heart tissues greatly diminished in the S group at week 4. Conclusion: Sildenafil alleviated right ventricular hypertrophy and mean RVP. These data suggest that sildenafil improves right ventricular function.

Surgical Outcomes of Cor Triatriatum Sinister: A Single-Center Experience

  • Kim, Donghee;Kwon, Bo Sang;Kim, Dong-Hee;Choi, Eun Seok;Yun, Tae-Jin;Park, Chun Soo
    • Journal of Chest Surgery
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    • 제55권2호
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    • pp.151-157
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    • 2022
  • Background: We investigated surgical outcomes after the surgical repair of cor triatriatum sinister (CTS). Methods: Thirty-two consecutive patients who underwent surgical repair of CTS from 1993 through 2020 were included in this study. The morphological characteristics, clinical features, and surgical outcomes were described and analyzed. Results: The median age and body weight at operation were 9 months (interquartile range [IQR], 3-238 months) and 7.5 kg (IQR, 5.8-49.6 kg), respectively. There were 16 males (50%). According to the modified Lucas classification, type IA (classical CTS) was most common (n=20, 62.5%). Atrial septal defect was associated in 22 patients (68.8%) and anomalous pulmonary venous return in 8 patients (25%). Pulmonary hypertension was preoperatively suspected with a high probability in 18 patients (56.3%). There was 1 early death (3.1%) after emergent membrane excision and hybrid palliation in a high-risk hypoplastic left heart syndrome patient. There were no late deaths. The overall survival rate was 96.9% at 15 years post-repair. No early survivors required reoperation during follow-up. Most survivors (31 of 32 patients, 96.9%) were in New York Heart Association functional class I at a median follow-up of 74 months (IQR, 39-195 months). At the latest echocardiography performed at a median of 42 months (IQR, 6-112 months) after repair, no residual lesion was observed except in 1 patient who had moderate pulmonary hypertension (mean pulmonary arterial pressure of 36 mm Hg). Conclusion: Surgical repair of cor triatriatum could be performed safely and effectively with an extremely low risk of recurrence.

PULMONARY VASCULAR EFFECTS OF GINSENOSIDES

  • Gillis C. Norman;Kim Hyeyoung;Chen Xiu;Park Hoon
    • 고려인삼학회:학술대회논문집
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    • 고려인삼학회 1993년도 학술대회지
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    • pp.36-39
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    • 1993
  • We reported earlier (Br. J. Pharmac. 82. 485 - 491. 1984) that ginsenosides from Panax ginseng CA. Meyer antagonized noradrenaline or prostaglandin $F_{2\alpha}-induced$ contractions of pulmonary and intrapulmonary arterial rings of rabbits. Because this effect resembled that of acetylcholine (ACh). we questioned whether these acitons were due to release of nitric oxide from vaseular endothelium. We therefore determined whether ginsenosides could vasodilate preconstricted lungs and also protect against free radical injury. which normally eliminates the vasodilator response to ACh(J. Appl. Physiol. 71. 821 - 825. 1991 J. We found that ginsenoside $Rg_1$ or a mixture of saponins could ,a) vasodilate perfused. $U_{46619}-preconstricted$ lungs. b) promote increased synthesis of nitric oxide by endothelial cells in culture and c) prevent the pulmonary edema often associated with free radical injury (Biochem. Biophys. Res. Comm. 189. 670 - 676. 1992). Thus, vasodilator and protective effects of ginsenosides against free radical injury may reflect enhanced synthesis and release of nitric oxide. These data suggest that ginsenosides may be useful in treatment of pulmonary and systemic hypertension. Aided by grants from the National Institutes of Health. Bethesda.

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심인성 폐부종과 폐포성 출혈을 보인 갈색세포종 1예 (A Case of Pheochromocytoma Accompanied with Alveolar Hemorrhage and Cardiogenic Pulmonary Edema)

  • 정종필;반희정;김수옥;손준광;주진영;권용수;오인재;김규식;김유일;임성철;김영철
    • Tuberculosis and Respiratory Diseases
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    • 제64권3호
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    • pp.219-223
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    • 2008
  • 저자들은 대량 객혈로 내원한 환자에서 폐 출혈과 함께 반복적인 심인성 폐부종, 카테콜라민 유도성 심부전이 합병된 드문 형태의 갈색세포종을 경험하여 이러한 임상 증상시 폐나 심장 질환 외에 갈색세포종에 대한 고려가 필요할 것으로 생각되어 문헌고찰과 함께 보고하는 바이다.

