-
The American Journal of Medicine Mar 2004In patients with pulmonary hypertension, extrinsic compression of the left main coronary artery by a dilated pulmonary trunk may cause angina, left ventricular ischemia,...
PURPOSE
In patients with pulmonary hypertension, extrinsic compression of the left main coronary artery by a dilated pulmonary trunk may cause angina, left ventricular ischemia, and sudden death. We assessed coronary artery compression in relation to pulmonary trunk diameter and other demographic, echocardiographic, hemodynamic, and scintigraphic variables.
METHODS
Thirty-six patients (aged 15 to 86 years) with pulmonary hypertension, either idiopathic or associated with congenital heart disease, were enrolled. Left main coronary artery compression was defined angiographically as > or =50% obstruction associated with downward displacement of the vessel. Pulmonary trunk and aortic diameters were measured by transthoracic echocardiography.
RESULTS
Twenty-six patients had angina, of whom 7 had left coronary artery compression. Compression was related to pulmonary trunk diameter (P = 0.002) and to the ratio of pulmonary trunk diameter to aortic diameter (P = 0.02). Compression was not seen at pulmonary artery diameters <40 mm; among 19 patients with values > or =40 mm, the rate was 37%. Similarly, compression did not occur at pulmonary trunk to aortic diameter ratios <1.21; among 27 patients with ratios > or =1.21, the rate was 26%.
CONCLUSION
In pulmonary hypertension, noninvasive measurement of pulmonary trunk diameter may be helpful in determining the likelihood of left coronary artery compression and in selecting patients for diagnostic coronary angiography.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Angina Pectoris; Aorta; Coronary Stenosis; Dilatation, Pathologic; Discriminant Analysis; Female; Humans; Hypertension, Pulmonary; Logistic Models; Male; Middle Aged; Multivariate Analysis; Pulmonary Artery; Ultrasonography
PubMed: 15006585
DOI: 10.1016/j.amjmed.2003.11.015 -
Journal of Cardiac Surgery Nov 2022We report a case of a 45-year-old man with severe aortic stenosis where computed tomography angiography incidentally revealed a fistulous communication between the conal...
We report a case of a 45-year-old man with severe aortic stenosis where computed tomography angiography incidentally revealed a fistulous communication between the conal branches of the right coronary artery and anterior interventricular artery and the left anterolateral aspect of the pulmonary trunk with a conglomerate of nondilated tortuous vessels along the anterior surface of right ventricular outflow tract.
Topics: Aortic Valve Stenosis; Coronary Angiography; Coronary Vessel Anomalies; Coronary Vessels; Fistula; Humans; Male; Middle Aged; Pulmonary Artery
PubMed: 35924997
DOI: 10.1111/jocs.16828 -
Echocardiography (Mount Kisco, N.Y.) Feb 2010We present a case of primary angiosarcoma of the pulmonary trunk that was initially misdiagnosed as a subacute massive pulmonary thromboembolism in a 26-year-old woman....
We present a case of primary angiosarcoma of the pulmonary trunk that was initially misdiagnosed as a subacute massive pulmonary thromboembolism in a 26-year-old woman. This is an extremely rare disease that is usually indistinguishable from acute or chronic thromboembolic disease of the pulmonary arteries because the clinical and radiologic findings of pulmonary artery angiosarcoma are similar to those of pulmonary thromboembolism. Although the incidence of pulmonary artery angiosarcoma is very low, our case demonstrates that this disease entity should be included in the differential diagnosis of pulmonary thromboembolism, especially in patients who do not respond to anticoagulant therapy or present with no identifiable source of thromboembolic events.
Topics: Adult; Diagnosis, Differential; Female; Hemangiosarcoma; Humans; Pulmonary Artery; Pulmonary Embolism; Ultrasonography; Vascular Neoplasms
PubMed: 20380673
DOI: 10.1111/j.1540-8175.2009.01059.x -
British Heart Journal Sep 1965
Topics: Adolescent; Adult; Aged; Child; Elasticity; Humans; In Vitro Techniques; Middle Aged; Pulmonary Artery
PubMed: 5829747
DOI: 10.1136/hrt.27.5.651 -
American Journal of Physiology.... May 2008The physiological basis of a characteristically low blood flow to the fetal lungs is incompletely understood. To determine the potential role of pulmonary vascular...
