Pulmonary Circulation: The circulation of the BLOOD through the LUNGS.Blood Circulation: The movement of the BLOOD as it is pumped through the CARDIOVASCULAR SYSTEM.Pulmonary Artery: The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs.Veins: The vessels carrying blood away from the capillary beds.Arteries: The vessels carrying blood away from the heart.Jugular Veins: Veins in the neck which drain the brain, face, and neck into the brachiocephalic or subclavian veins.Regional Blood Flow: The flow of BLOOD through or around an organ or region of the body.Femoral Vein: The vein accompanying the femoral artery in the same sheath; it is a continuation of the popliteal vein and becomes the external iliac vein.Hemodynamics: The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.Blood Pressure: PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS.Dogs: The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065)Hypertension, Pulmonary: Increased VASCULAR RESISTANCE in the PULMONARY CIRCULATION, usually secondary to HEART DISEASES or LUNG DISEASES.Lung: Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood.Vascular Resistance: The force that opposes the flow of BLOOD through a vascular bed. It is equal to the difference in BLOOD PRESSURE across the vascular bed divided by the CARDIAC OUTPUT.Anoxia: Relatively complete absence of oxygen in one or more tissues.Ductus Arteriosus: A fetal blood vessel connecting the pulmonary artery with the descending aorta.Pulmonary Heart Disease: Hypertrophy and dilation of the RIGHT VENTRICLE of the heart that is caused by PULMONARY HYPERTENSION. This condition is often associated with pulmonary parenchymal or vascular diseases, such as CHRONIC OBSTRUCTIVE PULMONARY DISEASE and PULMONARY EMBOLISM.Extracorporeal Circulation: Diversion of blood flow through a circuit located outside the body but continuous with the bodily circulation.Vasoconstriction: The physiological narrowing of BLOOD VESSELS by contraction of the VASCULAR SMOOTH MUSCLE.Pulmonary Veins: The veins that return the oxygenated blood from the lungs to the left atrium of the heart.Hypertrophy, Right Ventricular: Enlargement of the RIGHT VENTRICLE of the heart. This increase in ventricular mass is often attributed to PULMONARY HYPERTENSION and is a contributor to cardiovascular morbidity and mortality.Atrial Pressure: The pressure within the CARDIAC ATRIUM. It can be measured directly by using a pressure catheter (see HEART CATHETERIZATION). It can be also estimated using various imaging techniques or other pressure readings such as PULMONARY CAPILLARY WEDGE PRESSURE (an estimate of left atrial pressure) and CENTRAL VENOUS PRESSURE (an estimate of right atrial pressure).Nitric Oxide: A free radical gas produced endogenously by a variety of mammalian cells, synthesized from ARGININE by NITRIC OXIDE SYNTHASE. Nitric oxide is one of the ENDOTHELIUM-DEPENDENT RELAXING FACTORS released by the vascular endothelium and mediates VASODILATION. It also inhibits platelet aggregation, induces disaggregation of aggregated platelets, and inhibits platelet adhesion to the vascular endothelium. Nitric oxide activates cytosolic GUANYLATE CYCLASE and thus elevates intracellular levels of CYCLIC GMP.Cardiac Output: The volume of BLOOD passing through the HEART per unit of time. It is usually expressed as liters (volume) per minute so as not to be confused with STROKE VOLUME (volume per beat).Sheep: Any of the ruminant mammals with curved horns in the genus Ovis, family Bovidae. They possess lachrymal grooves and interdigital glands, which are absent in GOATS.Capillary Resistance: The vascular resistance to the flow of BLOOD through the CAPILLARIES portions of the peripheral vascular bed.Persistent Fetal Circulation Syndrome: A syndrome of persistent PULMONARY HYPERTENSION in the newborn infant (INFANT, NEWBORN) without demonstrable HEART DISEASES. This neonatal condition can be caused by severe pulmonary vasoconstriction (reactive type), hypertrophy of pulmonary arterial muscle (hypertrophic type), or abnormally developed pulmonary arterioles (hypoplastic type). The newborn patient exhibits CYANOSIS and ACIDOSIS due to the persistence of fetal circulatory pattern of right-to-left shunting of blood through a patent ductus arteriosus (DUCTUS ARTERIOSUS, PATENT) and at times a patent foramen ovale (FORAMEN OVALE, PATENT).Collateral Circulation: Maintenance of blood flow to an organ despite obstruction of a principal vessel. Blood flow is maintained through small vessels.Vasodilation: The physiological widening of BLOOD VESSELS by relaxing the underlying VASCULAR SMOOTH MUSCLE.Ventricular Function, Right: The hemodynamic and electrophysiological action of the right HEART VENTRICLE.Anatomy, Regional: The anatomical study of specific regions or parts of organisms, emphasizing the relationship between the various structures (e.g. muscles, nerves, skeletal, cardiovascular, etc.).Pulmonary Gas Exchange: The exchange of OXYGEN and CARBON DIOXIDE between alveolar air and pulmonary capillary blood that occurs across the BLOOD-AIR BARRIER.Blood Flow Velocity: A value equal to the total volume flow divided by the cross-sectional area of the vascular bed.Perfusion: Treatment process involving the injection of fluid into an organ or tissue.Vasodilator Agents: Drugs used to cause dilation of the blood vessels.Models, Cardiovascular: Theoretical representations that simulate the behavior or activity of the cardiovascular system, processes, or phenomena; includes the use of mathematical equations, computers and other electronic equipment.Pulmonary Wedge Pressure: The blood pressure as recorded after wedging a CATHETER in a small PULMONARY ARTERY; believed to reflect the PRESSURE in the pulmonary CAPILLARIES.Bronchial Arteries: Left bronchial arteries arise from the thoracic aorta, the right from the first aortic intercostal or the upper left bronchial artery; they supply the bronchi and the lower trachea.Enterohepatic Circulation: Recycling through liver by excretion in bile, reabsorption from intestines (INTESTINAL REABSORPTION) into portal circulation, passage back into liver, and re-excretion in bile.Fetus: The unborn young of a viviparous mammal, in the postembryonic period, after the major structures have been outlined. In humans, the unborn young from the end of the eighth week after CONCEPTION until BIRTH, as distinguished from the earlier EMBRYO, MAMMALIAN.Cardiac Catheterization: Procedures in which placement of CARDIAC CATHETERS is performed for therapeutic or diagnostic procedures.Pulmonary Edema: Excessive accumulation of extravascular fluid in the lung, an indication of a serious underlying disease or disorder. Pulmonary edema prevents efficient PULMONARY GAS EXCHANGE in the PULMONARY ALVEOLI, and can be life-threatening.Physiology: The biological science concerned with the life-supporting properties, functions, and processes of living organisms or their parts.Coronary Circulation: The circulation of blood through the CORONARY VESSELS of the HEART.Cerebrovascular Circulation: The circulation of blood through the BLOOD VESSELS of the BRAIN.15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic Acid: A stable prostaglandin endoperoxide analog which serves as a thromboxane mimetic. Its actions include mimicking the hydro-osmotic effect of VASOPRESSIN and activation of TYPE C PHOSPHOLIPASES. (From J Pharmacol Exp Ther 1983;224(1): 108-117; Biochem J 1984;222(1):103-110)Osteoarthropathy, Secondary Hypertrophic: Symmetrical osteitis of the four limbs, chiefly localized to the phalanges and the terminal epiphyses of the long bones of the forearm and leg, sometimes extending to the proximal ends of the limbs and the flat bones, and accompanied by dorsal kyphosis and joint involvement. It is often secondary to chronic conditions of the lungs and heart. (Dorland, 27th ed)Venous Pressure: The blood pressure in the VEINS. It is usually measured to assess the filling PRESSURE to the HEART VENTRICLE.Oxygen: An element with atomic symbol O, atomic number 8, and atomic weight [15.99903; 15.99977]. It is the most abundant element on earth and essential for respiration.Ventricular Dysfunction, Right: A condition in which the RIGHT VENTRICLE of the heart was functionally impaired. This condition usually leads to HEART FAILURE or MYOCARDIAL INFARCTION, and other cardiovascular complications. Diagnosis is made by measuring the diminished ejection fraction and a depressed level of motility of the right ventricular wall.Administration, Inhalation: The administration of drugs by the respiratory route. It includes insufflation into the respiratory tract.Pulsatile Flow: Rhythmic, intermittent propagation of a fluid through a BLOOD VESSEL or piping system, in contrast to constant, smooth propagation, which produces laminar flow.Endothelin-1: A 21-amino acid peptide produced in a variety of tissues including endothelial and vascular smooth-muscle cells, neurons and astrocytes in the central nervous system, and endometrial cells. It acts as a modulator of vasomotor tone, cell proliferation, and hormone production. (N Eng J Med 1995;333(6):356-63)Placental Circulation: The circulation of BLOOD, of both the mother and the FETUS, through the PLACENTA.Synchrotrons: Devices for accelerating protons or electrons in closed orbits where the accelerating voltage and magnetic field strength varies (the accelerating voltage is held constant for electrons) in order to keep the orbit radius constant.Respiration: The act of breathing with the LUNGS, consisting of INHALATION, or the taking into the lungs of the ambient air, and of EXHALATION, or the expelling of the modified air which contains more CARBON DIOXIDE than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= OXYGEN CONSUMPTION) or cell respiration (= CELL RESPIRATION).Cardiography, Impedance: A type of impedance plethysmography in which bioelectrical impedance is measured between electrodes positioned around the neck and around the lower thorax. It is used principally to calculate stroke volume and cardiac volume, but it is also related to myocardial contractility, thoracic fluid content, and circulation to the extremities.Splanchnic Circulation: The circulation of blood through the BLOOD VESSELS supplying the abdominal VISCERA.Capillaries: The minute vessels that connect the arterioles and venules.Endothelium, Vascular: Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components.Vasoconstrictor Agents: Drugs used to cause constriction of the blood vessels.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Pulmonary Valve Stenosis: The pathologic narrowing of the orifice of the PULMONARY VALVE. This lesion restricts blood outflow from the RIGHT VENTRICLE to the PULMONARY ARTERY. When the trileaflet valve is fused into an imperforate membrane, the blockage is complete.Monocrotaline: A pyrrolizidine alkaloid and a toxic plant constituent that poisons livestock and humans through the ingestion of contaminated grains and other foods. The alkaloid causes pulmonary artery hypertension, right ventricular hypertrophy, and pathological changes in the pulmonary vasculature. Significant attenuation of the cardiopulmonary changes are noted after oral magnesium treatment.Animals, Newborn: Refers to animals in the period of time just after birth.Blood Circulation Time: Determination of the shortest time interval between the injection of a substance in the vein and its arrival at some distant site in sufficient concentration to produce a recognizable end result. It represents approximately the inverse of the average velocity of blood flow between two points.Pulmonary Alveoli: Small polyhedral outpouchings along the walls of the alveolar sacs, alveolar ducts and terminal bronchioles through the walls of which gas exchange between alveolar air and pulmonary capillary blood takes place.Pulmonary Embolism: Blocking of the PULMONARY ARTERY or one of its branches by an EMBOLUS.Heart Defects, Congenital: Developmental abnormalities involving structures of the heart. These defects are present at birth but may be discovered later in life.Microcirculation: The circulation of the BLOOD through the MICROVASCULAR NETWORK.Nitric Oxide Synthase: An NADPH-dependent enzyme that catalyzes the conversion of L-ARGININE and OXYGEN to produce CITRULLINE and NITRIC OXIDE.Liver Circulation: The circulation of BLOOD through the LIVER.Adrenomedullin: A 52-amino acid peptide with multi-functions. It was originally isolated from PHEOCHROMOCYTOMA and ADRENAL MEDULLA but is widely distributed throughout the body including lung and kidney tissues. Besides controlling fluid-electrolyte homeostasis, adrenomedullin is a potent vasodilator and can inhibit pituitary ACTH secretion.Ductus Arteriosus, Patent: A congenital heart defect characterized by the persistent opening of fetal DUCTUS ARTERIOSUS that connects the PULMONARY ARTERY to the descending aorta (AORTA, DESCENDING) allowing unoxygenated blood to bypass the lung and flow to the PLACENTA. Normally, the ductus is closed shortly after birth.Blood Vessels: Any of the tubular vessels conveying the blood (arteries, arterioles, capillaries, venules, and veins).Nitroarginine: An inhibitor of nitric oxide synthetase which has been shown to prevent glutamate toxicity. Nitroarginine has been experimentally tested for its ability to prevent ammonia toxicity and ammonia-induced alterations in brain energy and ammonia metabolites. (Neurochem Res 1995:200(4):451-6)Prostaglandin Endoperoxides, Synthetic: Synthetic compounds that are analogs of the naturally occurring prostaglandin endoperoxides and that mimic their pharmacologic and physiologic activities. They are usually more stable than the naturally occurring compounds.Pregnancy: The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.Rats, Sprague-Dawley: A strain of albino rat used widely for experimental purposes because of its calmness and ease of handling. It was developed by the Sprague-Dawley Animal Company.Angiography: Radiography of blood vessels after injection of a contrast medium.Chronic Disease: Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)Blood Volume: Volume of circulating BLOOD. It is the sum of the PLASMA VOLUME and ERYTHROCYTE VOLUME.Endothelins: 21-Amino-acid peptides produced by vascular endothelial cells and functioning as potent vasoconstrictors. The endothelin family consists of three members, ENDOTHELIN-1; ENDOTHELIN-2; and ENDOTHELIN-3. All three peptides contain 21 amino acids, but vary in amino acid composition. The three peptides produce vasoconstrictor and pressor responses in various parts of the body. However, the quantitative profiles of the pharmacological activities are considerably different among the three isopeptides.Muscle, Smooth, Vascular: The nonstriated involuntary muscle tissue of blood vessels.Epoprostenol: A prostaglandin that is a powerful vasodilator and inhibits platelet aggregation. It is biosynthesized enzymatically from PROSTAGLANDIN ENDOPEROXIDES in human vascular tissue. The sodium salt has been also used to treat primary pulmonary hypertension (HYPERTENSION, PULMONARY).Blood Gas Analysis: Measurement of oxygen and carbon dioxide in the blood.Swine: Any of various animals that constitute the family Suidae and comprise stout-bodied, short-legged omnivorous mammals with thick skin, usually covered with coarse bristles, a rather long mobile snout, and small tail. Included are the genera Babyrousa, Phacochoerus (wart hogs), and Sus, the latter containing the domestic pig (see SUS SCROFA).Heart Ventricles: The lower right and left chambers of the heart. The right ventricle pumps venous BLOOD into the LUNGS and the left ventricle pumps oxygenated blood into the systemic arterial circulation.Nitric Oxide Synthase Type III: A CALCIUM-dependent, constitutively-expressed form of nitric oxide synthase found primarily in ENDOTHELIAL CELLS.Infant, Newborn: An infant during the first month after birth.Arteriovenous Fistula: An abnormal direct communication between an artery and a vein without passing through the CAPILLARIES. An A-V fistula usually leads to the formation of a dilated sac-like connection, arteriovenous aneurysm. The locations and size of the shunts determine the degree of effects on the cardiovascular functions such as BLOOD PRESSURE and HEART RATE.Heart: The hollow, muscular organ that maintains the circulation of the blood.Lung Diseases: Pathological processes involving any part of the LUNG.Heart Rate: The number of times the HEART VENTRICLES contract per unit of time, usually per minute.Rabbits: The species Oryctolagus cuniculus, in the family Leporidae, order LAGOMORPHA. Rabbits are born in burrows, furless, and with eyes and ears closed. In contrast with HARES, rabbits have 22 chromosome pairs.Receptors, Endothelin: Cell surface proteins that bind ENDOTHELINS with high affinity and trigger intracellular changes which influence the behavior of cells.Nitroprusside: A powerful vasodilator used in emergencies to lower blood pressure or to improve cardiac function. It is also an indicator for free sulfhydryl groups in proteins.Hematocrit: The volume of packed RED BLOOD CELLS in a blood specimen. The volume is measured by centrifugation in a tube with graduated markings, or with automated blood cell counters. It is an indicator of erythrocyte status in disease. For example, ANEMIA shows a low value; POLYCYTHEMIA, a high value.Cyclic GMP: Guanosine cyclic 3',5'-(hydrogen phosphate). A guanine nucleotide containing one phosphate group which is esterified to the sugar moiety in both the 3'- and 5'-positions. It is a cellular regulatory agent and has been described as a second messenger. Its levels increase in response to a variety of hormones, including acetylcholine, insulin, and oxytocin and it has been found to activate specific protein kinases. (From Merck Index, 11th ed)Pressure: A type of stress exerted uniformly in all directions. Its measure is the force exerted per unit area. (McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed)Dose-Response Relationship, Drug: The relationship between the dose of an administered drug and the response of the organism to the drug.Disease Models, Animal: Naturally occurring or experimentally induced animal diseases with pathological processes sufficiently similar to those of human diseases. They are used as study models for human diseases.Atrial Natriuretic Factor: A potent natriuretic and vasodilatory peptide or mixture of different-sized low molecular weight PEPTIDES derived from a common precursor and secreted mainly by the HEART ATRIUM. All these peptides share a sequence of about 20 AMINO ACIDS.Endothelial Cells: Highly specialized EPITHELIAL CELLS that line the HEART; BLOOD VESSELS; and lymph vessels, forming the ENDOTHELIUM. They are polygonal in shape and joined together by TIGHT JUNCTIONS. The tight junctions allow for variable permeability to specific macromolecules that are transported across the endothelial layer.Prostaglandins: A group of compounds derived from unsaturated 20-carbon fatty acids, primarily arachidonic acid, via the cyclooxygenase pathway. They are extremely potent mediators of a diverse group of physiological processes.NG-Nitroarginine Methyl Ester: A non-selective inhibitor of nitric oxide synthase. It has been used experimentally to induce hypertension.Echocardiography, Doppler: Measurement of intracardiac blood flow using an M-mode and/or two-dimensional (2-D) echocardiogram while simultaneously recording the spectrum of the audible Doppler signal (e.g., velocity, direction, amplitude, intensity, timing) reflected from the moving column of red blood cells.Carbon Dioxide: A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals.Capillary Permeability: The property of blood capillary ENDOTHELIUM that allows for the selective exchange of substances between the blood and surrounding tissues and through membranous barriers such as the BLOOD-AIR BARRIER; BLOOD-AQUEOUS BARRIER; BLOOD-BRAIN BARRIER; BLOOD-NERVE BARRIER; BLOOD-RETINAL BARRIER; and BLOOD-TESTIS BARRIER. Small lipid-soluble molecules such as carbon dioxide and oxygen move freely by diffusion. Water and water-soluble molecules cannot pass through the endothelial walls and are dependent on microscopic pores. These pores show narrow areas (TIGHT JUNCTIONS) which may limit large molecule movement.Rats, Wistar: A strain of albino rat developed at the Wistar Institute that has spread widely at other institutions. This has markedly diluted the original strain.Aorta: The main trunk of the systemic arteries.Amides: Organic compounds containing the -CO-NH2 radical. Amides are derived from acids by replacement of -OH by -NH2 or from ammonia by the replacement of H by an acyl group. (From Grant & Hackh's Chemical Dictionary, 5th ed)Arginine: An essential amino acid that is physiologically active in the L-form.Gestational Age: The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated as the time from the last day of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization.Acetylcholine: A neurotransmitter found at neuromuscular junctions, autonomic ganglia, parasympathetic effector junctions, a subset of sympathetic effector junctions, and at many sites in the central nervous system.Reference Values: The range or frequency distribution of a measurement in a population (of organisms, organs or things) that has not been selected for the presence of disease or abnormality.Oxygen Consumption: The rate at which oxygen is used by a tissue; microliters of oxygen STPD used per milligram of tissue per hour; the rate at which oxygen enters the blood from alveolar gas, equal in the steady state to the consumption of oxygen by tissue metabolism throughout the body. (Stedman, 25th ed, p346)rho-Associated Kinases: A group of intracellular-signaling serine threonine kinases that bind to RHO GTP-BINDING PROTEINS. They were originally found to mediate the effects of rhoA GTP-BINDING PROTEIN on the formation of STRESS FIBERS and FOCAL ADHESIONS. Rho-associated kinases have specificity for a variety of substrates including MYOSIN-LIGHT-CHAIN PHOSPHATASE and LIM KINASES.Rats, Inbred Strains: Genetically identical individuals developed from brother and sister matings which have been carried out for twenty or more generations or by parent x offspring matings carried out with certain restrictions. This also includes animals with a long history of closed colony breeding.Models, Biological: Theoretical representations that simulate the behavior or activity of biological processes or diseases. For disease models in living animals, DISEASE MODELS, ANIMAL is available. Biological models include the use of mathematical equations, computers, and other electronic equipment.Bronchi: The larger air passages of the lungs arising from the terminal bifurcation of the TRACHEA. They include the largest two primary bronchi which branch out into secondary bronchi, and tertiary bronchi which extend into BRONCHIOLES and PULMONARY ALVEOLI.Contrast Media: Substances used to allow enhanced visualization of tissues.Cross Circulation: The circulation in a portion of the body of one individual of blood supplied from another individual.Assisted Circulation: Pumping that aids the natural activity of the heart. (Dorland, 27th ed)Enzyme Inhibitors: Compounds or agents that combine with an enzyme in such a manner as to prevent the normal substrate-enzyme combination and the catalytic reaction.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Myocytes, Smooth Muscle: Non-striated, elongated, spindle-shaped cells found lining the digestive tract, uterus, and blood vessels. They are derived from specialized myoblasts (MYOBLASTS, SMOOTH MUSCLE).Mice, Inbred C57BLAcute Disease: Disease having a short and relatively severe course.Serotonin: A biochemical messenger and regulator, synthesized from the essential amino acid L-TRYPTOPHAN. In humans it is found primarily in the central nervous system, gastrointestinal tract, and blood platelets. Serotonin mediates several important physiological functions including neurotransmission, gastrointestinal motility, hemostasis, and cardiovascular integrity. Multiple receptor families (RECEPTORS, SEROTONIN) explain the broad physiological actions and distribution of this biochemical mediator.Heart Arrest: Cessation of heart beat or MYOCARDIAL CONTRACTION. If it is treated within a few minutes, heart arrest can be reversed in most cases to normal cardiac rhythm and effective circulation.Heart Failure: A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (VENTRICULAR DYSFUNCTION), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as MYOCARDIAL INFARCTION.Body Weight: The mass or quantity of heaviness of an individual. It is expressed by units of pounds or kilograms.Cells, Cultured: Cells propagated in vitro in special media conducive to their growth. Cultured cells are used to study developmental, morphologic, metabolic, physiologic, and genetic processes, among others.Echocardiography: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic.Angiotensin II: An octapeptide that is a potent but labile vasoconstrictor. It is produced from angiotensin I after the removal of two amino acids at the C-terminal by ANGIOTENSIN CONVERTING ENZYME. The amino acid in position 5 varies in different species. To block VASOCONSTRICTION and HYPERTENSION effect of angiotensin II, patients are often treated with ACE INHIBITORS or with ANGIOTENSIN II TYPE 1 RECEPTOR BLOCKERS.Renal Circulation: The circulation of the BLOOD through the vessels of the KIDNEY.Cardiopulmonary Resuscitation: The artificial substitution of heart and lung action as indicated for HEART ARREST resulting from electric shock, DROWNING, respiratory arrest, or other causes. The two major components of cardiopulmonary resuscitation are artificial ventilation (RESPIRATION, ARTIFICIAL) and closed-chest CARDIAC MASSAGE.