동맥간(動脈幹) 1례(例) 보고(報告) (Truncus Arteriosus -Report of a Case-)

  • 홍장수;박주철;노준량;김종환;서경필;이영균
    • Journal of Chest Surgery
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    • 제9권2호
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    • pp.271-275
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    • 1976
  • Truncus arteriosus is a rare and highly lethal cardiac anomaly characterized by a single arterial trunk emerging from the heart and supplying the coronary, systemic, and pulmonary circulations, The first successful correction of truncus arteriosus was reported by McGoon et al. in 1968 and was based on experimental work reported by Rastelli et al. in 1967 in which a conduit consisting of a homograft of the ascending aorta and aortic valve was used to establish continuity between the right ventricle and the pulmonary arteries, Modification of this procedure using a Dacron tube valved with porcine xenograft instead of a homograft have resulted in the current definite treatment for truncus arteriosus. This report describes an 3 years and 4 months old boy with heart failure from type I truncus arteriosus who was diagnosed as the V. S. D. with pulmonary hypertension preoperatively and underwent corrective surgery employing the Rastelli procedure using a Dacron conduit valved with canine xenograft, but died due to massive bleeding from the anastomosis sites in operating room.

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전신성 동맥 사상충증에 이환된 개의 양측성 대퇴동맥의 폐쇄 (Hindlimb Lameness Secondary to Bilateral Femoral Artery Occlusion in a Dog with Systemic Arterial Dirofilariasis)

  • 최우신;송진영;이영재;이동훈;김주형;장진화;강지훈;장동우
    • 한국임상수의학회지
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    • 제29권4호
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    • pp.334-338
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    • 2012
  • 3세 수컷 풍산견이 2주동안 지속된 좌측후지 파행과 식욕저하로 내원하였다. 환자의 외상 병력은 없었으며, 백신과 심장사상충 예방은 하지 않았다. 전혈구검사에서 중증의 백혈구 증가증과 호중구 핵좌방이동이 확인되었고, 혈액화학검사에서 저알부민혈증, 질소혈증, 간담도계 효소수치의 상승을 확인되었으며, 심장사상충 항원 키트에서 양성으로 확인되었다. 흉부 방사선 검사에서는 주폐동맥의 확장, 우심비대, 폐의 간질패턴이 관찰되었으며, 심장사상충 감염소견과 일치하였다. 이후 실시된 심초음파 검사에서 페동맥판역류와 폐성 고혈압이 확인되었다. 선택적 대퇴동맥 혈관 조영술에서 양측성 대퇴동맥의 폐쇄가 확인되었고, 환자는 혈관조영술후 폐사하였고 부검이 실시되었다. 부검결과 심장사상충 성충과 혈전이 좌우측 대퇴동맥 내강을 폐쇄시키고 있는 것이 확인되었다. 본 증례보고는 심장사상충이 대퇴동맥으로 비정상적 이주를 하여 후지의 파행을 유발한 케이스이며, 이를 보고하고자 한다.

만성폐쇄성폐질환 환자에서 Beraprost sodium의 효과에 대한 연구: 이중 맹검 무작위 임상시험 (Effect of Beraprost Sodium in Patients with Chronic Obstructive Pulmonary Disease)

