American journal of respiratory and critical care medicine
-
Am. J. Respir. Crit. Care Med. · Oct 2024
Sex-specific Genetic Determinants of Right Ventricular Structure and Function.
While sex differences in right heart phenotypes have been observed, the molecular drivers remain unknown. ⋯ BMPR1A has emerged as a biologically plausible candidate gene for female-specific genetic determination of RV function, showing associations with cardiac performance under chronically increased afterload in female patients with PAH.
-
Am. J. Respir. Crit. Care Med. · Oct 2024
The Effect of PEEP on Pulmonary Vascular Resistance Depends on Lung Recruitability in ARDS Patients.
Rationale: A U-shaped relationship should exist between lung volume and pulmonary vascular resistance (PVR), with minimal PVR at FRC. Thus, positive end-expiratory pressure (PEEP) in patients with acute respiratory distress syndrome (ARDS) should increase PVR if it induces significant lung distension compared with recruitment. However, this has never been proved in patients. ⋯ Raising PEEP decreased cardiac index only in preload responsive patients. Conclusions: PEEP increases PVR only when it induces significant lung distension compared with recruitment according to the R/I ratio. Tailoring PEEP on this recruitability index should mitigate its hemodynamic effects.