*Epoxyeicosatrienoic acid

Cause Vasodilation in the systemic arterial circulation. Cause Vasoconstriction of the Liver sinusoidal and pulmonary venous ... produced by endothelial cytochrome P-450 3A4 in monkey arterial relaxation". Hypertension Research. 26 (3): 237-43. doi:10.1291 ... ETEs are commonly produced by the stimulation of specific cell types. The stimulation causes arachidonic acid to be released ... CYP2C9, CYP2JP, and possibly the more recently characterized CYP2S1 appear to be the main produces of the EETs in humans with ...

*Decompression practice

... is reduced sufficiently that they pass through the pulmonary capillaries and reach the systemic circulation on the arterial ... A possible explanation is that during the final stage of ascent, bubbles are produced that are stopped in the lung capillaries ... Decompression stop depths are also corrected, using the ratio of surface pressures, and will produce actual stop depths which ... This procedure is based on the assumption that the decompression model will produce equivalent predictions for the same ...

*List of signs and symptoms of diving disorders

... causing pulmonary barotrauma (PBT). The air may then enter the arterial circulation producing arterial gas embolism (AGE), with ... Neuman, Tom S (2003). "10.5: Arterial Gas Embolism and Pulmonary Barotrauma". In Brubakk, Alf O; Neuman, Tom S. Bennett and ... Neuman, Tom S (2003). "10.5: Arterial Gas Embolism and Pulmonary Barotrauma". In Brubakk, Alf O; Neuman, Tom S. Bennett and ... Gas bubbles within the arterial circulation can block the supply of blood to any part of the body, including the brain, and can ...

*Diving medicine

... causing pulmonary barotrauma (PBT). The gas may then enter the arterial circulation producing arterial gas embolism (AGE), with ... Gas bubbles within the arterial circulation can block the supply of blood to any part of the body, including the brain, and can ... ISBN 1-905492-07-3. Neuman, Tom S (2003). "10.5: Arterial Gas Embolism and Pulmonary Barotrauma". In Brubakk, Alf O; Neuman, ... Pulmonary DCS is very rare in divers. If the breathing gas in a diver's lungs cannot freely escape during an ascent, the lungs ...

*Decompression practice

... is reduced sufficiently that they pass through the pulmonary capillaries and reach the systemic circulation on the arterial ... A possible explanation is that during the final stage of ascent, bubbles are produced that are stopped in the lung capillaries ... This procedure is based on the assumption that the decompression model will produce equivalent predictions for the same ... and will produce actual stop depths which are shallower than the sea level stop depths. Stop depth at altitude = Stop depth at ...

*Pathophysiology of hypertension

... and arterial aneurysm) in hypertensive persons. The endothelium of blood vessels produces an extensive range of substances that ... Angiotensin I is further cleaved by an enzyme that is located primarily but not exclusively in the pulmonary circulation bound ... Arterial baroreceptors are reset to a higher pressure in hypertensive patients, and this peripheral resetting reverts to normal ... Cardiac output and peripheral resistance are the two determinants of arterial pressure. Cardiac output is determined by stroke ...

*Methoxyflurane

Its effect on the pulmonary circulation is negligible, and it does not predispose the heart to cardiac dysrhythmias. ... Bleeding and increased arterial partial pressure of carbon dioxide (PaCO2) both induce further decreases in blood pressure, as ... In humans, methoxyflurane produces some decrease in blood pressure, but cardiac output, stroke volume, and total peripheral ... The kidney and liver toxicity observed after anesthetic doses is attributable to one or more metabolites produced by O- ...

*Vein

... where it is then pumped through the pulmonary arteries to the lungs. In pulmonary circulation the pulmonary veins return ... As the arterial blood was created 'sooty' vapors were created and passed to the lungs also via the pulmonary artery to be ... Most importantly, he argued that the beat of the heart produced a continuous circulation of blood through minute connections at ... However, in pulmonary circulation, the arteries carry deoxygenated blood from the heart to the lungs, and veins return blood ...

*Circulatory system

Systemic circulation. The systemic circulation and capillary networks shown and also as separate from the pulmonary circulation ... As the arterial blood was created 'sooty' vapors were created and passed to the lungs also via the pulmonary artery to be ... Most importantly, he argued that the beat of the heart produced a continuous circulation of blood through minute connections at ... The pulmonary circulation as it passes from the heart. Showing both the pulmonary and bronchial arteries. ...

*Respiratory alkalosis

The increased breathing produces increased alveolar respiration, expelling CO2 from the circulation. This alters the dynamic ... Acidosis Alkalosis Arterial blood gas Chemical equilibrium Hypocalcemia Metabolic acidosis Metabolic alkalosis pCO2 pH pKa ... Stress Pulmonary disorder Thermal insult High altitude areas Salicylate poisoning (aspirin overdose) Fever Hyperventilation ( ... Alkalemia refers to an arterial blood pH of greater than 7.45. Respiratory alkalosis is very rarely life-threatening, though pH ...

*Ischemia

... foreign bodies in the circulation, e.g. amniotic fluid embolism) Traumatic injury to an extremity may produce partial or total ... Acute arterial occlusion may develop as a result of arterial dissection in the carotid artery or aorta or as a result of ... The thrombi may dislodge and may travel anywhere in the circulatory system, where they may lead to pulmonary embolus, an acute ... Paralysis is a very late sign of acute arterial ischemia and signals the death of nerves supplying the extremity. Foot drop may ...

*Blood

However, one exception includes pulmonary arteries, which contain the most deoxygenated blood in the body, while the pulmonary ... which drains into the left subclavian vein where lymph rejoins the systemic blood circulation. Blood circulation transports ... Arterial blood carries oxygen from inhaled air to all of the cells of the body, and venous blood carries carbon dioxide, a ... In south East Asian popular culture, it is often said that if a man's nose produces a small flow of blood, he is experiencing ...

*Amrinone

... decreases the pulmonary capillary wedge pressure while increasing cardiac output because it functions as an arterial ... Early studies in patients with heart failure showed that amrinone produced short-term hemodynamic improvement, but had limited ... Circulation. 62: 28-34. doi:10.1161/01.cir.62.1.28. Konstam M.A.; Cohen S.R.; Weiland D.S.; Martin T.T.; Das D.; Isner J.M.; ... An increase in cAMP with the administration of amrinone in vascular smooth muscle produces vasodilation by facilitating calcium ...

*Thrombus

... and travel through the pulmonary artery, resulting in a pulmonary embolism. Arterial thrombosis resulting from hypertension or ... For example, Haementeria ghilianii, an Amazon leech, produces an enzyme called hementin from its salivary glands.[9] As of 2012 ... A venous embolus (mostly from deep vein thrombosis in the lower limbs) will travel through the systemic circulation, reach the ... Blood clot prevention and treatment reduce the risk of stroke, heart attack and pulmonary embolism. Heparin and warfarin are ...

*Thrombus

... and travel through the pulmonary artery, resulting in a pulmonary embolism. Arterial thrombosis resulting from hypertension or ... For example, Haementeria ghilianii, an Amazon leech, produces an enzyme called hementin from its salivary glands.[9] As of 2012 ... A venous embolus (mostly from deep vein thrombosis in the lower limbs) will travel through the systemic circulation, reach the ... Blood clot prevention and treatment reduce the risk of stroke, heart attack and pulmonary embolism. Heparin and warfarin are ...

