2024
Tumoral Pulmonary Hypertension in a Patient With Metastatic Breast Cancer: Diagnostic Opportunity of the Right Heart Catheterization
Tarras E, Sen S, Wang H, Singh I. Tumoral Pulmonary Hypertension in a Patient With Metastatic Breast Cancer: Diagnostic Opportunity of the Right Heart Catheterization. 2024, a2208-a2208. DOI: 10.1164/ajrccm-conference.2024.209.1_meetingabstracts.a2208.Peer-Reviewed Original Research
2023
Response to letter to the editor “noninvasive determinants of pulmonary hypertension in interstitial lung disease”
Joseph P, Savarimuthu S, Oakland H, Cullinan M, Heerdt P, Singh I. Response to letter to the editor “noninvasive determinants of pulmonary hypertension in interstitial lung disease”. Pulmonary Circulation 2023, 13: e12238. PMID: 37180828, PMCID: PMC10166920, DOI: 10.1002/pul2.12238.Peer-Reviewed Original ResearchInterstitial lung diseaseNoninvasive determinantsPulmonary hypertensionLung diseaseHypertensionDiseaseNoninvasive determinants of pulmonary hypertension in interstitial lung disease
Joseph P, Savarimuthu S, Zhao J, Yan X, Oakland H, Cullinan M, Heerdt P, Singh I. Noninvasive determinants of pulmonary hypertension in interstitial lung disease. Pulmonary Circulation 2023, 13: e12197. PMID: 36814586, PMCID: PMC9939578, DOI: 10.1002/pul2.12197.Peer-Reviewed Original ResearchInterstitial lung diseaseFVC/DLCO ratioPH-ILDRight heart catheterizationPulmonary hypertensionHeart catheterizationILD patientsLung diseaseDiagnostic right heart catheterizationRight ventricular systolic pressurePulmonary vascular capacitanceVentricular systolic pressureCharacteristic curve analysisMaximum oxygen uptakeExertional capacityNoninvasive determinantsSystolic pressureVascular capacitancePhysiologic evaluationPatientsNoninvasive variablesMultivariate analysisMmHgDiagnostic standardPotential initiation
2021
Chronic Thromboembolic Pulmonary Hypertension: the Bench
Alba GA, Atri D, Darbha S, Singh I, Tapson VF, Lewis MI, Chun HJ, Yu YR, Maron BA, Rajagopal S. Chronic Thromboembolic Pulmonary Hypertension: the Bench. Current Cardiology Reports 2021, 23: 141. PMID: 34410515, DOI: 10.1007/s11886-021-01572-6.Peer-Reviewed Original ResearchConceptsPulmonary embolismAcute pulmonary embolismThromboembolic pulmonary hypertensionPlatelet-rich thrombiPulmonary hypertensionUncommon complicationMedical therapyPulmonary vasculatureImmune cellsAnimal modelsEndothelial cellsPathobiologyPlatelet biologyThrombusHuman samplesTherapyCurrent knowledgeSummaryThe developmentCTEPHHypertensionVasculopathyCellsComplicationsEmbolismInflammationChronic Thromboembolic Pulmonary Hypertension: the Bedside
Matusov Y, Singh I, Yu YR, Chun HJ, Maron BA, Tapson VF, Lewis MI, Rajagopal S. Chronic Thromboembolic Pulmonary Hypertension: the Bedside. Current Cardiology Reports 2021, 23: 147. PMID: 34410530, PMCID: PMC8375459, DOI: 10.1007/s11886-021-01573-5.Peer-Reviewed Original ResearchConceptsPulmonary arterial hypertensionPulmonary embolismMedical therapyRight ventricular failureThromboembolic pulmonary hypertensionAcute pulmonary embolismArterial hypertensionPulmonary hypertensionVentricular failureUncommon complicationDisease mimicsPulmonary vasculatureMultimodality approachUnderlying pathologyPercutaneous interventionCurrent diagnosisCTEPHHypertensionTherapyDiagnosisTreatmentEmbolismComplicationsEmboliSurgeryQuantification of Arterial and Venous Morphologic Markers in Pulmonary Arterial Hypertension Using CT Imaging
Rahaghi FN, Nardelli P, Harder E, Singh I, Sánchez-Ferrero GV, Ross JC, San José Estépar R, Ash SY, Hunsaker AR, Maron BA, Leopold JA, Waxman AB, San José Estépar R, Washko GR. Quantification of Arterial and Venous Morphologic Markers in Pulmonary Arterial Hypertension Using CT Imaging. CHEST Journal 2021, 160: 2220-2231. PMID: 34270966, PMCID: PMC8692106, DOI: 10.1016/j.chest.2021.06.069.Peer-Reviewed Original ResearchConceptsExercise pulmonary hypertensionPulmonary arterial hypertensionControl subjectsPulmonary hypertensionSmall vessel volumeArterial hypertensionPulmonary arteryPulmonary vasculatureVascular tortuosityVascular volumeArterial volumePrecapillary pulmonary hypertensionCohort of patientsPulmonary vascular volumeVenous manifestationsThromboembolic diseaseCT angiogramArterial tortuosityHypertensionCT scanVessel volumeHeterogeneous diseasePatientsStudy designArteryPressure-based estimation of right ventricular ejection fraction: Validation as a clinically relevant target for drug development in a rodent model of pulmonary hypertension
