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Related Concept Videos

Pulmonary Hypertension: Classification and Pathogenesis01:30

Pulmonary Hypertension: Classification and Pathogenesis

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Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
There are various classifications for PH, each relating to different underlying causes and also...
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Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a...
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Blood Pressure01:24

Blood Pressure

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The movement of blood in a human body, commonly referred to as blood flow, is determined by the volume of blood that traverses a certain section of the bodily system per unit time. It is the rhythmic contraction of the heart's ventricles that primarily instigates this movement. As the ventricles contract, blood is forced into the prominent arteries, which then flow from areas of greater pressure to lower pressure areas. This movement continues into smaller arteries and arterioles and...
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Pulmonary Embolism I: Introduction01:29

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Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
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Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists01:18

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Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
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Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers01:26

Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers

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Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
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Related Experiment Video

Updated: Mar 31, 2026

Invasive Hemodynamic Monitoring of Aortic and Pulmonary Artery Hemodynamics in a Large Animal Model of ARDS
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Hemodynamic Thresholds for Precapillary Pulmonary Hypertension.

Christian Gerges1, Mario Gerges1, Nika Skoro-Sajer1

  • 1Department of Internal Medicine II, Division of Cardiology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria.

Chest
|October 27, 2015
PubMed
Summary
This summary is machine-generated.

Differentiating pulmonary arterial hypertension (PAH) from postcapillary pulmonary hypertension (PH) is crucial for treatment. New hemodynamic cutoffs, specifically mean pulmonary arterial wedge pressure (mPAWP) < 12 mm Hg and diastolic pulmonary vascular pressure gradient (DPG) > 20 mm Hg, identify PAH patients likely to respond to prostacyclin therapy.

Keywords:
heart failurehemodynamicspulmonary circulationpulmonary hypertension

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Area of Science:

  • Cardiology
  • Pulmonary Medicine
  • Hemodynamics

Background:

  • Accurate hemodynamic differentiation between pulmonary arterial hypertension (PAH) and postcapillary pulmonary hypertension (PH) is critical due to distinct treatment strategies.
  • Targeted therapies are effective for PAH but not recommended for postcapillary PH.
  • Identifying patients likely to respond to treatment is essential for optimizing outcomes.

Purpose of the Study:

  • To establish a diagnostic algorithm for distinguishing PAH from postcapillary PH.
  • To identify hemodynamic parameters predicting treatment response in PAH patients.

Main Methods:

  • Analysis of a large database (4,363 patients) undergoing right and left heart catheterization to determine hemodynamic cutoffs.
  • Pooled analysis of four randomized, placebo-controlled trials (541 PAH patients) to validate cutoffs against treatment response to treprostinil.

Main Results:

  • Mean pulmonary arterial wedge pressure (mPAWP) < 12 mm Hg and diastolic pulmonary vascular pressure gradient (DPG) ≥ 7 mm Hg were identified as optimal discriminators.
  • In treatment trials, significant hemodynamic improvement occurred in patients with mPAWP < 12 mm Hg, DPG > 20 mm Hg, or both.

Conclusions:

  • Hemodynamic criteria of mPAWP < 12 mm Hg and DPG > 20 mm Hg effectively identify PAH patients who are likely to experience significant hemodynamic improvement with prostacyclin treatment.
  • These findings aid in refining treatment selection for pulmonary hypertension.