*Thrombus

... and travel through the pulmonary artery resulting in a pulmonary embolism. Arterial thrombosis resulting from hypertension or ... A venous embolus (mostly from deep vein thrombosis in the lower limbs) will travel through the systemic circulation, reach the ... For example, Haementeria ghilianii, an Amazon leech, produces an enzyme called hementin from its salivary glands. As of 2012[ ... Blood clot prevention and treatment reduces the risk of stroke, heart attack and pulmonary embolism. Heparin and warfarin are ...

*Freediving blackout

Drowning can produce a gasping pattern of apnea while the heart is still beating, and ventilation alone may be sufficient, as ... The airway-breathing-circulation sequence should be followed, not starting with compressions, as the basic problem is lack of ... Suctioning of pulmonary oedema fluid should be balanced against the need for oxygenisation. The target of ventilation is to ... This is about 4% oxygen in the lungs and 45% oxygen saturation of the arterial blood. At 30 msw (4 bar), 2% by volume oxygen in ...

*Aerospace physiology

Pulmonary arterial pressure will increase even if the person is acclimated, presenting dilatation of the right side of the ... Arteriole spasms include the major part of the blood flow through the pulmonary vessels, producing a short circuit in the blood ... This means less blood reaches the heart, affecting its ability to function, with decreased circulation. The effects for ... In an altitude of 3040 meters, arterial saturation of oxygen elevates to 90%, but over this altitude arterial saturation of ...

*Nitric oxide

This is as the nitric oxide decreases the pulmonary circulation's resistance by dilating pulmonary blood vessels. The increased ... Inhaled nitric oxide appears to increase the partial pressure of arterial oxygen (PaO2) by dilating pulmonary vessels in better ... and pulmonary edema in patients with CREST syndrome. Nitric oxide is a compound produced by many cells of the body. It relaxes ... Nitric oxide/oxygen blends are used in critical care to promote capillary and pulmonary dilation to treat primary pulmonary ...

*Homeostasis

... may thrive and produce more dimethyl sulfide (DMS). The DMS molecules act as cloud condensation nuclei, which produce more ... Arterial blood pressure[edit]. Main articles: Baroreflex and Renin-angiotensin system. The brain can regulate blood flow over a ... However, when the blood circulates through the lungs a pulmonary capillary endothelial enzyme called angiotensin-converting ... through which venous blood by-passes the lungs and goes directly into the systemic circulation) have similarly high hematocrits ...

*Hypoxia (medical)

These produce a hypoxic breathing gas which can produce unconsciousness and death without symptoms. This may cause inert gas ... This is known as hypoxic pulmonary vasoconstriction, or "HPV". When the pulmonary capillary pressure remains elevated ... Polycythemia, in which the body increases the number of red blood cells in circulation, thickens the blood, raising the danger ... Oxygen diffuses from the breathed air, mixed with water vapour, to arterial blood, where its partial pressure is around 100 ...

*Thrombus

... and travel through the pulmonary artery resulting in a pulmonary embolism. Arterial thrombosis resulting from hypertension or ... For example, Haementeria ghilianii, an Amazon leech, produces an enzyme called hementin from its salivary glands.[9] As of 2012 ... A venous embolus (mostly from deep vein thrombosis in the lower limbs) will travel through the systemic circulation, reach the ... Blood clot prevention and treatment reduce the risk of stroke, heart attack and pulmonary embolism. Heparin and warfarin are ...

*Hypoxia (medical)

pulmonary gas pressures. *alveolar gas equation. *alveolar-arterial gradient. *hemoglobin. *oxygen-haemoglobin dissociation ... Arieff, Allen I. (2013). Hypoxia, Metabolic Acidosis, and the Circulation. Springer. pp. 4-5. ISBN 978-1461475422. .. ... There is reason to believe that continuous, 24-hours-per-day oxygen use in appropriately selected patients would produce a ... This is known as hypoxic pulmonary vasoconstriction, or "HPV".[33] Chronic[edit]. When the pulmonary capillary pressure remains ...

*Collateralization

They also produce NO from inducible nitric oxide synthetase (iNOS), which is essential for arteriogenesis. The bulk of new ... 2 of 7; p=0.05); (2) greater increases in pulmonary artery end diastolic pressure in those without collaterals (p=0.05); and (3 ... Schaper W, The collateral circulation of the heart, New York, N.Y.: Elsevier, 1971. Kolibash AJ, et al., "Coronary collateral ... Schaper summarizes the status-2009 knowledge of coronary collateral transformation in a recent review: "Following an arterial ...

*Drowning

Aspirated water that reaches the alveoli destroys the pulmonary surfactant, which causes pulmonary oedema and decreased lung ... Drowning can produce a gasping pattern of apnea while the heart is still beating, and ventilation alone may be sufficient, as ... The airway-breathing-circulation (ABC) sequence should be followed, rather than starting with compressions as is typical in ... This typically occurs at an arterial partial pressure of carbon dioxide of 55 mm Hg, but may differ significantly from ...

*Antiplatelet drug

They are effective in the arterial circulation, where anticoagulants have little effect.[citation needed] They are widely used ... Thrombolytic therapy is used in myocardial infarction, cerebral infarction, and, on occasion, in massive pulmonary embolism. ... Plasminogen activators (PA), tissue-type plasminogen activators (alteplase, tenecteplase) are produced by recombinant ... Treatment of established arterial thrombosis includes the use of antiplatelet drugs and thrombolytic therapy. Antiplatelet ...