The physiological basis of a characteristically low blood flow to the fetal lungs is incompletely understood. To determine the potential role of pulmonary vascular interaction in this phenomenon, simultaneous wave intensity analysis (WIA) was performed in the pulmonary trunk (PT) and left pulmonary artery (LPA) of 10 anesthetized late-gestation fetal sheep instrumented with PT and LPA micromanometer catheters to measure pressure (P) and transit-time flow probes to obtain blood velocity (U). Studies were performed at rest and during brief complete occlusion of the ductus arteriosus to augment pulmonary vasoconstriction (n = 4) or main pulmonary artery to abolish wave transmission from the lungs (n = 3). Wave intensity (dI(W)) was calculated as the product of the P and U rates of change. Forward and backward components of dI(W) were determined after calculation of wave speed. PT and LPA WIA displayed an early systolic forward compression wave (FCW(is)) increasing P and U, and a late systolic forward expansion wave decreasing P and U. However, a marked midsystolic fall in LPA U to near-zero was related to an extremely prominent midsystolic backward compression wave (BCW(ms)) that arose approximately 5 cm distal to the LPA, was threefold larger than the PT BCW(ms) (P < 0.001), of similar size to FCW(is) at rest (P > 0.6), larger than FCW(is) following ductal occlusion (P < 0.05) and abolished after main pulmonary artery occlusion. These findings suggest that the absence of pulmonary arterial midsystolic forward flow which accompanies a low fetal lung blood flow is due to a BCW(ms) generated in part by cyclical vasoconstriction within the pulmonary microcirculation.
Topics: Animals; Blood Gas Analysis; Blood Pressure; Female; Fetus; Pregnancy; Pulmonary Artery; Pulmonary Circulation; Sheep; Vasoconstriction
PubMed: 18287223
DOI: 10.1152/ajpregu.00743.2007 -
Echocardiography (Mount Kisco, N.Y.) Mar 2017Up to 50% patients with Takayasu arteritis have pulmonary artery involvement. Hence, the early identification of pulmonary artery involvement to facilitate prompt...
BACKGROUND
Up to 50% patients with Takayasu arteritis have pulmonary artery involvement. Hence, the early identification of pulmonary artery involvement to facilitate prompt treatment is required.
METHODS
This retrospective study was performed in patients diagnosed with Takayasu arteritis between January 2009 and January 2016. Pulmonary artery involvement was confirmed with computed tomographic pulmonary angiography. Images from transthoracic echocardiography in three windows (suprasternal right pulmonary artery long-axis view, parasternal aortic short-axis view, and subxiphoid view) were documented and analyzed.
RESULTS
A total of 27 patients had Takayasu arteritis and pulmonary artery involvement. Characteristic changes identified by echocardiography included luminal medium-to-high echogenic signals, stenosis, and occlusion, as well as intimal thickening. Left pulmonary artery involvement was revealed in the parasternal aortic short-axis view. Right pulmonary artery involvement was best observed in the suprasternal right pulmonary artery long-axis view, with complementary views from the parasternal aortic short-axis and subxiphoid angles. Pulmonary trunk involvement was not observed in all three windows.
CONCLUSIONS
Transthoracic echocardiography could be a useful noninvasive test to detect pulmonary artery involvement in patients with Takayasu arteritis.
Topics: Adult; Echocardiography; Female; Humans; Male; Pulmonary Artery; Retrospective Studies; Takayasu Arteritis
PubMed: 28139021
DOI: 10.1111/echo.13464 -
BMC Cardiovascular Disorders Dec 2021Growth differentiation factor (GDF)-15 is linked to inflammation, cancer, and atherosclerosis. GDF-15 is expressed in most tissues but is extremely induced under...
Characterization of atherosclerotic plaques in blood vessels with low oxygenated blood and blood pressure (Pulmonary trunk): role of growth differentiation factor-15 (GDF-15).
BACKGROUND
Growth differentiation factor (GDF)-15 is linked to inflammation, cancer, and atherosclerosis. GDF-15 is expressed in most tissues but is extremely induced under pathological conditions. Elevated serum levels are suggested as a risk factor and a marker for cardiovascular diseases. However, the cellular sources and the effects of GDF-15 on the cardiovascular system have not been completely elucidated including progression, and morphology of atherosclerotic plaques. Thus, this work aimed to characterize the influence of GDF-15 deficiency on the morphology of atherosclerotic plaques in blood vessels with low-oxygen blood and low blood pressure as the pulmonary trunk (PT), in hypercholesterolemic ApoE mice.
METHODS
GDF-15 ApoE mice were generated by crossbreeding of ApoE- and GDF-15 mice. After feeding a cholesterol-enriched diet (CED) for 20 weeks, samples of the brachiocephalic trunk (BT) and PT were dissected and lumen stenosis (LS) was measured. Furthermore, changes in the cellularity of the PT, amounts of apoptosis-, autophagy-, inflammation- and proliferation-relevant proteins were immunohisto-morphometrically analyzed. Additionally, we examined an atherosclerotic plaque in a human post mortem sample of the pulmonary artery.
RESULTS
After CED the body weight of GDF-15ApoE was 22.9% higher than ApoE. Double knockout mice showed also an 35.3% increase of plasma triglyceride levels, whereas plasma cholesterol was similar in both genotypes. LS in the BT and PT of GDF-15ApoE mice was significantly reduced by 19.0% and by 6.7% compared to ApoE. Comparing LS in PT and BT of the same genotype revealed a significant 38.8% (ApoE) or 26.4% (GDF-15ApoE) lower LS in the PT. Immunohistomorphometry of atherosclerotic lesions in PT of GDF-15ApoE revealed significantly increased levels (39.8% and 7.3%) of CD68 macrophages (MΦ) and α-actin smooth muscle cells than in ApoE. The density of TUNEL , apoptotic cells was significantly (32.9%) higher in plaques of PT of GDF-15ApoE than in ApoE. Analysis of atherosclerotic lesion of a human pulmonary artery showed sm-α-actin, CD68, TUNEL, Ki67, and APG5L/ATG cells as observed in PT. COX-2 and IL-6 immunoreactivities were predominantly located in endothelial cells and subendothelial space. In BT and PT of GDF15ApoE mice the necrotic area was 10% and 6.5% lower than in ApoE. In BT and PT of GDF15ApoE we found 40% and 57% less unstable plaques than ApoE mice.
