John Swiston’s research while affiliated with Vancouver Coastal Health and other places

... This contrasts with findings in adults with PAH, where studies have shown the PAPi to be predictive of outcomes, with a lower PAPi associated with 1-year mortality [8,10]. However, even in adult patients, controversy exists regarding the additional value of this composite variable, as it is suggested to be primarily driven by its component mRAP, a well-known predictor of RV failure and death [12]. ...

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The Pulmonary Artery Pulsatility Index Provides No Additional Prognostic Information in Pediatric Pulmonary Arterial Hypertension

... be neither asked nor answered, despite being arguably one of the central issues for this (or any) chronic health condition. There is an increasing commitment to patient involvement in the PAH field 23,24 in realms ranging from research priorities through to trial design 25 and innovation targets, 26 as reflected in the consensus recommendations for PAH treatment developed at the 6th World Symposium on Pulmonary Hypertension. 27 Despite the importance of QOL, its formal measurement is not included in the risk assessment methodology proposed by the latest ESC/ERS pulmonary hypertension guidelines, 4 no doubt partly due to limitations of current tools, including a lack of complete standardization across varied populations and the challenges of capturing the full spectrum of symptoms and impact of the condition. ...

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Assessing quality of life in pulmonary arterial hypertension: An independent prognostic marker

... Centralizing care in this manner facilitates the accumulation of specialized knowledge and skills, which can significantly enhance the treatment and management of CTEPH. 57) This strategy emphasizes the importance of directing patients to specialized CTEPH centers as a crucial step towards cultivating expertise and establishing expert centers within their own countries. ...

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Recent Advances in Chronic Thromboembolic Pulmonary Hypertension: Expanding the Disease Concept and Treatment Options

... The drug with the longest persistence of use was riociguat (mean of 199.2 days), which is recommended to start with a titration phase with a dose of 1.0 mg three times a day and a progressive increase of 0.5 mg every 2 weeks up to a maximum dose of 2.5 mg three times a day as tolerated, which is surely associated with a higher follow-up time for the patient, allowing evaluation of the drug's effectiveness and tolerability [20]. Among the co-medications that patients received, the significant use of antihypertensives such as renin-angiotensin-aldosterone system blockers and beta-blockers, as well as other cardiovascular drugs, is striking, showing a significant frequency of this type of comorbidity, similar to that identified in patients with IPAH in the COMPERA registry [10], and also the use of anticonvulsants in 21% of the population evaluated, although the indication was not identified, these medications are widely used not only in epilepsy but also in indications such as bipolar affective disorder, neuropathic pain, migraine, or insomnia [21,22]. ...

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Treatment Patterns of Patients With Pulmonary Hypertension: A Descriptive Study in Colombia

... [20] We did not observe differences in survival by study period when comparing studies with mid-diagnosis/ enrolment year between 2005 and 2011 to those between 2012 and 2017, despite availability of additional therapies and risk stratification strategies for PAH in the latter period. This finding was consistent with analyses of registry data from Germany (2010-2019), Canada (2009-2021) and the Netherlands (2005-2009), not finding differences in survival when stratifying by diagnostic period [51,72,73]. Authors explained their findings by lack of coverage of combination therapy [51], while others detected an increase in combination therapy that they hypothesized to be overall insufficient [73]. ...

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Survival, morbidity, and quality of life in pulmonary arterial hypertension patients: a systematic review of outcomes reported by population-based observational studies

... 6MWD is a less invasive measurement than PVR and is a common endpoint measure in PAH clinical trials; therefore, we linked our multiscale model of PVR to 6MWD through a linear regression model ( Supplementary Fig. 1). The model was derived using baseline individual patient PVR and 6MWD values from the FREEDOM-EV clinical trial 2,4 . As seen in Supplementary Fig. 1, FREEDOM-EV patient 6MWD is significantly negatively correlated with PVR (Pearson's correlation coefficient = −0.38, ...

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Simulation of clinical trials of oral treprostinil in pulmonary arterial hypertension using a virtual population

... In addition, CT imaging enables the delineation of CLAD phenotypes through detection of bronchial wall thickening and expiratory air trapping, as seen with obstructive phenotypes, or by the identification of subpleural thickening and ground-glass opacities, as seen with restrictive phenotypes. 9 CT is often central to determining the severity of lung involvement and to discussions surrounding CLAD prognosis and treatment. Although it has many advantages, CT sensitivity for the early detection of CLAD ranges from 25% to 88% depending on the criteria used. ...

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Hyperpolarized 129Xe MRI and Spectroscopy of Gas-Exchange Abnormalities in Bilateral Lung Transplant Recipients

... A metaanalysis showed that although PH-targeted therapy may improve exercise capacity in patients with left heart disease (LHD), the risk of adverse events is higher. A meta-analysis showed that although pH targeted therapy can improve the exercise ability of patients with left heart disease (LHD), the risk of adverse events is higher, but the efficacy of human pH HFPEF patients still needs further clinical trials to verify, and the treatment strategy of skeletal muscle and right ventricular AMPK pathway may be a potential direction for the prevention of PH-LHD (125)(126)(127)(128)(129)(130)(131). ...

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Therapeutic challenges and new therapeutic targets for combined capillary pulmonary hypertension: a review

... 16 We supplemented mortality predictions from these tools with estimates of the effects of critical illness. Our recommendations apply only to PAH (not to PH groups [2][3][4][5]. ...

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Triaging Access to Critical Care Resources in Patients With Chronic Respiratory Diseases in the Event of a Major COVID-19 Surge: Key Highlights From the Canadian Thoracic Society (CTS) Position Statement

... Беременность при наличии ДМПП не противопоказана. Здесь ведущую роль играет присутствие легочной гипертензии [33]. Риск угрозы для жизни при беременности у пациенток без легочной гипертензии низкий. ...

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Atrial Septal Defect & Patent Foramen Ovale: Features of Ultrasound Diagnostics, Treatment and Monitoring in Children at the Present Stage