*Arteriole

However, the arterioles of skeletal muscle, cardiac muscle, and pulmonary circulation vasodilate in response to these hormones ... The up and down fluctuation of the arterial blood pressure is due to the pulsatile nature of the cardiac output and determined ... Generally, norepinephrine and epinephrine (hormones produced by sympathetic nerves and the adrenal gland medulla) are ... Pulmonary arterioles are a noteworthy exception as they vasodilate in response to high oxygen. Brain arterioles are ...
1.Inhaled vasodilators such as nitric oxide and epoprostenol (prostaglandin I2) are now widely employed as supportive therapies to improve oxygenation and reduce pulmonary vascular resistance in patients with acute and chronic pulmonary hypertension. However, few data exist concerning their effects in normal individuals. The aim of this study was to characterize the response of the pulmonary circulation in normal individuals to inhaled nitric oxide and nebulized prostaglandin I2.. 2.Eight healthy volunteers were exposed to inhaled nitric oxide (0, 20 and 40 ;p.p.m.) and nebulized prostaglandin I2 (10 ;μg/ml). Changes in effective pulmonary blood flow and diffusing capacity of the lung for carbon monoxide (TLCO) were measured using respiratory mass spectrometry. Bicycle ergometry was used to increase effective pulmonary blood flow as a positive control.. 3.Exercise produced significant ...
Pulmonary capillary blood flow was measured in man during slow breathing by a modification of the body plethysmograph technique for measuring N2O uptake. In seated subjects breathing slowly, flow was significantly higher during inhalation. In supine subjects whose legs were raised, the difference between inhalation and exhalation was not significant. Flow was usually greater during tidal inhalation than exhalation, but there was considerable variation. The changes in flow were not directly related to intrathoracic pressures or lung volumes. The results suggest that it is the amount and pressure of the venous blood available for aspiration into the thorax that influences pulmonary capillary blood flow during the course of a respiratory cycle.. ...
TY - JOUR. T1 - Effects of S-nitrosation and cross-linking of hemoglobin on hypoxic pulmonary vasoconstriction in isolated rat lungs. AU - Deem, Steven. AU - Kim, Joung Uk. AU - Manjula, Belur N.. AU - Acharya, A. Seetharama. AU - Kerr, Mark E.. AU - Patel, Rakesh P.. AU - Gladwin, Mark T.. AU - Swenson, Erik R.. PY - 2002/10/4. Y1 - 2002/10/4. N2 - Free hemoglobin (Hb) and red blood cells augment hypoxic pulmonary vasoconstriction (HPV) by scavenging nitric oxide (NO). S-nitrosation of Hb (SNO-Hb) may confer vasodilatory properties by allowing release of NO during deoxygenation and/or by interaction with small-molecular weight thiols. Likewise, cross-linking of free Hb may limit its vasoconstrictive effect by preventing abluminal movement of the molecule. We compared the effects of free SNO-Hb and Hb intramolecularly cross-linked at the β-cysteine 93 residue [Bis(maleidophenyl)-polyethylene glycol2000HbA (Bis-Mal-PEGHb)] to those of free oxyHb on pulmonary ...
Apparatus and methods for non-invasively determining the cardiac output or pulmonary capillary blood flow of a patient using partial re-breathing techniques. The apparatus includes a substantially instantaneously adjustable deadspace volume for accommodating differences in sizes or breathing capacities of various patients. The apparatus may be constructed of inexpensive elements, including one or more two-way valves, which render the apparatus very simple to use and inexpensive so that the unit may be employed as a disposable product. The method of the invention includes estimating the cardiac output or pulmonary capillary blood flow of a patient based on partial pressure of alveolar CO2 rather than on the partial pressure of end tidal CO2, as previously practiced. A computer program for calculating the cardiac output or pulmonary capillary blood flow of a patient is also disclosed.
TY - JOUR. T1 - Effect of catecholamines on pulmonary circulation at elevated vascular tone. AU - Barman, Scott A. PY - 1995/1/1. Y1 - 1995/1/1. N2 - The effect of catecholamine stimulation on the longitudinal resistance and compliance distribution in the canine pulmonary vasculature was evaluated under control vascular tone and after vascular tone was elevated using the thromboxane analogue U-46619. The arterial-, venous-, and double-occlusion techniques were used to measure the segmental resistances and compliances in isolated dog lung blood perfused at constant flow. The results of this study indicate that at control vascular tone the catecholamines norepinephrine and epinephrine increase pulmonary vascular resistance and decrease pulmonary vascular compliance through α1- and α2-receptor-mediated stimulation with precapillary α1- and α2-receptors and postcapillary ...
Looking for pulmonary circulation? Find out information about pulmonary circulation. The circulation of blood through the lungs for the purpose of oxygenation and the release of carbon dioxide. Also known as lesser circulation Explanation of pulmonary circulation
In isolated blood-perfused rat lungs, brief periods of ventilation hypoxia (2% O2) produce pulmonary vasoconstriction. In isolated lungs perfused with a salt-albumin solution, hypoxia produces no pulmonary vasoconstrictor responses in most preparations and only minimal responses in others. Vasoactive agents including angiotensin II, phenylephrine, epinephrine, norepinephrine, bradykinin, histamine, serotonin, and methoxamine were added to the salt-albumin perfusate to determine which substance, if any, was necessary for a pulmonary vasoconstrictor response during hypoxia. The addition of angiotensin II (12-120 nM) to the perfusate during hypoxia resulted in marked pulmonary vasoconstriction in proportion to the amount of angiotensin II added (a maximal response to hypoxia occurred with 120 nM angiotensin II). None of the other agents had the same effect, nor was their vasoactivity dependent on angiotensin II. Angiotensin II augmented the ...
TY - JOUR. T1 - Endothelin B receptor deficiency potentiates ET-1 and hypoxic pulmonary vasoconstriction. AU - Ivy, D. Dunbar. AU - Mcmurtry, Ivan F.. AU - Yanagisawa, Masashi. AU - Gariepy, Cheryl E.. AU - Le Cras, Timothy D.. AU - Gebb, Sarah A.. AU - Morris, Kenneth G.. AU - Wiseman, Richard C.. AU - Abman, Steven H.. PY - 2001/5. Y1 - 2001/5. N2 - Endothelin (ET)-1 contributes to the regulation of pulmonary vascular tone by stimulation of the ETA and ETB receptors. Although activation of the ETA receptor causes vasoconstriction, stimulation of the ETB receptors can elicit either vasodilation or vasoconstriction. To examine the physiological role of the ETB receptor in the pulmonary circulation, we studied a genetic rat model of ETB receptor deficiency [transgenic(sl/sl)]. We hypothesized that deficiency of the ETB receptor would predispose the transgenic(sl/sl) rat lung circulation to ...
TY - CHAP. T1 - Development of the Pulmonary Endothelium in Development of the Pulmonary Circulation. T2 - Vasculogenesis and Angiogenesis. AU - Schwarz, Margaret. AU - Cleaver, Ondine B.. PY - 2009/9/11. Y1 - 2009/9/11. KW - Angiogenesis and vasculogenesis in developing lung. KW - Arterial versus venous differentiation. KW - Blood islands and hemangioblasts. KW - Endothelial-specific factors. KW - Pulmonary endothelium and pulmonary circulation. KW - Sprouting angiogenesis. KW - Tubulogenesis. KW - Vascular cell ontogeny. KW - Vasculogenesis. KW - VEGF-A and isoforms. UR - http://www.scopus.com/inward/record.url?scp=84889270740&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=84889270740&partnerID=8YFLogxK. U2 - 10.1002/9780470747490.ch1. DO - 10.1002/9780470747490.ch1. M3 - Chapter. AN - SCOPUS:84889270740. SN - ...
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BACKGROUND: Hypoxic pulmonary vasoconstriction (HPV) is a defense mechanism to maintain adequate oxygenation. It has been reported that metabolism inhibition augments HPV. The purpose of the present study was, therefore, to determine the effect of metabolism inhibition on HPV in a rabbit model of isolated lung perfusion with exclusion of the influential factors on HPV. METHODS: In adult rabbits, lungs were isolated and perfused with a constant pulmonary perfusate flow. Acid-base status and temperature of perfusate was also constantly maintained. Thirty minutes after, the baseline hypoxic pressor response (HPR) was measured as the difference of pulmonary artery pressure (PAP) between a period of 21% normoxic gas inhalation and that of 3% hypoxic gas inhalation. After another thirty minutes, 2-deoxy-D-glucose 100 mg was mixed with the perfusate, and then HPR was measured three times. After checking metabolism inhibition effects, D-glucose 300 mg was mixed to ...
TY - JOUR. T1 - Effect of dihomo-gamma-linolenic acid on the canine pulmonary vascular bed.. AU - Hyman, A. L.. AU - Spannhake, Ernst W. AU - Chapnick, B. M.. AU - McNamara, D. B.. AU - Mathe, A. A.. AU - Kadowitz, P. J.. PY - 1978/2. Y1 - 1978/2. N2 - The effect of dihomo-gamma-linolenic acid (DGLA), the precursor of the monoenoic prostaglandins (PG), F1alpha and E1, on the pulmonary vascular bed of the intact dog was studied under conditions of controlled pulmonary blood flow. DGLA increased pulmonary vascular resistance in a dose-related manner by constricting intrapulmonary veins and upstream segments, presumably pulmonary arteries. Intrapulmonary injection of DGLA also increased transpulmonary injection of DGLA also increased transpulmonary airway pressure, presumably by increasing airway resistance and decreasing lung compliance or both. The ...
TY - JOUR. T1 - Effect of ablated bronchial blood flow on survival rate and pulmonary function after burn and smoke inhalation in sheep. AU - Hamahata, Atsumori. AU - Enkhbaatar, Perenlei. AU - Hiroyuki, Sakurai. AU - Nozaki, Motohiro. AU - Traber, Daniel L.. PY - 2009/9. Y1 - 2009/9. N2 - The bronchial circulation plays a significant role in the pathophysiological changes of burn and smoke-inhalation injury. Bronchial blood flow markedly increases immediately after inhalational injury. This study examines whether the ablation of the bronchial artery attenuates pathophysiological changes and improves survival after burn and smoke-inhalational injury in an ovine model. Acute lung injury was induced by 40% total body surface-area third-degree cutaneous burn and cotton smoke inhalation (48 breaths of cotton smoke, ,40 °C) under deep anaesthesia. Twelve adult female sheep were divided into two groups: (1) sham (injured, non-ablated bronchial artery, n = 6); (2) ...
Although these findings are interesting, they deserve some comments. First, whereas indexing EVLW to PBW may reduce the number of patients with acute respiratory distress syndrome (ARDS) with normal EVLW, in this population, the EVLW/ABW index performed best [2]. Furthermore, the absence of a link between EVLW and PaO2/FiO2 (calculated r2 of 0.14 to 0.23) could explain that these indices identified only 33% of ALI and 38% of ARDS cases. Second, the EVLW/PBV terminology appears very unusual. The transpulmonary thermodilution technique determines cardiac output, intrathoracic thermal volume (ITTV), pulmonary thermal volume (PTV) and global end-diastolic volume (Global end-diastolic volume (GEDV) = ITTV - PTV). The estimated blood volume of the chest (Intrathoracic blood volume (ITBV) = GEDV + PBV) permits the calculation of PBV (ITBV = 1.25 × GEDV - 28.4 ml) [3]. Importantly, the PiCCO monitor automatically provides, at each calibration, an estimation of the ...
The time course of the pulmonary vascular response to hypoxia in humans has not been fully defined. In this investigation, study A was designed to assess the form of the increase in pulmonary vascular tone at the onset of hypoxia and to determine whether a steady plateau ensues over the following approximately 20 min. Twelve volunteers were exposed twice to 5 min of isocapnic euoxia (end-tidal Po(2) = 100 Torr), 25 min of isocapnic hypoxia (end-tidal Po(2) = 50 Torr), and finally 5 min of isocapnic euoxia. Study B was designed to look for the onset of a slower pulmonary vascular response, and, if possible, to determine a latency for this process. Seven volunteers were exposed to 5 min of isocapnic euoxia, 105 min of isocapnic hypoxia, and finally 10 min of isocapnic euoxia. For both studies, control protocols consisting of isocapnic euoxia were undertaken. Doppler echocardiography was used to measure cardiac output and the maximum tricuspid pressure gradient ...
In patients with one anatomical or functional ventricular chamber, which encompasses a spectrum of rare and complex congenital cardiac malformations, a staged surgical approach in view of an ultimate Fontan operation has become the procedure of choice. Especially in the earlier era, perioperative mortality was the leading cause of death. However, many patients have a long and high-quality life, continuously improved by a better understanding of Fontan hemodynamics and the refinement of the surgical procedures. Nevertheless, the prospect of eventual failure of the Fontan circulation remains a major concern. More specifically, evaluation of the pulmonary circulation becomes particularly important as the failing Fontan circulation has become a common indication for cardiac transplantation. Although essential, especially in the preoperative setting, a comprehensive evaluation of the ...
TY - JOUR. T1 - Chronic endothelin A receptor blockade in lambs with increased pulmonary blood flow and pressure. AU - Fratz, Sohrab. AU - Meyrick, Barbara. AU - Ovadia, Boaz. AU - Johengen, Michael J.. AU - Reinhartz, Olaf. AU - Azakie, Anthony. AU - Ross, Greg. AU - Fitzgerald, Robert. AU - Oishi, Peter. AU - Hess, John. AU - Black, Stephen M.. AU - Fineman, Jeffrey R.. PY - 2004/9/1. Y1 - 2004/9/1. N2 - Endothelin receptor blockade is an emerging therapy for pulmonary hypertension. However, hemodynamic and structural effects and potential changes in endogenous nitric oxide (NO)-cGMP and endothelin-1 signaling of chronic endothelin A receptor blockade in pulmonary hypertension secondary to congenital heart disease are unknown. Therefore, the objectives of this study were to determine hemodynamic and structural effects and potential changes in endogenous NO-cGMP and endothelin-1 signaling of chronic endothelin A receptor blockade in a lamb model of ...
Radionuclide lung perfusion imaging was performed on 27 patients with valvular disease of the left heart. The ratio of upper to total counts for the lungs, determined by computer, was correlated against pulmonary vascular mean pressures. A close correlation (r = 0.91) was obtained against pulmonary wedge pressure. After corrective cardiac surgery upper/total ratios fell towards normal in four patients in whom pulmonary vascular pressures were measured and the correlation persisted. This simple non-invasive index can be used to follow changes in pulmonary venous hypertension. ...
In primary pulmonary hypertension, the cause is unknown, but the abnormal changes associated with blood vessels in the lungs. Secondary pulmonary hypertension is a complication of many diseases of the lungs, heart and chest cavity. Cor pulmonale is a consequence of prolonged high blood pressure in the pulmonary circulation in which the right ventricle has become enlarged. Right ventricle is relatively thin and have limited ability to appreciate, therefore, the right side of the heart could begin to fail if blood pressure in the pulmonary circulation are persistently high. It occurs when the right-sided heart failure ...
Apart from the numbness and tingling that is common in hands and feet, one can also feel the feet turning cold or the skin being affected with too many infections. Another complication called claudication may happen where the calf muscles are cramped while walking. The skin color changing to blue and red are all indications of poor blood circulation problems.. The first thing to do would be to consult a doctor. Those suffering with peripheral vascular disease or heart disease must ensure that their blood pressure levels are monitored often. Apart from these reducing cholesterol content in the body is of utmost importance by reducing intake of greasy foods. One must quit smoking , and consuming alcohol as these are amongst the main causes of poor blood circulation.. If there are infections on the feet, they must be treated as early as possible to ensure that they dont spread. Strangely enough even accidents and mental trauma can lead to poor ...
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Some of the chemical and physico-chemical characteristics of the respiratory blood pigment chlorocruorin have been dealt with in previous papers (H. M. Fox, 1926, 1932). An experimental investigation is described below of the blood circulation in sabellids and serpulids. These polychæte worms have chlorocruorin in solution in their blood plasma. The work was done in part in the Marine Biological Laboratories of Banyuls, Plymouth, and Tamaris, and my sincere thanks are due to the Directors and staffs of these institutions for their welcom and help. 1. The Normal Blood Circulation. In sabellids and serpulids both the anatomy of the blood system and the mode of blood circulation are peculiar and different from those in other polychæte worms. The best description of the anatomy of the blood system is that of Meyer (1888) ...
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Centers RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.. ...
TY - JOUR. T1 - Effect of Sildenafil on the acute pulmonary vasodilator response to inhaled nitric oxide in adults with primary pulmonary hypertension. AU - Lepore, John J.. AU - Maroo, Anjli. AU - Pereira, Naveen Luke. AU - Ginns, Leo C.. AU - Dec, G. William. AU - Zapol, Warren M.. AU - Bloch, Kenneth D.. AU - Semigran, Marc J.. PY - 2002/9/15. Y1 - 2002/9/15. UR - http://www.scopus.com/inward/record.url?scp=0037106989&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=0037106989&partnerID=8YFLogxK. U2 - 10.1016/S0002-9149(02)02586-9. DO - 10.1016/S0002-9149(02)02586-9. M3 - Article. C2 - 12231108. AN - SCOPUS:0037106989. VL - 90. SP - 677. EP - 680. JO - American Journal of Cardiology. JF - American Journal of Cardiology. SN - 0002-9149. IS - 6. ER - ...
We will use a method to analyze the length-scale of perfusion heterogeneity before and after surgery for CTEPH. Briefly, this method consists of filtering the images with filters of different spatial size (length, mm) and measuring the coefficient of variation (CV) of perfusion in the imaged field. We then bin the CV into the following intervals: 12-36 mm, 36-60 mm, 60-84 mm, 84-108 mm and ,108 mm and compare the CV in each bin among subjects ...
Pulmonary Circulations first Impact Factor will be released in June 2017. Since its launch in 2011, our journal has become established as a unique venue of communication for clinical, translational and basic research in the fields of pulmonary circulation and pulmonary vascular disease.
Although electrocardiographic evidence of right ventricular hypertrophy is considered common in newborn infants with coarctation of the aorta, the reason for this finding is not well established. Investigations of the pulmonary vascular bed of these infants have resulted in variable findings, probably due to the differences in morphometric techniques, coexisting cardiac defects, and variable postnatal age at time of death. To study more carefully the pulmonary vascular bed, we produced coarctation of the aorta in fetal lambs at 103--126 days gestation. Twelve to 32 days later the fetuses were reoperated on and systemic and pulmonary arterial blood pressures, and arterial blood gas tensions were determined to be normal. At autopsy, juxtaductal coarctations extended a mean of 2.8 mm into the aortic lumen and occupied 9.5 mm of the aortic circumference. The fifth-generation ...
Background Bile-duct ligated (BDL) rats recruit pulmonary intravascular macrophages (PIMs) and are highly susceptible to endotoxin-induced mortality. The mechanisms of this enhanced susceptibility and...
TY - JOUR. T1 - Perfusion heterogeneity in the pulmonary acinus. AU - Tanabe, Nobuhiro. AU - Todoran, Thomas M.. AU - Zenk, Gerald M.. AU - Bunton, Brenda R.. AU - Wagner, Wiltz W.. AU - Presson, Robert. PY - 1998/3. Y1 - 1998/3. N2 - There is little information on the distribution of acinar perfusion because it is difficult to resolve blood flow within such small regions. We hypothesized that the known heterogeneity of arteriolar blood flow and capillary blood flow would result in heterogeneous acinar perfusion. To test this hypothesis, the passage of fluorescent dye boluses through the subpleural microcirculation of isolated dog lobes was videotaped by using fluorescence microscopy. As the videotapes were replayed, dye-dilution curves were recorded from each of the tributary branches of Y-shaped venules that drained an acinus. From the dye curves, we calculated the mean appearance time of each curve. The difference in mean appearance times between venular ...
Sleep apnea (SA) affects as many as 20% of the adult population in the United States. It elicits intermittent hypoxia (IH) and causes pulmonary hypertension (PH), however the mechanisms of this PH have not been well studied. IH has been shown to cause polycythemia, pulmonary vascular remodeling and increases in vasoconstrictor reactivity. CO2 supplementation may be protective in the development of PH, therefore we assessed effects of IH with and without CO2 supplementation on indices of PH and pulmonary vasoconstrictor reactivity. IH with CO2 supplementation resulted in eucapnic IH (E-IH) and the lack of polycythemia or vascular remodeling. However, E-IH caused significant right ventricular hypertrophy and increased pulmonary vasoconstrictor reactivity, which was mediated by vascular smooth muscle (VSM) Ca2+ sensitization. We, therefore, sought to determine the mechanism of this enhanced vasoconstrictor reactivity by assessing ...
The purpose of this study is to determine and compare changes in lung diffusing capacity, cardiac output, and pulmonary vascular pressures during exercise for younger versus older individuals. It is possible that the blood vessels of the lungs play a greater role in unexplained exercise intolerance and shortnesss of breath in older individuals than previously thought.. ...