CONCLUSIONS
Atherosclerotic lesions occur in both, BT and PT, however, the size is smaller in PT, possibly due to the effect of the low-oxygen blood and/or lower blood pressure. GDF-15 is involved in atherosclerotic processes in BT and PT, although different mechanisms (e.g. apoptosis) in these two vessels seem to exist.
Topics: Animals; Apoptosis; Arterial Pressure; Atherosclerosis; Autophagy; Biomarkers; Cell Proliferation; Disease Models, Animal; Growth Differentiation Factor 15; Humans; Hypercholesterolemia; Lipids; Male; Mice, Inbred C57BL; Mice, Knockout, ApoE; Necrosis; Oxygen; Plaque, Atherosclerotic; Pulmonary Artery; Mice
PubMed: 34920697
DOI: 10.1186/s12872-021-02420-9 -
Asian Cardiovascular & Thoracic Annals Mar 2022Absence of arterial duct, a sixth aortic arch derivative, plays an important etiologic role in Tetralogy of Fallot with absent pulmonary valve syndrome. When fetal...
Absence of arterial duct, a sixth aortic arch derivative, plays an important etiologic role in Tetralogy of Fallot with absent pulmonary valve syndrome. When fetal ductus is absent, the large right ventricular stroke volume dilates the pulmonary trunk leading to pulmonary regurgitation. A proximal extension of the embryonic insult to the entire left sixth arch causes absence of the left pulmonary artery, a common association of absent pulmonary valve syndrome. On the contrary, absence of right pulmonary artery is not reported in absent pulmonary valve syndrome. A rare combination of tetralogy, absent pulmonary valve syndrome and isolation of a hypoplastic right pulmonary artery offered challenges to diagnosis and management.
Topics: Humans; Pulmonary Artery; Pulmonary Atresia; Pulmonary Valve; Tetralogy of Fallot; Treatment Outcome
PubMed: 33789442
DOI: 10.1177/02184923211006309 -
Annals of the Royal College of Surgeons... Oct 1975The branchial arch vessels of the human embryo have been studied by histological and radiographic methods and the modelling that occurs during the period Day 25-Day 52... (Review)
Review
The branchial arch vessels of the human embryo have been studied by histological and radiographic methods and the modelling that occurs during the period Day 25-Day 52 postfertilization is described. It has been shown that the myoendocardial reticulum is reamed out by blood flow and it is suggested that hydrodynamic force is the fundamental factor which determines chamber structure of the heart and flow pattern in the outflow tracts and great vessels. The sixth aortic arch vessels contribute tissue to the pulmonary trunk and proximal pulmonary arteries. The 'postbranchial pulmonary arteries' are morphologically distinct and form the pulmonary arteries at the lung hila. The primitive pulmonary plexus around the tips of the developing tracheobronchial primordia is formed from segmental vessels arising from the dorsal aorta. Bronchial arteries can be demonstrated only late in intrauterine life. The numerous bronchopulmonary precapillary anastomoses which are found in the fetus at this time have been demonstrated radiographically.
Topics: Animals; Aorta; Bronchi; Bronchial Arteries; Child, Preschool; Endocardium; Fetal Heart; Heart; Heart Defects, Congenital; Humans; Infant; Pressure; Pulmonary Artery; Pulmonary Circulation
PubMed: 1103698
DOI: No ID Found -
Pulmonary artery aneurysm secondary to patent arterial duct and infection: A case report and review.Echocardiography (Mount Kisco, N.Y.) Nov 2018Pulmonary artery aneurysms (PAAs) are very rare condition. In this paper, we report a case of a twenty-year-old female patient with the aneurysm of the pulmonary trunk... (Review)
Review
Pulmonary artery aneurysms (PAAs) are very rare condition. In this paper, we report a case of a twenty-year-old female patient with the aneurysm of the pulmonary trunk secondary to the patent arterial duct (PDA) and infection. Diagnosis of PAA was confirmed by echocardiography. The pulmonary artery computed tomographic angiography also revealed the aneurysm and drawn a similar conclusion as echo did. The patient underwent surgery of ligation of PDA and PAA aneurysmectomy repairing with pericardium graft.
Topics: Adult; Aneurysm; Ductus Arteriosus, Patent; Female; Follow-Up Studies; Humans; Ligation; Pulmonary Artery; Staphylococcal Infections; Staphylococcus aureus; Young Adult
PubMed: 30267632
DOI: 10.1111/echo.14138