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American Journal of Physiology. Cell... Mar 2020Unlike the pulmonary artery (PA), the pathophysiological changes of the pulmonary vein (PV) in the development of pulmonary hypertension (PH) remain largely unknown. In...
Unlike the pulmonary artery (PA), the pathophysiological changes of the pulmonary vein (PV) in the development of pulmonary hypertension (PH) remain largely unknown. In this study, we comprehensively investigated the structural and functional changes in the PV isolated from the chronic hypoxia (CH; 10% O, 21 days)-induced PH rat model (CHPH). Results showed that CH caused an increase in right ventricular pressure but did not affect the mean pulmonary venous pressure and the left atrial pressure. Similar to the PA, vascular lumen stenosis and medial thickening were also observed in the intrapulmonary veins isolated from the CHPH rats. Notably, CH induced more severe loss in the endothelium of intrapulmonary veins than the arteries. Then, the contractile response to 5-HT and U46619 was significantly greater in the intrapulmonary small veins (ISPV) and arteries (ISPA) isolated from CHPH rats than those from normoxic rats but not in the extrapulmonary and intrapulmonary large veins. Treatment with nifedipine (Nif), SKF96365 (SKF), or ryanodine and caffeine either partially attenuated (Nif) or dramatically abolished (SKF or ryanodine and caffeine) 5-HT-induced maximal contraction in ISPV from both normoxic and CHPH rats. Because of the severe loss of endothelium in the PV of CHPH rats, the decrease in acetylcholine (ACh)-induced endothelium-dependent relaxation was significantly larger in ISPV than ISPA, whereas the sodium nitroprusside-induced endothelium-independent relaxation was not altered in both ISPA and ISPV. In conclusion, our results provide fundamental data to comprehensively define the PV system in CHPH rat model.
Topics: Animals; Cells, Cultured; Chronic Disease; Disease Models, Animal; Hypertension, Pulmonary; Hypoxia; Male; Organ Culture Techniques; Pulmonary Veins; Rats; Rats, Sprague-Dawley; Vasoconstrictor Agents; Vasodilator Agents
PubMed: 31940248
DOI: 10.1152/ajpcell.00289.2019 -
Journal of Interventional Cardiac... Dec 2023Cryoballoon (CB)-guided pulmonary vein isolation (PVI) is an established treatment for atrial fibrillation (AF). This observational study aimed to assess the role of... (Observational Study)
Observational Study
BACKGROUND
Cryoballoon (CB)-guided pulmonary vein isolation (PVI) is an established treatment for atrial fibrillation (AF). This observational study aimed to assess the role of individual anatomical characteristics to predict long-term freedom from arrhythmia recurrence after CB-guided PVI for paroxysmal AF (PAF).
METHODS
Three hundred fifty three consecutive patients (58 ± 11 years, 56% males), undergoing PVI between 2012 and 2018 were analysed. Individual pulmonary vein (PV) anatomy was assessed using preprocedural cardiac magnetic resonance imaging (MRI). For each PV, the cross-sectional area (CSA) was calculated. The impact of PV characteristics and CSA on long-term AF-free survival was evaluated.
RESULTS
Acute PVI was achieved in all patients. Two hundred twenty-three patients (63%) had a normal PV anatomy (2 left- and 2 right-sided PV). Variant PV anatomy was present in 130 patients (37%). During the observation period of 48 months, AF-recurrence was documented in 167 patients (47 %). Patients with AF-recurrence presented with significantly enlarged right-sided PVs and left superior PVs (LSPVs) (p < 0.001). The presence of left common PVs (LCPVs) (n = 75, Log-rank p < 0.001) as well as right variant PVs (n = 35, Log rank p < 0.001) was associated with a significantly impaired long-term AF-free survival rate as compared to patients with normal PV characteristics.
CONCLUSION
Variant PV anatomy is a good predictor for AF-recurrence. A correlation between an enlarged CSA of right-sided PVs as well as LSPVs and AF-recurrence was documented.
Topics: Male; Humans; Female; Atrial Fibrillation; Cryosurgery; Pulmonary Veins; Magnetic Resonance Imaging; Treatment Outcome; Catheter Ablation; Recurrence
PubMed: 37145294
DOI: 10.1007/s10840-023-01554-4 -
JACC. Clinical Electrophysiology Oct 2020
Topics: Athletes; Atrial Fibrillation; Catheter Ablation; Humans; Pulmonary Veins
PubMed: 33092754
DOI: 10.1016/j.jacep.2020.06.013 -
Pediatric Cardiology Oct 2023The fetal pulmonary circulation represents less than 25% of the fetal cardiac output. In comparison with the pulmonary arteries, studies on pulmonary veins are few and... (Review)
Review
The fetal pulmonary circulation represents less than 25% of the fetal cardiac output. In comparison with the pulmonary arteries, studies on pulmonary veins are few and limited, and many questions remain to be answered. The literature reports that pulmonary veins play an important role in regulating vascular flow, forming an active segment of the pulmonary circulation. The development of more sophisticated ultrasonography technology has allowed the investigation of the extraparenchymal pulmonary veins and their waveform. The recognition of the pulmonary vein anatomy in echocardiography is important for the diagnosis of anomalous pulmonary venous connections, with a significant impact on prognosis. On the other hand, the identification of the normal pulmonary vein waveform seems to be a reliable way to study left heart function, with potential applicability in fetal and maternal pathology. Thus, the goal of this narrative review was to provide a clinically oriented perspective of the available literature on this topic.