材料. 当归,北耆,川芎,玉竹,红枣,党参. 可供素食. 保存方法:置于冰箱中冷藏. 净重: 75g. Additional Info. What exactly is it with the necessity to increase blood circulation or mores to the stage, what it really blood circulation exactly? Well, place in laymans terms, its this is the movement of blood with the body. A little more detail is the fact that blood circulation happens when the blood moves round the body inside what is known the blood circulation system. The blood circulation system consists of blood ships (otherwise known as arterial blood vessels), veins and capillary vessels. Our heart continuously pumps the blood through our ships before the day we die or encounter serious problems.. A few of the common signs and symptoms of poor blood circulation can include tingling sensation or numbness of ...
Major aortopulmonary collateral arteries (or MAPCAs) are arteries that develop to supply blood to the lungs when native pulmonary circulation is underdeveloped. Instead of coming from the pulmonary trunk, supply develops from the aorta and other systemic arteries. Major aortopulmonary collateral arteries (MAPCAs) develop early in embryonic life but regress as the normal pulmonary arteries (vessels that will supply deoxygenated blood to the lungs) develop. In certain heart conditions the pulmonary arteries do not develop. The collaterals continue to grow, and can become the main supply of blood to the lungs. Though it is usually associated with congenital heart diseases with decreased pulmonary blood flow like tetralogy of Fallot or pulmonary atresia it may be seen sometimes in isolation i.e. not associated with any congenital heart disease ...
Hypercapnia has been shown in animal experiments to induce pulmonary hypertension. This study measured the sensitivity and time course of the human pulmonary vascular response to sustained (4 h) hypercapnia and hypocapnia. Twelve volunteers undertook three protocols: 1) 4-h euoxic (end-tidal Po(2) = 100 Torr) hypercapnia (end-tidal Pco(2) was 10 Torr above normal), followed by 2 h of recovery with euoxic eucapnia; 2) 4-h euoxic hypocapnia (end-tidal Pco(2) was 10 Torr below normal) followed by 2 h of recovery; and 3) 6-h air breathing (control). Pulmonary vascular resistance was assessed at 0.5- to 1-h intervals by using Doppler echocardiography via the maximum tricuspid pressure gradient during systole. Results show progressive changes in pressure gradient over 1-2 h after the onset or offset of the stimuli, and sensitivities of 0.6 to 1 Torr change in pressure gradient per Torr change in end-tidal Pco(2). The human pulmonary circulatory ...
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Blood flow between these two vascular beds may not always be equal. If a state occurs in which pulmonary vascular resistance increases or systemic vascular resistance decreases blood will preferentially shift to the peripheral circulation at the expense of blood flow to the lungs. This is the pathophysiology behind the hypercyanotic spell ("Tet spell") seen in children with tetralogy of Fallot and similar lesions. Increases in systemic vascular resistance or decreases in pulmonary vascular resistance will produce the opposite effect shunting blood to the pulmonary circulation at the expense of peripheral perfusion.. This may occur when a childs baseline state of hypoxic pulmonary hypertension is suddenly reversed with additional oxygen or assisted ventilations that decrease avelolar carbon dioxide concentrations.. In the patient presented, a univentricular heart distributed ...
Introduction: Severe chronic obstructive pulmonary disease (COPD) is often associated with secondary pulmonary hypertension (PH), which worsens prognosis. PH can be lowered by oxygen, but also by inhaled nitric oxide (NO), which has the potential to improve the health status of these patients. NO is an important mediator in vascular reactions in the pulmonary circulation. Oral compounds can act through NO-mediated pathways, but delivering pulsed inhaled NO (iNO) directly to the airways and pulmonary vasculature could equally benefit patients. Therefore, a proof-of-concept study was performed to quantify pulmonary blood vessel caliber changes after iNO administration using computed tomography (CT)-based functional respiratory imaging (FRI). Methods: Six patients with secondary PH due to COPD received "pulsed" iNO in combination with oxygen for 20 minutes via a nasal cannula. Patients ...
We investigated the possible contributions of reactive oxygen species and of viscosity changes to hemodilution-induced inhibition of hypoxic pulmonary vasoconstriction (HPV) in dogs. Fourteen isoflurane-anesthetized dogs were randomly assigned to receive N-acetylcysteine (NAC) 200 mg/kg IV (n = 7) or placebo (n = 7). Mean pulmonary artery pressure (Ppa) was measured with cardiac output maintained constant by a manipulation of venous return in hyperoxia (fraction of inspired oxygen, 0.4) and in hypoxia (fraction of inspired oxygen, 0.1) at baseline and after stepwise reductions in hematocrit from 40% to 20%. Measured Ppa was compared with predicted Ppa by using a viscoelastic model. HPV was expressed as hypoxic Ppa minus hyperoxic Ppa. Hemodilution was associated with a decrease in HPV from 7 ± 1 mm Hg to 3 ± 1 mm Hg (P , 0.01), and this was completely prevented by NAC (HPV was unchanged, from 8 ± 1 to 8 ± 1 mm Hg; not significant). Hemodilution in the model decreased HPV ...
Persistent fetal circulation (also called Persistent Pulmonary Hypertension of the Newborn, PPHN) is a condition caused by a failure in the systemic circulation and pulmonary circulation to convert from the antenatal circulation pattern to the "normal" pattern. In a fetus, there is high pulmonary vascular resistance and low pulmonary blood flow as the fetus does not use the lungs for oxygen transfer. When the baby is born, the lungs are needed for oxygen transfer and need high blood flow which is encouraged by low pulmonary vascular resistance. It can be associated with pulmonary hypertension. Because of this, the condition is also widely known as Persistent Pulmonary Hypertension of the Newborn (PPHN). This has a good prognosis, as it is reversible. Causes ...
The strong link between blood circulation and exercise is simply another fabulous reason to exercise - in addition to weight loss and other health benefits. Indeed, when we exercise for circulation , we are certain to increase our energy
There are some controversies regarding the usefulness of leaving additional pulmonary blood flow when establishing a bidirectional cavopulmonary shunt. From April 2002 to September 2008, 13 patients (mean age, 24 +/- 16 months) underwent a bidirectio
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An extracorporeal support system including an extracorporeal support apparatus and an arterial circulation support catheter. The arterial circulation support catheter includes a blood lumen with a proximal end coupled to extracorporeal support apparatus and a distal end inserted into the blood circulation. A vent lumen has a distal end that crosses the aortic valve into the left ventricle and provides direct venting of the left ventricle through the vent lumen. An arterial circulation support catheter occluding member is positioned either in an interior or at an exterior of the arterial circulation support catheter. A venous circulation support catheter is provided and ...
OBJECTIVE Significant and balanced pulmonary artery (PA) growth following arterial duct (AD) stenting has already been reported in literature. However, no data are so far available about the role of this percutaneous approach in promoting PA growth in the case of congenital heart disease (CHD) with completely duct-dependent pulmonary blood flow (CDD-PBF). Aim of this study was to evaluate the effect of AD stenting in this pathophysiological setting. METHODS PA growth was evaluated as Nakata index and McGoon ratio as well as individual PA z-score changes in 49 patients submitted to neonatal AD stenting according to their pathophysiology (CDD-PBF (n=15) versus multiple PBF sources (n=34)). RESULTS Control angiography was performed 7.2±6.4 months (range 1-8, median 6) after AD stenting. In the whole population, significant and balanced PA growth was recorded (Nakata index+122±117%; left pulmonary artery (LPA) z-score ...
Video articles in JoVE about pulmonary circulation include Induction and Characterization of Pulmonary Hypertension in Mice using the Hypoxia/SU5416 Model, Surgical Placement of Catheters for Long-term Cardiovascular Exercise Testing in Swine, Videomorphometric Analysis of Hypoxic Pulmonary Vasoconstriction of Intra-pulmonary Arteries Using Murine Precision Cut Lung Slices, 2-Vessel Occlusion/Hypotension: A Rat Model of Global Brain Ischemia, Induction of Right Ventricular Failure by Pulmonary Artery Constriction and Evaluation of Right Ventricular Function in Mice, Synthesis, Functionalization, and Characterization of Fusogenic Porous Silicon Nanoparticles for Oligonucleotide Delivery, The Left Pneumonectomy Combined with Monocrotaline or Sugen as a Model of Pulmonary Hypertension in Rats, Induction and Phenotyping of Acute Right Heart Failure in a Large Animal Model of ...
1. Overall mean pulmonary arterial pressure (MPAP)/cardiac index (CI) relationships were investigated in 13 pentobarbital anaesthetized dogs ventilated consecutively with a fraction of inspired O2 (F1o2) of 0.4 and with a F1o2 of 0.1. This sequence of alternated F1o2 0.4 and F1o2 0.1 was repeated (1) in the dogs with a strong pulmonary pressor response to hypoxia (more than 20% increase in pulmonary vascular resistance) (n = 6) under a continuous infusion of the leukotriene receptor blocker FPL 57231 (2 mg min−1 kg−1), and (2) in the dogs with a weak pressor response to hypoxia (n = 7) after cyclo-oxygenase inhibition by acetylsalicylic acid (1 g intravenously). Five-point MPAP/CI plots were constructed by opening a femoral arteriovenous fistula or by stepwise inflations of an inferior vena cava balloon catheter. The MPAP/CI plots were rectilinear in all experimental conditions.. 2. In responders, hypoxia was associated with ...
More than any other chronic respiratory disease, asthma is characterized by functional and clinical variability: expiratory flow obstruction, dyspnoea and wheezing may be absent, mild, or severe. Moreover, pulmonary gas exchange often does not closely relate to measured airway obstruction. Accordingly, the correlation between arterial oxygen tension and airflow (Pa,O2) rate indices of obstruction is poor, both in a single patient over time, and within groups of clinically similar patients. Here, these concepts are extended by examining relationships between airflow obstruction and gas exchange across the clinical spectrum of asthma (from asymptomatic to acute severe). Six individual studies encompassing 86 patients are analysed together, focusing on: 1) airways obstruction; 2) arterial blood gas data; and 3) the distribution of alveolar ventilation/perfusion (VA/Q) ratios, measured by the multiple inert gas elimination ...
Neither of the catecholamines affected blood flow distribution unfavorably. Although both catecholamines increased coronary blood flow, this increase can never account for the increase in systemic blood flow, because coronary blood flow expressed as a percentage of systemic blood flow (about 8% in the lambs with shunt) did not change. Because isoproterenol did not change cerebral, renal or splanchnic blood flow, blood flow to the carcass will have been increased. In the lambs with shunt there was no need for an increase in blood flow, because blood flow to the vital organs at rest (except for the heart) was the same in the lambs with shunt and in the control lambs. It remains unclear how isoproterenol affects blood flow distribution when blood flow to the vital organs is jeopardized. Unfortunately, the lambs with shunt in whom that happened died before a proper study could be done. Despite the fact that systemic blood flow was the same in the lambs with shunt and the control lambs, we think our ...
TY - JOUR. T1 - Navigating the Pulmonary Perfusion Map. T2 - Dual-Energy Computed Tomography in Acute Pulmonary Embolism. AU - Alis, Jonathan. AU - Latson, Larry A.. AU - Haramati, Linda B.. AU - Shmukler, Anna. PY - 2018/11/1. Y1 - 2018/11/1. N2 - Pulmonary embolism is the third most common acute cardiovascular disease. Dual-energy computed tomography perfusion imaging is a promising adjunct in the detection of acute PE providing simultaneous functional assessment of pulmonary perfusion alongside the high-resolution morphological information from computed tomography pulmonary angiography. We review the evidence to date and common causes of perfusion defects including artifacts, parenchymal, and vascular causes, and discuss its potential in furthering our understanding of physiology and pathophysiology in acute pulmonary embolism.. AB - Pulmonary embolism is the third most common acute ...
BACKGROUND AND AIMS: Newer studies suggest that carvedilol, a beta-blocker with a moderate anti-alpha-1 activity, is superior to propranolol in reducing the portal pressure and risk of variceal bleeding. The effect on arterial blood pressure is a matter of concern especially in decompensated patients. AIMS: to assess potential differential effects of beta-blockers and beta-blockers with moderate anti-alpha-1 activity on selected haemodynamic, humoral, and respiratory characteristics in cirrhosis. METHODS: Patients with cirrhosis and portal hypertension were randomised to receive carvedilol (n=16) or propranolol (n=13). Cardiac, systemic and splanchnic parameters along with oxygen saturation and plasma renin were measured at inclusion and after 3 months. RESULTS: Arterial blood pressure, heart rate, and cardiac output decreased equally, central circulation time and systemic vascular resistance increased ...
Two-dimensional suprasternal notch echocardiograms of the right pulmonary artery were obtained in 50 normal infants and children to determine the right pulmonary artery diameter. An excellent nonlinear correlation between the right pulmonary artery diameter (RPA) in cm and body surface area (BSA) in m2was observed: RPA (systole) = 1.41 (BSA)051, r = 0.94 and RPA (diastole) = 1.28 (BSA)0.52, r = 0.93. These data were utilized to calculate the normal range (3rd and 97th percentiles) of right pulmonary artery diameter as a function of body surface area. The right pulmonary artery diameter was also measured in 37 patients with tetralogy of Fallot, 30 patients with a secundum atrial septal defect and 12 patients with pulmonary valve insufficiency of various causes. Pulmonary artery diameter was less than the 3rd percentile for body surface area in 16 of the 37 patients with tetralogy of Fallot, ...
Chronic up-regulation of hypoxic pulmonary vasoconstriction is also the primary mechanism for pulmonary hypertension due to long-term exposure to high altitude. This is best exemplified by the yak, native to the Himalayan region of Central Asia, compared with domestic cattle native to the lowlands, when exposed to long-term high altitude (,2,500 m). Yaks have adapted to life in high altitude by blunting pulmonary vasoconstriction in response to chronic hypoxia, which allows them to maintain low pulmonary arterial pressure. Unlike the yak, when domestic cattle native to the lowlands are exposed to long-term high altitude, they exhibit substantial hypoxic pulmonary vasoconstriction resulting in pulmonary vascular remodeling, pulmonary hypertension, peripheral edema (neck swelling), right-sided heart failure, and eventually death; a phenomenon known as brisket ...
Scleroderma (especially CREST syndrome). Mixed connective tissue disease Systemic lupus erythematosus Rheumatoid arthritis Dermatomyositis. Which occurs more frequently, primary or secondary pulmonary hypertension?. Primary (unexplained) pulmonary hypertension is a rare disorder. Secondary pulmonary hypertension is seen considerably more often in practice.. What population group is most frequently affected by primary pulmonary hypertension?. Although primary pulmonary hypertension occurs in both sexes and virtually all age groups, it has a tendency to affect young females. The female-to-male predominance is 1.7:1, and the mean age is 36 years.. Is surgical therapy now an option for patients with pulmonary hypertension secondary to chronic recurrent thromboembolism?. Appropriate prevention of recurrent thromboembolism continues to be extremely important. In addition to this prevention, it is now possible to ...
The mismatching of alveolar ventilation and perfusion (VA/Q) is the major determinant of impaired gas exchange. The gold standard for analyzing VA/Q distribution is the multiple inert gas elimination technique (MIGET), conventionally based on gas chromatography (GC), and, although simple in principle, a technically demanding procedure limiting its use. A new technique based on micropore membrane inlet mass spectrometry (MMIMS) combined MIGET with mass spectrometry, simplifying the sample handling process, and potentially providing VA/Q distributions for a general clinical approach.. The kinetics of volatile anesthetics are well known in patients with healthy lungs. The uptake and distribution of inhaled anesthetics have usually been modeled by physiologic models. However, these models have limitations, and they do not consider ventilation/perfusion matching. Respiratory diseases account for a large part of morbidity and mortality and are associated with pulmonary VA/Q mismatch that may ...
Isolated unilateral absence of the right pulmonary artery without any intracardiac anomaly is a rare congenital cardiovascular disorder. We performed a successful surgical reconstruction with autologous tissue of this anomaly. The patient was a 1-month-old boy who had been transferred to our center at 3 days of age because of tachypnea and heart murmur. Multi-detector CT and radial angiography imaging revealed isolated unilateral absence of the right pulmonary artery and left patent ductus arteriosus. Conservative treatment did not help his progressive heart failure and pulmonary hypertension due to an acute increase of pulmonary blood flow. Therefore surgical correction was determined to avoid the worsening of those symptoms. Under cardiopulmonary bypass, the right pulmonary artery branching off from the brachiocephalic artery was removed and anastomosed to the main pulmonary artery with an ...
The smooth circulation of blood is essential for our health. Circulation of blood is produced by the good cooperation between the heart, blood, blood vessel and other components. When interference occurs on one component, then the blood circulation will be disrupted. The result, the blood supply is insufficient and needs further can cause heart attack,…
Great circulation enhances Oxygen by means of the human body, which is healthier for your coronary heart and strengthens the vessels that need the oxygen. This also enhances energy levels. Lower blood circulation like when you are unwell tends to fall the sum of energy you have and can even convey on fatigue. Apart from that, the more difficult the coronary heart has to work, the much more pressure it areas on the organ so very good blood circulation keeps the coronary heart in peak condition-or at the very least as very good as it can be. The legs and the ft have to have a good deal of work to acquire very good blood circulation, which is enhanced by means of the kickboxing things to do. In addition, healthier blood circulation enhances mobile advancement capabilities and general organ health, as perfectly as healthier skin tone. Last of ...
Blood flows throughout the veins, arteries and capillaries of our body to bring oxygen, heat and nutrients. The heart and the circulatory system are quite simply a pump and hoses. In the case of people with chronic cold hands and feet, they may have poor blood circulation.
Poor blood circulation occurs when the normal flow of blood is interrupted causing dizziness, numbness, cold feet and hands among other symptoms. When you suspect bad circulation, seek medical advice for possible treatment to prevent more serious conditions.
Intrauterine growth retardation (IUGR) is associated with the development of adult-onset diseases, including pulmonary hypertension. However, the underlying mechanism of the early nutritional insult that results in pulmonary vascular dysfunction later in life is not fully understood. Here, we investigated the role of tyrosine phosphorylation of voltage-gated potassium channel 1.5 (Kv1.5) in this prenatal event that results in exaggerated adult vascular dysfunction. A rat model of chronic hypoxia (2 weeks of hypoxia at 12 weeks old) following IUGR was used to investigate the physiological and structural effect of intrauterine malnutrition on the pulmonary artery by evaluating pulmonary artery systolic pressure and vascular diameter in male rats. Kv1.5 expression and tyrosine phosphorylation in pulmonary artery smooth muscle cells (PASMCs) were determined. We found that IUGR increased mean pulmonary artery ...
Fatigue is the causes of poor blood circulation. Blood circulation is vital to your whole bodys well being because all your organs are dependent on it. Now your skin, being the most obvious organ of your body, is extremely dependent on blood circulation. Poor blood circulation induced by fatigue will entail consequences like pale complexion resulting from skin discoloration. The lack of oxygen which your blood transports will also be likely to cause dark spots. Having deprived of blood to function properly, your lymphatic system will start dumping out toxins through your skin in the form of oil and thus, causing acne. All of these could be avoided if consistently get your required sleeping hours.. Beauty products are most effective overnight. The beauty treatment of sleep is not isolated just only to itself, but is also welcome to other beauty treatments - especially with ...
According to the doctors, it is actually good to have scrub bath occasionally as it promotes blood circulation and helps maintain your skin velvety and feeling refreshed. People with oily skin can benefit from scrub bath, as it also reduces acne. Doctor Kim Yong Jiu, director of Dermatology department in Yonsei University College of Medicine, said, "Without scrub bath, you might accumulate oil on your skin overtime, dead skin will then accumulate because they cant be washed off easily, acne will then start to developed.". If you use soap, the bubbles will get clog the pores, thereby preventing your skin from breathing. For best results, one should soak in warm water for about 30 minutes before scrubbing the skin. One should never scrub their skin too hard, as there is a tendency for the epidermis to be scrubbed out, thereby damaging the skin. Mudong Wonderful World Skin Hospital Director Lee Hao Nan said, "If you scrub your skin with too much force or have it done ...
Dr.Reckeweg R 67 drops is homeopathic medicine to treat various symptoms of poor blood circulation through a proprietary blend of several homeopathic herbs (available in drops).