  • 이상도;서광원;이정연;허진원;최익수;박재선;심태선;오연목;박인원;류왕성;최병휘
    • Tuberculosis and Respiratory Diseases
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    • 제57권4호
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    • pp.320-328
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    • 2004
  • 연구배경 : 만성폐쇄성폐질환의 경과 중 조기에 나타나는 폐혈관의 변화는 이후 만성폐쇄성폐질환의 불량한 예후 인자인 폐고혈압증의 원인이 된다. Beraprost sodium (BPS)은 경구투여가 가능한 prostacyclin 유사 약제이며, 원발성폐고혈압 환자에서 생존율을 향상시킨다고 알려져 있다. 본 연구는 만성폐쇄성폐질환 환자에 대한 BPS의 효과에 대해 알아보고자 하였다. 연구방법 : 본 연구는 이중맹검, 무작위, 무효약대조, 2기관 임상시험이다. 2003년 6월부터 2004년 6월까지 만성폐쇄성폐질환 환자 21명이 선정되었다(이중 BPS를 3개월간 복용한 BPS군은 11명, 무효약을 복용한 무효약군은 10명). 기초평가, 폐기능검사, 혈역학적 지표에서 두 군간 통계적 차이는 없었다. 연구결과 : 심장초음파검사에서 Trans Tricuspid valve Pressure Gradient(TTPG) 측정값이 BPS군에서 BPS 복용 전보다 복용 3개월 후 현저한 감소를 보였다[17.7(${\pm}11.4$)에서 8.2(${\pm}8.9$) mm Hg, p-value<0.05]. 한편 무효약군 에서는 통계학적 차이가 없었다. 6분 도보거리는 무효약군에서는 감소를 보였고 BPS군에서는 증가된 결과를 보였으나 통계적 유의성은 없었다. 결 론 : 만성폐쇄성폐질환 환자에서 BPS의 경구복용은 폐동맥압을 감소하게 하였다. 이런 결과의 임상적 중요 성인 증상 및 질병의 자연경과의 개선을 조사하기 위한 추가연구가 필요할 것으로 사료된다.

Transfusion-associated Circulatory Overload after Rapid Whole Blood Transfusion in a Dog

  • Kang, Seongwoo;Kim, Hyunwoo;Bae, Junwoo;Kim, Woosun;Ahn, Soomin;Yang, Hayoung;Lee, Sang-Kwon;Choi, Jihye;Chae, Joon-Seok;Park, Bae-Keun;Kim, Hyeon-Cheol;Choi, Kyoung-Seong;Park, Jinho;Kim, Suhee;Do, Yoonjung;Yoo, Jae Gyu;Yu, DoHyeon
    • 한국임상수의학회지
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    • 제34권5호
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    • pp.356-358
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    • 2017
  • A dog (neutered male Schnauzer, 11 years old, 8 kg) presented with recurrence of immune-mediated hemolytic anemia. Rapid whole blood transfusion was initiated, and then sudden tachycardia and dyspnea were observed. Invasive arterial blood pressure, arterial blood gas analysis, and thoracic radiograph indicated transfusion-associated circulatory overload (TACO). Persistent high blood pressure of 160-205 mmHg was observed; the thoracic radiograph revealed interstitial infiltration and a fissure line, which suggested pulmonary edema and pleural effusion. Despite furosemide administration and nasal oxygen supplementation, hypertension and respiratory distress were not completely controlled. Finally, cardiac arrest occurred and the patient expired due to TACO 24 hours after the transfusion.

Canonical Transient Receptor Potential Channels and Their Link with Cardio/Cerebro-Vascular Diseases

  • Xiao, Xiong;Liu, Hui-Xia;Shen, Kuo;Cao, Wei;Li, Xiao-Qiang
    • Biomolecules & Therapeutics
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    • 제25권5호
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    • pp.471-481
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    • 2017
  • The canonical transient receptor potential channels (TRPCs) constitute a series of nonselective cation channels with variable degrees of $Ca^{2+}$ selectivity. TRPCs consist of seven mammalian members, TRPC1, TRPC2, TRPC3, TRPC4, TRPC5, TRPC6, and TRPC7, which are further divided into four subtypes, TRPC1, TRPC2, TRPC4/5, and TRPC3/6/7. These channels take charge of various essential cell functions such as contraction, relaxation, proliferation, and dysfunction. This review, organized into seven main sections, will provide an overview of current knowledge about the underlying pathogenesis of TRPCs in cardio/cerebro-vascular diseases, including hypertension, pulmonary arterial hypertension, cardiac hypertrophy, atherosclerosis, arrhythmia, and cerebrovascular ischemia reperfusion injury. Collectively, TRPCs could become a group of drug targets with important physiological functions for the therapy of human cardio/cerebro-vascular diseases.