Topics: Pregnancy; Female; Humans; Pulmonary Veins; Ultrasonography, Prenatal; Fetus; Echocardiography; Ultrasonography, Doppler
PubMed: 37505268
DOI: 10.1007/s00246-023-03244-4 -
JACC. Clinical Electrophysiology Apr 2023
Topics: Humans; Pulmonary Veins; Atrial Fibrillation; Catheter Ablation
PubMed: 37100533
DOI: 10.1016/j.jacep.2022.12.026 -
Medicina (Kaunas, Lithuania) 2014Pulmonary vein (PV) sleeves are established as the main substrate taking part in the mechanisms of atrial fibrillation (AF) initiation. However, we have extremely few...
BACKGROUND AND OBJECTIVE
Pulmonary vein (PV) sleeves are established as the main substrate taking part in the mechanisms of atrial fibrillation (AF) initiation. However, we have extremely few data concerning their physiological role in the heart contractility. The aim of the study was to estimate the mechanical function of the left atrium (LA) and PV sleeves before and early after their isolation.
MATERIALS AND METHODS
A total of 17 patients with a mean age of 57.4±8.3 years who underwent PVs isolation due to AF were enrolled in the study. A day before the procedure a computed tomography (CT) of the LA and PVs and dopplerography of transmitral flow were performed. During the procedure the mechanical function of the LA and PV sleeves were estimated by transesophageal echocardiography and manometry in the left heart chambers.
RESULTS
During the invasive study the patterns of the heart chambers and PV sleeves pressure were identified. These patterns confirmed the active role of the PV sleeves in LA filling and active LA relaxation during left ventricular systole. After PV isolation an alteration of transmitral blood flow and increase of LA pressure were registered. However, diastolic dysfunction was ruled out by LV manometry, thereby testifying LA mechanical function disturbance. The change in PV hemodynamics also occurred as a result of the decrease in PV sleeves contractility, revealed by manometry and paired CT scans.
CONCLUSIONS
The PVs take an active part in left atrial filling by contraction of their sleeves. Antrum isolation of the PVs leads to the deterioration of their contractility and LA reservoir function.
Topics: Aged; Atrial Fibrillation; Catheter Ablation; Echocardiography, Doppler; Female; Heart Atria; Hemodynamics; Humans; Mechanical Phenomena; Middle Aged; Multidetector Computed Tomography; Myocardial Contraction; Pulmonary Veins; Systole
PubMed: 25541269
DOI: 10.1016/j.medici.2014.11.008 -
Methodist DeBakey Cardiovascular Journal Apr 2021Catheter ablation has become a cornerstone treatment for atrial fibrillation (AF). Pulmonary vein isolation is the accepted approach for paroxysmal AF ablation, but it... (Review)
Review
Catheter ablation has become a cornerstone treatment for atrial fibrillation (AF). Pulmonary vein isolation is the accepted approach for paroxysmal AF ablation, but it is less effective for persistent AF. The vein of Marshall (VOM) is located in the epicardial left atrium and can be a source of AF triggers as well as a tract for autonomic nerves. It directly communicates with the underlying myocardium, including the left atrial ridge and the posterior mitral isthmus. This review discusses the latest evidence regarding the mechanisms, procedural aspects, and outcomes of VOM ethanol infusion when used as an adjunct to pulmonary vein isolation in patients with persistent AF.
Topics: Ablation Techniques; Action Potentials; Animals; Atrial Fibrillation; Coronary Vessels; Ethanol; Heart Rate; Humans; Infusions, Intravenous; Pulmonary Veins
PubMed: 34104321
DOI: 10.14797/ZQME8581 -
JACC. Cardiovascular Interventions Nov 2022
Topics: Humans; Pulmonary Veins; Treatment Outcome; Pulmonary Veno-Occlusive Disease; Angioplasty, Balloon; Ultrasonography, Interventional; Stents
PubMed: 36357037
DOI: 10.1016/j.jcin.2022.08.025 -
Journal of Cardiovascular... Feb 2002Accurate discrimination of atrial and pulmonary vein potentials recorded circumferentially within the pulmonary veins is important when performing segmental isolation of...
INTRODUCTION
Accurate discrimination of atrial and pulmonary vein potentials recorded circumferentially within the pulmonary veins is important when performing segmental isolation of the pulmonary veins in patients with atrial fibrillation.
METHODS AND RESULTS
Twenty patients with paroxysmal atrial fibrillation underwent pulmonary vein mapping with a decapolar Lasso catheter during sinus rhythm and during pacing in the distal coronary sinus and left atrial appendage. Bipolar and unipolar electrograms were recorded within the left superior, right superior, and left inferior pulmonary veins. The atrial potentials were larger in the left pulmonary veins than in the right superior pulmonary vein, whereas the pulmonary vein potentials in the superior pulmonary veins were larger than in the left inferior pulmonary vein. The atrial and pulmonary vein potentials usually were readily distinguished during sinus rhythm in the right superior pulmonary vein. Characteristic distribution and morphologies of the atrial potentials as well as the response to distal coronary sinus and left atrial appendage pacing were useful for differentiating the atrial and pulmonary vein potentials in the left pulmonary veins.
CONCLUSION
Atrial and pulmonary vein potentials recorded circumferentially within the pulmonary veins have characteristic features that are useful in distinguishing them from each other. In the left pulmonary veins, discrimination of the atrial and pulmonary vein potentials is aided by coronary sinus or left atrial appendage pacing.
Topics: Analysis of Variance; Atrial Fibrillation; Electrocardiography; Electrophysiology; Female; Heart Atria; Humans; Male; Middle Aged; Pulmonary Veins
PubMed: 11900284
DOI: 10.1046/j.1540-8167.2002.00118.x -
JACC. Clinical Electrophysiology Sep 2021
Topics: Atrial Fibrillation; Cryosurgery; Humans; Pulmonary Veins
PubMed: 34332869
DOI: 10.1016/j.jacep.2021.04.010