TY - JOUR. T1 - Airway blood flow distribution and lung edema after histamine infusion in awake sheep. AU - Kramer, G. C.. AU - Lindsey, D. C.. AU - Wu, C. H.. AU - Mertens, S.. AU - Russell, L. A.. AU - Cross, Carroll E. PY - 1988. Y1 - 1988. N2 - The present study was designed to evaluate the distribution of bronchial blood flow to major airways and peripheral lung and to quantitate lung edema during a 2-h histamine infusion (2 μg·kg-1·min-1) in unanesthetized sheep. By the use of radioactive microspheres, the blood flow to trachea and to tracheal cartilage, smooth muscle, and mucosa/submucosa was determined along with measurements of blood flow to different sized airway segments and the systemic blood flow to lung parenchyma. Histamine greatly increased blood flow to medium-sized (5- to 10-mm-diam) central airways in which blood flow increased 5-10 times base line, whereas in small (1- to 5-mm-diam) central airways the increase was 10-15 times. Blood flow in tracheal mucosa/submucosa ...
Chronic hypoxia causes pulmonary hypertension associated with structural alterations in pulmonary vessels and sustained vasoconstriction. The transcriptional mechanisms responsible for these distinctive changes are unclear. We have previously reported that CREB1 is activated in the lung in response to alveolar hypoxia but not in other organs. To directly investigate the role of α and Δ isoforms of CREB1 in the regulation of pulmonary vascular resistance we examined the responses of mice in which these isoforms of CREB1 had been inactivated by gene mutation, leaving only the β isoform intact (CREBαΔ mice). Here we report that expression of CREB regulated genes was altered in the lungs of CREBαΔ mice. CREBαΔ mice had greater pulmonary vascular resistance than wild types, both basally in normoxia and following exposure to hypoxic conditions for three weeks. There was no difference in rho kinase mediated vasoconstriction between CREBαΔ and wild ...
Title:Is the Hepatic Factor a miRNA that Maintains the Integrity of Pulmonary Microvasculature by Inhibiting the Vascular Endothelial Growth Factor?. VOLUME: 13 ISSUE: 3. Author(s):Joseph J. Vettukattil*. Affiliation:Congenital Heart Center, Helen DeVos Childrens Hospital, 100 Michigan NE (MC248), Grand Rapids, MI 49503. Keywords:Endoglin, hepatic factor, hepatopulmonary syndrome, hereditary hemorrhagic telangiectasia, miRNA, pulmonary arteriovenous malformations, vascular endothelial growth factor.. Abstract:Background: The "hepatic factor," a molecule or group of molecules present in the hepatic venous blood, essential for the prevention of the development of pulmonary arteriovenous malformations (PAVMs) and right-to-left shunting has been a conceptual enigma in the understanding of many related conditions. Methods: Patients with various forms of liver diseases including acute hepatic failure, and others with normal hepatic function like ...
The interaction between inspiratory fraction of O2 (FIO2) and endogenous nitric oxide (NO) regulation of pulmonary vascular tone was examined in intact anesthetized dogs. Stimulus (FIO2 of 1, 0.4, 0.21, 0.12, and 0.1)-response (changes in pulmonary artery pressure minus pulmonary artery occlusion pressure) curves were constructed with cardiac output kept constant (by opening a femoral arteriovenous bypass or inflating an inferior vena cava balloon catheter), before and after administration of compounds acting at different levels of the L-arginine-NO pathway, NG-nitro-L-arginine (L-NNA, 10 mg/kg iv, n = 16), a NO synthase inhibitor, and methylene blue (8 mg/kg iv, n = 16), a guanylate cyclase inhibitor. L-NNA and methylene blue did not influence pulmonary vascular tone in hyperoxic and in normoxic conditions, but they increased it during hypoxia, thus enhancing the vasopressor response to hypoxia (from 4.5 +/- 0.9 to 10.4 +/- 1.2 mmHg and ...
Chronic thromboembolic pulmonary hypertension (CTEPH) is a potentially curable condition [1]. The current treatment of choice for CTEPH is pulmonary endarterectomy (PEA) in patients who are considered candidates for surgical therapy. However, some CTEPH patients have thrombotic disease that affects the distal segmental pulmonary artery branches, while others have major medical co-morbidities which make them less than optimal candidates for surgical PEA. So, what are the alternatives when there is an inadequate response to medical therapy with pulmonary vasodilating agents such as Riociguat? Angioplasty has been performed in most vascular beds with excellent results since Dr. Andreas Gruentzig paved the way for balloon angioplasty. However, experience with angioplasty in the pulmonary vasculature has been mostly limited to pediatric patients with congenital pulmonary artery stenosis.. A group from Boston had ...
Selection of patients with congenital heart disease for surgical septation in biventricular repair or surgical palliation in functionally single ventricles requires low pulmonary vascular resistance (PVR). Where there is uncertainty, PVR can be assessed using hybrid cardiovascular magnetic resonance (CMR) and fluoroscopic (X-Ray) guided cardiac catheterizations (XMR). CMR/XMR catheterization is a validated technique for accurate assessment of pulmonary vascular resistance. However, data concerning its application in clinical practice is lacking. PVR assessments were performed in 167 studies in 149 congenital heart disease patients by CMR/XMR catheterization. Data was collated on patient demographics, procedural data, complications and outcomes. Institutional ethics approval was obtained. Median age was 3.6 years (6 days - 67 years) and weight 13.8 kg (2.3 -122 kg). One hundred and eight studies were in biventricular circulations and 59 in ...
Systemic-to-pulmonary collateral flow in patients with palliated univentricular heart physiology: measurement using cardiovascular magnetic resonance 4D velocity acquisition : Systemic-to-pulmonary collateral flow (SPCF) may constitute a risk factor for increased morbidity and mortality in patients with single-ventricle physiology (SV). However, clinical research is limited by the complexity of multi-vessel two-dimensional (2D) cardiovascular magnetic resonance (CMR) flow measurements. We sought to validate four-dimensional (4D) velocity acquisition sequence for
article{dc35f6eb-2fe8-4e13-a6ad-684fbfae520e, abstract = {Introduction: The diagnosis of acute lung injury (ALI) may be more robust if more accurate physiological markers can be identified. Extravascular lung water (EVLW) is one possible marker, and it has been shown to correlate with respiratory function and mortality in patients with sepsis. Whether EVLW confers diagnostic value in a general population with shock, as well as which index performs best, is unclear. We investigated the diagnostic accuracy of various EVLW indices in patients with shock. Methods: We studied a prospective, observational cohort of 51 patients with shock admitted to a tertiary ICU. EVLW was measured within 6 hours of ICU admission and indexed to actual body weight (EVLW/ABW), predicted body weight (EVLW/PBW) and pulmonary blood volume (EVLW/PBV). The relationship of these indices to the diagnosis and severity of lung injury and ICU mortality were studied. Positive and negative likelihood ratios, pre- and posttest ...
article{dc35f6eb-2fe8-4e13-a6ad-684fbfae520e, abstract = {Introduction: The diagnosis of acute lung injury (ALI) may be more robust if more accurate physiological markers can be identified. Extravascular lung water (EVLW) is one possible marker, and it has been shown to correlate with respiratory function and mortality in patients with sepsis. Whether EVLW confers diagnostic value in a general population with shock, as well as which index performs best, is unclear. We investigated the diagnostic accuracy of various EVLW indices in patients with shock. Methods: We studied a prospective, observational cohort of 51 patients with shock admitted to a tertiary ICU. EVLW was measured within 6 hours of ICU admission and indexed to actual body weight (EVLW/ABW), predicted body weight (EVLW/PBW) and pulmonary blood volume (EVLW/PBV). The relationship of these indices to the diagnosis and severity of lung injury and ICU mortality were studied. Positive and negative likelihood ratios, pre- and posttest ...
A differential diagnosis of the pulmonary oedema is important because the therapeutic approach is quite different. In cardiogenic pulmonary oedema, a negative fluid balance is sought, while in cases of permeability pulmonary oedema treating the cause of inflammation has priority. The Pulmonary Vascular Permeability Index (PVPI) enables this differential diagnosis. This parameter is calculated from the relation between Extravascular Lung Water (EVLW) and Pulmonary Blood Volume (PBV). A PVPI value in the range of 1 to 3 points to a cardiogenic pulmonary oedema, while a PVPI value greater than 3 suggests a permeability pulmonary oedema.. ...
BACKGROUND Chronic thromboembolic pulmonary hypertension (CTEPH) is associated with proximal pulmonary artery obstruction and vascular remodeling. We hypothesized that pulmonary arterial smooth muscle (PASMC) and endothelial cells (PAEC) may actively contribute to remodeling of the proximal pulmonary vascular wall in CTEPH. Our present objective was to characterize PASMC and PAEC from large arteries of CTEPH patients and investigate their potential involvement in vascular remodeling. METHODS Primary cultures of proximal PAEC and PASMC from patients with CTEPH, with non-thromboembolic pulmonary hypertension (PH) and lung donors have been established. PAEC and PASMC have been characterized by immunofluorescence using specific markers. Expression of smooth muscle specific markers within the pulmonary vascular wall has been studied by immunofluorescence and Western blotting. ...
Pulmonary arterial hypertension (PAH) is a rare disease (15 cases per million) that is characterized by widespread loss of the pulmonary microcirculation and elevated pulmonary vascular resistance leading to pathological right ventricular remodeling and ultimately right heart failure. Regenerative cell therapies (i.e., therapies involving cells with stem or progenitor-like properties) could potentially restore the effective lung microcirculation and provide a curative therapy for PAH. Preclinical evidence suggests that regenerative cell therapy using endothelial progenitor cells or mesenchymal stem cells may be beneficial in the treatment of PAH. These findings have led to the completion of a small number of human clinical trials, albeit with modest effect compared to animal studies. The objective of this systematic review is to compare the efficacy and ...
1. In a group of nine middle-aged patients undergoing varicose vein surgery, cardiac output, right atrial, pulmonary arterial and capillary pressures, and leg blood flow were measured after induction of general anaesthesia but before operation, and also during operation before and after blood substitution.. 2. Under anaesthesia, the mean preoperative blood flows in the superficial and common femoral arteries were 160 ml/min and 280 ml/min respectively. These flows are comparable with those obtained in other studies under similar conditions but lower than values obtained in conscious subjects. During the operation the leg blood flow decreased by 24%. As cardiac output remained unchanged, the fractional leg blood flow fell. After transfusion of 900 ml of blood the leg blood flow doubled.. 3. It is concluded that anaesthesia, surgical trauma and variations in blood volume greatly influence the leg blood flow and that an adequate substitution of operative blood ...
BACKGROUND AND PURPOSE: To examine radiation-induced changes in regional lung perfusion per dose level in 58 non-small-cell lung cancer (NSCLC) patients treated with intensity-modulated radiotherapy (IMRT).. MATERIAL AND METHODS: NSCLC patients receiving chemo-radiotherapy (RT) of minimum 60 Gy were included prospectively in the study. Lung perfusion single-photon emission computed tomography (SPECT/CT) was performed before and serially after RT. Changes (relative to baseline, %) in regional lung perfusion were correlated with regional dose. Toxicity outcome was radiation pneumonitis (RP) CTC grades 2-5.. RESULTS: Perfusion changes were associated with dose. Dose-dependent reduction in regional perfusion was observed at 3, 6 and 12 months of follow-up. Relative perfusion loss per dose bin was 4% at 1 month, 14% at 3 months, 13% at 6 months and 21% at 12 months after RT. In patients with RP, perfusion reduction was larger in high dose lung regions, compared to those without RP. Low dose regions, ...
Kheyfets, Vitaly O., Rios, Lourdes, Smith, Triston, Schroeder, Theodore, Mueller, Jeffrey, Murali, Srinivas, Lasorda, David, Zikos, Anthony, Spotti, Jennifer, Reilly, John J., and Finol, Ender A. "The Influence of Pulmonary Hemodynamics on Right Ventricular Function in Pulmonary Hypertension." Proceedings of the ASME 2013 Summer Bioengineering Conference. Volume 1A: Abdominal Aortic Aneurysms; Active and Reactive Soft Matter; Atherosclerosis; BioFluid Mechanics; Education; Biotransport Phenomena; Bone, Joint and Spine Mechanics; Brain Injury; Cardiac Mechanics; Cardiovascular Devices, Fluids and Imaging; Cartilage and Disc Mechanics; Cell and Tissue Engineering; Cerebral Aneurysms; Computational Biofluid Dynamics; Device Design, Human Dynamics, and Rehabilitation; Drug Delivery and Disease Treatment; Engineered Cellular Environments. Sunriver, Oregon, USA. June 26-29, 2013. V01AT19A006. ASME. https://doi.org/10.1115/SBC2013-14440. Download citation file:. ...
Detailed information is lacking correlating the clinical and physiologic status of patients who had previously undergone closure of left-to-right shunts. Thirty-six patients were studied up to 11 years postoperation to determine [1] the incidence of reopened left-to-right shunts, [2] the status of ventricular function, and [3] the incidence of abnormal pulmonary vascular reactivity. Twelve patients with patent ductus arteriosus (PDA) were studied an average of 8 years postoperatively. Recanalization of PDAs was noted in 4 patients and was unsuspected in 3. Cardiac output with exercise was abnormal in 1 of 3 patients. Six of 12 subjects had an abnormal increase ...
Introduction: Some, but not all patients with advanced heart failure (HF) develop precapillary pulmonary hypertension (PH) due to unidentified mechanisms. We hypothesized that diminished local sensitivity to endogenous BNP, reflected by low rate of cGMP release, might be responsible for PH.. Methods: 18 patients with systolic HF and high pulmonary vascular resistance (PVR , 3 w.u. in euvolemia, PHHF) and 28 HF patients with low PVR (non-PHHF) of similar age, gender, body size and HF severity (52±12 years, 54% ischemic, NYHA 2,9±0,7, EF 23±4%) underwent right heart cath. Samples were obtained from pulmonary artery (PA) catheter before and during wedging (02sat.,95%) to calculate transpulmonary BNP uptake and cGMP release (concentration difference × CO). PHHF patients were re-measured 1 hour after oral dose of sildenafil (40mg).. Results: PHHF had similar systemic resistance (SVR), BNPPA (684 vs. 607 pg/ml, p=0.8) as non-PHHF, but higher PVR ...
ABSTRACTThe present study aimed to investigate the role of quaternary ammonium salt of U50,488H (Q-U50,488H) in hypoxic pulmonary hypertension (HPH) and underlying mechanisms involved. A HPH animal model was established in rats under hypoxia and the mean pulmonary arterial pressure (mPAP) and right
A histological study was made of the small pulmonary blood vessels in pieces of lung obtained at necropsy from 19 long-term residents of La Paz, Bolivia (3800 m). There was variation in the response of the pulmonary vasculature of these subjects to the chronic hypoxia of high altitude. The most characteristic finding, seen in seven of the 16 cases beyond infancy, was distal extension of vascular smooth muscle into pulmonary arterioles as small as 20 micrometer in diameter. Medial hypertrophy of the muscular pulmonary arteries occurred in only three of these seven subjects. Intimal fibrosis was seen in eight of the 19 cases and was ascribed to age; such fibrotic proliferation may affect the reversibility of hypoxic pulmonary hypertension and associated vascular changes in highlanders.. ...
Acute venous thromboembolism resolves in most cases. However, an estimated 0.5%-3.8% of pulmonary embolism (PE) survivors develop chronic thromboembolic pulmonary hypertension (CTEPH) resulting from mechanical obstruction of the pulmonary arteries [1-3]. Most patients with CTEPH have experienced a PE in their lifetime; however, up to 25% of patients have never reported a thrombotic event [4].
Chronic thromboembolic pulmonary hypertension (CTEPH) is an uncommon consequence of acute pulmonary embolism. We report CTEPH in a 58-year-old male who had pleurisy with a small haemorrhagic pleural effusion three months ago. The six-month course of
Owing to the lack of a reliable, noninvasive method to measure pulmonary artery pressure, the diagnosis of pulmonary hypertension is difficult and uncertain. Perhaps this uncertainty engendered several recent reviews of the literature on pulmonary hypertension. Without explicitly stating so, the authors devote this review to the commonest form of pulmonary hypertension in humans at sea level, namely hypoxic pulmonary hypertension secondary to chronic obstructive lung disease. However, rather than concentrating on pulmonary hypertension, which is the physiologic disorder that distinguishes heart disease secondary to chronic lung disease from other forms of heart disease, the authors use the World Health ...
Simple formulas may remain within the text of the manuscript if they can be set on the line: The pulmonary vascular resistance index (PVRI) was calculated as follows: PVRI = (MPAP − PCWP)/CI, where MPAP indicates mean pulmonary artery pressure; PCWP, pulmonary capillary wedge pressure; and CI, cardiac index. Long or complicated formulas should be centered on a separate line. In either case, symbols and signs should be marked in detail. Such formulas may be handled either as copy or as prepared art, depending on the availability of special characters and use of software for equation preparation. For online publications, formulas that require more
Simple formulas may remain within the text of the manuscript if they can be set on the line: The pulmonary vascular resistance index (PVRI) was calculated as follows: PVRI = (MPAP − PCWP)/CI, where MPAP indicates mean pulmonary artery pressure; PCWP, pulmonary capillary wedge pressure; and CI, cardiac index. Long or complicated formulas should be centered on a separate line. In either case, symbols and signs should be marked in detail. Such formulas may be handled either as copy or as prepared art, depending on the availability of special characters and use of software for equation preparation. For online publications, formulas that require more
Background: Bone cementation may cause pulmonary vasoconstriction and ventilation/perfusion abnormalities in patients undergoing cemented hip hemiarthroplasty. In this randomised trial, we tested the hypothesis that intra-operative inhalation of prostacyclin could attenuate the increase in pulmonary vascular resistance index (PVRI, primary endpoint) when compared to inhaled saline in this group of patients. Methods: Twenty-two patients with displaced femoral neck fractures were allocated to receive inhaled aerosolised prostacyclin (20 ng/kg/min) (n = 11) or inhaled saline (NaCl, 9 mg/mL) (n = 11). All patients received total intravenous anaesthesia and were catheterised with radial and pulmonary artery fast response thermodilution catheters, for measurements of arterial and pulmonary arterial pressures, cardiac output, right ventricular ejection fraction and effective ...
TY - JOUR. T1 - Congenital alveolar capillary dysplasia. T2 - A developmental vascular anomaly causing persistent pulmonary hypertension of the newborn. AU - Khorsand, Jila. AU - Tennant, Robert. AU - Gillies, Concettina. AU - Philipps, Anthony F. PY - 1985. Y1 - 1985. N2 - The clinical course and histologic findings are presented of an infant with an unusual form of pulmonary dysplasia. Characteristic sonographic findings and progressive hypoxemia led to the diagnosis of persistence of the fetal circulation. The patient expired despite ventilatory and pharmacologic intervention. Postmortem findings of severe pulmonary capillary hypoplasia, despite normal anatomical and biochemical parenchymal maturation, were observed. It is suggested that factors controlling pulmonary capillary maturation may be significantly different from those involved in airway and pulmonary parenchymal development... ...
For understandable reasons, the pulmonary circulation remains an enigma to most doctors. This is because the cardinal symptom, dyspnoea, is shared with many more common diseases, and the signs of pulmonary hypertension are difficult to elicit for the non-specialist. Consequently, the delay between onset of symptoms and diagnosis is two years, and the mean survival from the time of diagnosis is only another two years in untreated patients with severe hypertension of the pulmonary artery. In the past, pulmonary hypertension was not treatable, but now several treatments are available.. Severe pulmonary hypertension, with a total prevalence of about 30-50/million, can be primary or associated with apparently disparate conditions including connective tissue disease, congenital heart disease, chronic pulmonary thromboembolism, HIV infection, use of an appetite suppressant, and ...
Pulmonary hypertension occurs when pulmonary arteries/capillaries vasoconstrictive (narrow), are obstructed, or receive excessive blood flow. The capillaries of the lungs are very tiny branches of blood vessels only one cell in thickness, connecting the smallest veins to the smallest arteries for the exchange of oxygen and carbon dioxide to the blood and tissues. Arteries carry oxygenated blood from the heart to the lungs, so high blood pressure in the left atrium of the heart can also cause elevated pressure in the capillaries of the lungs.. High pulmonary blood pressure is dangerous because it can alter the shape and performance of the heart. The right ventricle is enlarged while the left ventricle fills abnormally. Less oxygenated blood reaches the body, leading to troubled breathing, exercise intolerance, and blue-purple tinged skin. Eventually, this increased blood pressure in the right heart can result in the pooling of blood in the body. The tricuspid ...
Dr. Gustavo A. Heresi presents Serum CXC-Chemokine Ligand 10 is Associated with Severity of Chronic Thromboembolic Pulmonary Hypertension, recorded live at the UC San Diego Health Sulpizio Cardiovascular Center National Proceedings: CTEPH 2017., TV Network

Pulmonary heart: PULMONARY HEART (LS) is a clinical syndrome caused byPulmonary heart: PULMONARY HEART (LS) is a clinical syndrome caused by

b) compression of the pulmonary artery from the outside; c) a significant decrease in the bed of the pulmonary circulation as a ... Alveolar hypoxia contributes to an increase in pressure in the pulmonary artery and through arterial hypoxemia, which leads to ... produced by normal vascular endothelial cells. The pressure in the pulmonary artery increases with compression of the ... as well as the appearance of hypertension in the pulmonary circulation) is necessarily preceded by pulmonary (respiratory) ...
more infohttp://en.medicine-guidebook.com/vnutrennie-bolezni_718_legochnoe-serdtse.html

Abstract 19017: Sex Differences in Severe Pulmonary Arterial Hypertension Produced by SU5416 in a Colony of Hyper-responsive...Abstract 19017: Sex Differences in Severe Pulmonary Arterial Hypertension Produced by SU5416 in a Colony of "Hyper-responsive"...

Thank you for your interest in spreading the word on Circulation.. NOTE: We only request your email address so that the person ... Abstract 19017: Sex Differences in Severe Pulmonary Arterial Hypertension Produced by SU5416 in a Colony of "Hyper-responsive" ... Abstract 19017: Sex Differences in Severe Pulmonary Arterial Hypertension Produced by SU5416 in a Colony of "Hyper-responsive" ... Abstract 19017: Sex Differences in Severe Pulmonary Arterial Hypertension Produced by SU5416 in a Colony of "Hyper-responsive" ...
more infohttp://circ.ahajournals.org/content/132/Suppl_3/A19017

https://www.medicalnewstoday.com/articles/186328.phphttps://www.medicalnewstoday.com/articles/186328.php

An injection of 2-3 ml of air into the cerebral circulation can be fatal. Just 0.5-1 ml of air in the pulmonary vein can cause ... If an arterial gas embolism reaches the brain, it is referred to as a cerebral embolism and can cause a stroke. ... An estimated 57% of orthopedic surgeries produce air embolisms. *Symptoms of air embolism include aching joints, feelings of ... Pulmonary barotrauma: if a diver holds their breath during a rapid ascent, trauma can be caused to the lining of the lungs. As ...
more infohttps://www.medicalnewstoday.com/articles/186328.php

Epoxyeicosatrienoic acid - WikipediaEpoxyeicosatrienoic acid - Wikipedia

Cause Vasodilation in the systemic arterial circulation. Cause Vasoconstriction of the Liver sinusoidal and pulmonary venous ... produced by endothelial cytochrome P-450 3A4 in monkey arterial relaxation". Hypertension Research. 26 (3): 237-43. doi:10.1291 ... ETEs are commonly produced by the stimulation of specific cell types. The stimulation causes arachidonic acid to be released ... CYP2C9, CYP2JP, and possibly the more recently characterized CYP2S1 appear to be the main produces of the EETs in humans with ...
more infohttps://en.wikipedia.org/wiki/Epoxyeicosatrienoic_acid

Bosentan for the Prevention of Overcirculation-Induced Experimental Pulmonary Arterial Hypertension | CirculationBosentan for the Prevention of Overcirculation-Induced Experimental Pulmonary Arterial Hypertension | Circulation

Pulmonary vascular disease has been shown to be associated with induction of tenascin-C,29 a mitogenic cofactor produced ... systemic arterial pressure, thermodilution cardiac output (Q), ultrasonic instantaneous pulmonary arterial flow, and blood ... and tenascin in overcirculation-induced pulmonary hypertension in piglets, as a model of early pulmonary arterial hypertension ... Pulmonary arterial morphometry was performed as reported by Shehata et al.12 Only arteries with an external diameter (ED) ,500 ...
more infohttp://circ.ahajournals.org/content/107/9/1329

PGI2 as a Regulator of Inflammatory DiseasesPGI2 as a Regulator of Inflammatory Diseases

... produced in mammalian vasculature with elevated levels in pulmonary arterial segments when compared to systemic circulation [14 ... PGI2 has a long history of use for the treatment of pulmonary arterial hypertension (PAH) [14, 16, 28]. Regrettably, it ... For these reasons, PGI2 has a long history of use for the treatment of pulmonary arterial hypertension (PAH). Only recently, ... PGI2 analogues have been successfully used for therapy in pulmonary arterial hypertension, peripheral occlusive disease, ...
more infohttps://www.hindawi.com/journals/mi/2012/926968/

Decompression practice - WikipediaDecompression practice - Wikipedia

... is reduced sufficiently that they pass through the pulmonary capillaries and reach the systemic circulation on the arterial ... A possible explanation is that during the final stage of ascent, bubbles are produced that are stopped in the lung capillaries ... Decompression stop depths are also corrected, using the ratio of surface pressures, and will produce actual stop depths which ... This procedure is based on the assumption that the decompression model will produce equivalent predictions for the same ...
more infohttps://en.wikipedia.org/wiki/Dive_tables

Hemostasis Flashcards by Ryan Bailey | BrainscapeHemostasis Flashcards by Ryan Bailey | Brainscape

... producing an obstruction on the arterial side of systemic circulation ... Anemic infarct (no blood). Occur primarily in solid organs with end-arterial circulation. Examples include kidneys and spleen. ... A hemorrhagic infart, usually occurrin in loose tissues or tissues with secondary circulation. May also occur in cases where ... Increased capillary hydrostatic pressure due to arterial dilation or impaired venous return ...
more infohttps://www.brainscape.com/flashcards/hemostasis-2639077/packs/4591033

List of signs and symptoms of diving disorders - WikipediaList of signs and symptoms of diving disorders - Wikipedia

... causing pulmonary barotrauma (PBT). The air may then enter the arterial circulation producing arterial gas embolism (AGE), with ... Neuman, Tom S (2003). "10.5: Arterial Gas Embolism and Pulmonary Barotrauma". In Brubakk, Alf O; Neuman, Tom S. Bennett and ... Neuman, Tom S (2003). "10.5: Arterial Gas Embolism and Pulmonary Barotrauma". In Brubakk, Alf O; Neuman, Tom S. Bennett and ... Gas bubbles within the arterial circulation can block the supply of blood to any part of the body, including the brain, and can ...
more infohttps://en.wikipedia.org/wiki/List_of_signs_and_symptoms_of_diving_disorders

Evidence for the Involvement of Type I Interferon in Pulmonary Arterial HypertensionNovelty and Significance | Circulation...Evidence for the Involvement of Type I Interferon in Pulmonary Arterial HypertensionNovelty and Significance | Circulation...

... arguably the most compelling clinical case for endogenously produced IFN and PAH may be that associated with systemic sclerosis ... human pulmonary artery smooth muscle cell. IP10. interferon γ inducible protein 10. PAH. pulmonary arterial hypertension. RV. ... Pulmonary arterial hypertension (PAH) is a rare but devastating disease, which is defined as a mean pulmonary artery pressure ... Fibrous remodeling of the pulmonary venous system in pulmonary arterial hypertension associated with connective tissue diseases ...
more infohttp://circres.ahajournals.org/content/114/4/677

Endothelium-dependent contractions in rabbit pulmonary artery are mediated by thromboxane A2. | Circulation ResearchEndothelium-dependent contractions in rabbit pulmonary artery are mediated by thromboxane A2. | Circulation Research

TXA2 appears to be the EDCF released by AA and MeCH in rabbit pulmonary artery; however, TXA2 is not produced by endothelial ... Cultured rabbit pulmonary arterial endothelial cells synthesized 6-keto-PGF1 alpha but not TXB2. Immunohistochemical studies ... in the rabbit pulmonary artery. AA and MeCH contract the rabbit pulmonary artery; however, the effects of both are blocked by ... Endothelium-dependent contractions in rabbit pulmonary artery are mediated by thromboxane A2.. C J Buzzard, S L Pfister, W B ...
more infohttp://circres.ahajournals.org/content/72/5/1023

Prostacyclin Therapy for Pulmonary Arterial HypertensionProstacyclin Therapy for Pulmonary Arterial Hypertension

Pulmonary arterial hypertension. Circulation 2006;114(13):1417-31. [PubMed]. 13. Galie N, Torbicki A, Barst R, Dartevelle P, ... either are transfected by using a viral vector or are delivered in another fashion into the pulmonary vasculature to produce a ... Long-term response to calcium channel blockers in idiopathic pulmonary arterial hypertension. Circulation 2005;111(23):3105-11 ... Iloprost for pulmonary vasodilator testing in idiopathic pulmonary arterial hypertension. Eur Respir J 2009;33(6):1354-60. [ ...
more infohttp://pubmedcentralcanada.ca/pmcc/articles/PMC2929860/

Cannabinoids and glaucoma | British Journal of OphthalmologyCannabinoids and glaucoma | British Journal of Ophthalmology

... ischaemic heart disease and pulmonary arterial hypertension, among others.65 The possible role of endothelin-1 in the ... has a significant role in the regulation of local circulation, producing vasoconstriction and being involved in the ... Haeffliger IO, Meyer P, Flammer J, et al. The vascular endothelium as a regulator of the ocular circulation: a new concept in ... The IOP reducing effect does not seem to be related to a systemic reduction of arterial blood pressure.40 However, a direct ...
more infohttps://bjo.bmj.com/content/88/5/708%20

Volatolomics of breath as an emerging frontier in pulmonary arterial hypertension | European Respiratory SocietyVolatolomics of breath as an emerging frontier in pulmonary arterial hypertension | European Respiratory Society

Adaptation and remodelling of the pulmonary circulation in pulmonary hypertension. Can J Cardiol 2015; 31: 407-415. ... the MCT model would produce features of severe pulmonary hypertension and heart failure within 3 weeks; however, due to MCT ... Pulmonary arterial hypertension. Pulmonary arterial hypertension (PAH) is a progressive cardiopulmonary disease characterised ... Pulmonary lymphoid neogenesis in idiopathic pulmonary arterial hypertension. Am J Respir Crit Care Med 2012; 185: 311-321. ...
more infohttp://erj.ersjournals.com/content/49/2/1601897.full

Riociguat for interstitial lung disease and pulmonary hypertension: a pilot trial | European Respiratory SocietyRiociguat for interstitial lung disease and pulmonary hypertension: a pilot trial | European Respiratory Society

Pulmonary arterial hypertension. Circulation 2006; 114: 1417-1431.. OpenUrlFREE Full Text ... Endothelium-derived relaxing factor produced and released from artery and vein is nitric oxide. Proc Natl Acad Sci USA 1987; 84 ... Prevalence and outcomes of pulmonary arterial hypertension in advanced idiopathic pulmonary fibrosis. Chest 2006; 129: 746-752. ... Mean±sd change from baseline in a) arterial carbon dioxide tension (PaCO2), b) arterial oxygen tension (PaO2) and c) arterial ...
more infohttps://erj.ersjournals.com/content/41/4/853.full

Neo-Synephrine Injection - FDA prescribing information, side effects and usesNeo-Synephrine Injection - FDA prescribing information, side effects and uses

Pulmonary vessels are constricted, and pulmonary arterial pressure is raised.. The drug is a powerful vasoconstrictor with ... Circulation time is slightly prolonged, and venous pressure is slightly increased; venous constriction is not marked. Most ... NEO-SYNEPHRINE hydrochloride produces vasoconstriction that lasts longer than that of epinephrine and ephedrine. Responses are ... In therapeutic doses, it produces little if any stimulation of either the spinal cord or cerebrum. A singular advantage of this ...
more infohttps://www.drugs.com/pro/neo-synephrine-injection.html

7-oxabicycloheptyl substituted heterocyclic amide prostaglandin analogs - E. R. Squibb & Sons, Inc.7-oxabicycloheptyl substituted heterocyclic amide prostaglandin analogs - E. R. Squibb & Sons, Inc.

They may be useful to prevent thrombosis following vascular injury produced in the course of diagnostic or therapeutic ... The compounds may be used in the treatment of venous thrombosis or embolism, including pulmonary embolism, deep venous ... The compounds of this invention are useful as inhibitors of arterial or venous vasoconstriction. Accordingly, they may be ... A method for preventing or reducing platelet loss during extracorporeal circulation which comprises administering to a ...
more infohttp://www.freepatentsonline.com/5162352.html

The right ventricle: interaction with the pulmonary circulation | Critical Care | Full TextThe right ventricle: interaction with the pulmonary circulation | Critical Care | Full Text

Chronic pulmonary hypertension induces progressive RV hypertrophy to match RV contractility to the increased pulmonary arterial ... Owning to the irreversible nature of most forms of pulmonary hypertension, when the pulmonary arterial elastance greatly ... Treatments include reversing the causes of pulmonary hypertension and sustaining mean arterial pressure higher than pulmonary ... Normally, blood flow varies with minimal changes in pulmonary arterial pressure. Similarly, RV filling normally occurs with ...
more infohttps://ccforum.biomedcentral.com/articles/10.1186/s13054-016-1440-0

Developing a Rational Approach to Tobacco Use Treatment in Pulmonary Practice: A Review of the Biological Basis of Nicotine...Developing a Rational Approach to Tobacco Use Treatment in Pulmonary Practice: A Review of the Biological Basis of Nicotine...

... capable of producing very rapid peaks in levels carried in arterial blood to the brain.39,40 Because it is delivered to the ... nicotine absorbed into the pulmonary venous circulation carries high concentrations of nicotine back to the left ventricle, ... Guidelines published by the US Department of Health and Human Services, and tool kits produced by pulmonary professional ... Pulmonary physicians are familiar with this model in the context of asthma and COPD, in which subjective, objective, and ...
more infohttp://pubmedcentralcanada.ca/pmcc/articles/PMC3375065/?lang=en-ca

Basic science of pulmonary arterial hypertension for clinicians: new concepts and experimental therapies.  - PubMed - NCBIBasic science of pulmonary arterial hypertension for clinicians: new concepts and experimental therapies. - PubMed - NCBI

Circulation. 2010 May 11;121(18):2045-66. doi: 10.1161/CIRCULATIONAHA.108.847707. Research Support, N.I.H., Extramural; ... Superoxide dismutase (SOD2) rapidly converts superoxide anion (produced at complexes I and III) to H2O2, which serves as a ... Circulation. 2010 May 11;121(18):2045-66. doi: 10.1161/CIRCULATIONAHA.108.847707. ... Basic science of pulmonary arterial hypertension for clinicians: new concepts and experimental therapies.. Archer SL1, Weir EK ...
more infohttps://www.ncbi.nlm.nih.gov/pubmed/20458021

What kind of Shock?  - USMLE Forum ArchivesWhat kind of Shock? - USMLE Forum Archives

... which produces constriction of the bronchi and pulmonary circulation. Cardiogenic shock (choice B) reflects the inability of ... Hypovolemic shock (choice C) occurs when blood volume decreases to a point at which it is inadequate to maintain arterial ... The correct answer is E. Septic shock is a complex, multisystem organ failure that can be produced either by LPS (which is ... The resulting degranulation produces massive histamine and adenosine release, ...
more infohttp://www.usmleforum.com/archives/2006/1/134421.php

Renal function and icuRenal function and icu

Nitrates increase arterial diameter and improve arterial conductance, and at higher doses produce dilation of the arteriolar or ... 40) Nitroglycerine produces venodilation at very low dosages, with little additional vasodilatation of the venous circulation ... Monitoring with a central venous catheter and, if necessary, with a pulmonary artery catheter and/or volumetric monitoring as ... When compared to high dose dopamine, norepinephrine is more effective in res-toring mean arterial pressure. For this reason it ...
more infohttp://www.signavitae.com/2007/05/renal-function-and-icu/

comparison of the pharmacological and mechanical properties in vitro of large and small pulmonary arteries of the rat |...comparison of the pharmacological and mechanical properties in vitro of large and small pulmonary arteries of the rat |...

4. The mechanism that maintains the low arterial tone of the pulmonary circulation is unknown, but it may involve the release ... bradykinin produced a significantly greater response in the small arteries (P , 0.001). In comparison with large pulmonary ... This is substantially lower than that found for systemic vessels, and reflects the normal low pulmonary arterial pressure. ... The active molecular form of plasma adrenomedullin is extracted in the pulmonary circulation in patients with mitral stenosis: ...
more infohttps://portlandpress.com/clinsci/article/82/1/55/75473/A-comparison-of-the-pharmacological-and-mechanical

Patent WO1994028792A1 - Intra-abdominal pressure measurement apparatus and method - Google PatentsPatent WO1994028792A1 - Intra-abdominal pressure measurement apparatus and method - Google Patents

A fall in bicarbonate occurs only when venous blood enters the pulmonary circulation, an "open system" from which the C02 added ... arterial or venous pH; mixed venous bicarbonate; arterial oxygen saturation (e.g., as measured by pulse oximetry) ; arterial ... does not produce a significant reduction in bicarbonate concentration but does produce a significant rise in pC02. ... The bicarbonate is only reduced by the loss of C02 during the passage of the venous effluent through the pulmonary circulation ...
more infohttp://www.google.com.au/patents/WO1994028792A1?cl=en

Bolus dynamics: theoretical and experimental aspects.Bolus dynamics: theoretical and experimental aspects.

This paper analyses the arterial enhancement produced by short intravenous boluses of iodinated contrast medium, with ... direct effects on the heart and pulmonary circulation, the distribution of transit times in the cardiopulmonary circulation and ... This paper analyses the arterial enhancement produced by short intravenous boluses of iodinated contrast medium, with ... The characteristics of the arterial time-attenuation curve are a function of the rate of contrast medium transit to the ...
more infohttp://www.biomedsearch.com/nih/Bolus-dynamics-theoretical-experimental-aspects/9166070.html
  • Idiopathic pulmonary hypertension, which can occur from infancy into late adulthood, has the strongest genetic component 2 and the worst prognosis. (pubmedcentralcanada.ca)
  • Other tests to support the diagnosis of idiopathic PAH (and to exclude secondary causes of PAH) include pulmonary ventilation/perfusion scans (V/Q scans), pulmonary function tests, overnight oximetry, and serology tests for connective-tissue disorders. (pubmedcentralcanada.ca)
  • A recent placebo-controlled 12-week study of the PDE-5 inhibitor sildenafil in patients with advanced idiopathic pulmonary fibrosis (IPF) failed to show a significant change in 6-min walk distance (6MWD), although there were beneficial effects on arterial blood gases and carbon monoxide diffusion capacity and health-related quality of life measures [ 16 ]. (ersjournals.com)
  • In essence, PAH includes the idiopathic PAH (IPAH) and associated conditions that affect pulmonary arteries, with similar presentations and responses to PAH-specific medical therapies. (renalandurologynews.com)
  • It has been replaced by the term idiopathic pulmonary arterial hypertension or IPAH. (renalandurologynews.com)
  • Stocker in 2002 recommended the term congenital pulmonary airway malformation (CPAM) as being preferable to the term congenital cystic adenomatoid malformation, since the lesions are cystic in only 3 of the 5 types of these lesions and are adenomatoid in only 1 type (type 3). (medscape.com)
  • Pulmonary vascular slings were first defined in 1958 1 by Contro et al and recognized as a rare cause of congenital bronchobstruction. (appliedradiology.com)
  • 8 Both types of slings, but especially type II, are associated with other cardiovascular, pulmonary, and congenital abnormalities. (appliedradiology.com)
  • Veins are classified in a number of ways, including superficial vs. deep, pulmonary vs. systemic, and large vs. small. (wikipedia.org)
  • Furthermore, 4 mum diameter bubbles are much more prevalent in the veins of dogs suffering from decompression sickness than they are in dog arteries, presumably because they are filtered out effectively by the pulmonary circulation. (rubicon-foundation.org)
  • 23 . The method of claim 14 where the return conduit is attached in a first step, and a portion of the pulmonary veins are connected to the prosthetic chamber, before all of the pulmonary veins are disconnected from the native atrium. (google.es)
  • 24 . A prosthetic chamber made from implantable materials, including a one way valve, an outlet conduit and more than one inlet conduit and the inlet conduits are designed to attach to the pulmonary veins. (google.es)
  • We developed a baroreflex model combined with a lumped-parameter model of the circulation, including viscoelastic stress-relaxation of the systemic veins. (physiology.org)
  • A transient decrease in BP in response to HUT can result from rapid filling of the veins (and, thus, a reduction in preload) or arterial dilation related to muscle activation (and, thus, a reduction in afterload). (physiology.org)
  • Conversely, pulmonary embolism occurs in up to 50% of patients with proximal DVT of the legs (involving the popliteal and/or more proximal veins), and is less likely when the thrombus is confined to the calf veins. (bmj.com)
  • 8 Management of this type needs to address not only the aberrant pulmonary artery, but also the airway abnormality. (appliedradiology.com)
  • This technique provides functional vascular and airway detail, and it may aid in targeting pulmonary angiograms in the abnormal lung or lobe. (medscape.com)
  • Alterations of pulmonary function can be due to obstructive airway disease (e.g., emphysema, chronic bronchitis, asthma), restrictive pulmonary disorders with primary loss of lung volume (e.g., pulmonary resection, thoracoplasty, chest cage deformity as in kyphoscoliosis or obesity), or infiltrative interstitial disorders (e.g., diffuse pulmonary fibrosis). (ssa.gov)
  • Gas exchange abnormalities without significant airway obstruction can be produced by interstitial disorders. (ssa.gov)
  • Hypoxia is a possible regulator of versican accumulation, which may promote proliferation of pulmonary smooth-muscle cells and vascular remodeling in PAH. (diva-portal.org)
  • Maximum intensity projection of a T1-weighted MRI acquired after the intravenous administration of contrast material shows a normal-appearing pulmonary arterial tree. (medscape.com)
  • Methods and Results- Thirty 3-week-old piglets were randomized to placebo or to bosentan 15 mg/kg BID after the anastomosis of the left subclavian artery to the pulmonary arterial trunk or after a sham operation. (ahajournals.org)
  • Fifteen growing piglets were assigned to a sham operation (n = 8) or to an anastomosis of the left innominate artery to the pulmonary arterial trunk (n = 7). (plos.org)
  • Acute increases in RV outflow resistance, as may occur with acute pulmonary embolism, will cause acute RV dilation and, by ventricular interdependence, markedly decreased LV diastolic compliance, rapidly spiraling to acute cardiogenic shock and death. (biomedcentral.com)
  • Urokinase (UK) 2 200 U/kg·h for 12 hours infusion(UK-12 h)is an ACCP recommended regimen in treating acute pulmonary embolism (PE). (biomedcentral.com)
  • Most deaths directly attributable to acute pulmonary embolism occur before the diagnosis can be confirmed and effective treatment implemented, which makes prevention in high risk patients imperative. (bmj.com)
  • The internal diameter of the esophagus was found to be unaffected on a prior upper GI study, most likely as a result of the narrow diameter of the left crossing pulmonary artery anterior to the esophagus. (appliedradiology.com)
  • We assessed the safety, tolerability and preliminary efficacy of riociguat, a soluble guanylate cyclase stimulator, in patients with pulmonary hypertension associated with interstitial lung disease (PH-ILD). (ersjournals.com)
  • Interstitial lung disease (ILD) represents a heterogeneous group of diseases that share common functional features including a decline in pulmonary compliance and impairment of gas exchange [ 1 - 3 ]. (ersjournals.com)
  • Methods We conducted a retrospective cohort study among patients transported by emergency medical services during a 29-month period who were diagnosed with either obstructive pulmonary disease or congestive heart failure (CHF) by ICD-9 codes. (bmj.com)
  • Rapid constriction of splanchnic resistance arteries in response to a sudden increase in sympathetic tone contributes to the recovery of orthostatic arterial pressure upon standing. (ebscohost.com)
  • However, the molecular mechanism of PBR-induced dysfunction in arterial constriction is not fully understood. (ebscohost.com)
  • In normal anesthetized rats, mean arterial pressure (MAP) rapidly reduced upon 90° head-up tilt from supine position and then immediately recovered without change in heart rate, suggesting a rapid arterial constriction. (ebscohost.com)
  • Currently, the most common classification used for PE is the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) criteria, which are based on the largest study of PE to date. (medscape.com)
  • The overall incidence and mortality of pulmonary embolism in the population is unknown because the clinical diagnosis is unreliable, many events are asymptomatic, variable methods of prophylaxis are applied, necropsy rates are low, and death certification is inaccurate. (bmj.com)