Elassal A, Steppan J, Charania S, Santhanam L, Singh I, Heerdt PM. Pressure-based estimation of right ventricular ejection fraction: Validation as a clinically relevant target for drug development in a rodent model of pulmonary hypertension. Journal Of Pharmacological And Toxicological Methods 2021, 112: 107102. PMID: 34245885, PMCID: PMC8616781, DOI: 10.1016/j.vascn.2021.107102.Peer-Reviewed Original ResearchConceptsRight ventricular ejection fractionPulmonary arterial hypertensionRV pressure waveformsVentricular ejection fractionEjection fractionDepressed right ventricular ejection fractionClear prognostic significanceRight ventricular pressurePressure waveformVolume measurementsPAH therapyPulmonary hypertensionArterial hypertensionPrognostic significanceBland-Altman analysisVentricular pressureRat modelRV volumesRodent modelsDrug effectsHypertensionDrug developmentBeat intervalsRatsRelevant targetsArterial load and right ventricular-vascular coupling in pulmonary hypertension
Oakland H, Joseph P, Naeije R, Elassal A, Cullinan M, Heerdt PM, Singh I. Arterial load and right ventricular-vascular coupling in pulmonary hypertension. Journal Of Applied Physiology 2021, 131: 424-433. PMID: 34043473, PMCID: PMC8325619, DOI: 10.1152/japplphysiol.00204.2021.Peer-Reviewed Original ResearchConceptsPulmonary artery hypertensionRV-PA uncouplingPulmonary vascular resistancePressure waveform analysisRight ventriclePulmonary vascular impedancePulmonary hypertensionVascular impedanceRight heart catheterization dataRight ventricular-vascular couplingRV-pulmonary arterial couplingCpc-PH groupEjection fraction patientsHeart catheterization dataRV pressure curveRV-PA couplingLeft heart diseaseVentricular-vascular couplingSex-matched controlsAfterload parametersCpc-PHIpc-PHPH-HFpEFRV afterloadArtery hypertensionMacrophage-derived PDGF-B induces muscularization in murine and human pulmonary hypertension
Ntokou A, Dave JM, Kauffman AC, Sauler M, Ryu C, Hwa J, Herzog EL, Singh I, Saltzman WM, Greif DM. Macrophage-derived PDGF-B induces muscularization in murine and human pulmonary hypertension. JCI Insight 2021, 6: e139067. PMID: 33591958, PMCID: PMC8026182, DOI: 10.1172/jci.insight.139067.Peer-Reviewed Original ResearchConceptsRight ventricle hypertrophyPulmonary hypertensionDistal muscularizationSmooth muscle cellsHypoxia-inducible factor 2APulmonary arterial hypertension patientsLysM-Cre miceArterial hypertension patientsHuman pulmonary hypertensionHypoxia-inducible factor 1aPlatelet-derived growth factorMacrophage-conditioned mediumVentricle hypertrophyHypertension patientsDistal arteriolesMacrophage accumulationFl miceCardiovascular diseaseInterventional strategiesMuscularizationHypoxia exposureExcess macrophagesSMC proliferationLethal diseaseMuscle cellsPulmonary Hypertension in Pregnancy
Singh I, Horn E, Haythe J. Pulmonary Hypertension in Pregnancy. Clinics In Chest Medicine 2021, 42: 91-99. PMID: 33541621, DOI: 10.1016/j.ccm.2020.10.006.Peer-Reviewed Original ResearchConceptsPulmonary hypertensionPH patientsHigh maternal morbiditySystemic hemodynamic alterationsImmediate postpartum periodPotential deleterious consequencesMaternal morbidityHemodynamic alterationsPostpartum periodPhysiologic changesPregnancyCardiopulmonary circulationHypertensionPatientsDeleterious consequencesMorbidityMortality
2020
Systemic vascular distensibility relates to exercise capacity in connective tissue disease
Singh I, Oliveira RKF, Naeije R, Oldham WM, Faria-Urbina M, Waxman AB, Systrom DM. Systemic vascular distensibility relates to exercise capacity in connective tissue disease. Rheumatology 2020, 60: 1429-1434. PMID: 33001175, DOI: 10.1093/rheumatology/keaa510.Peer-Reviewed Original ResearchConceptsCTD patientsSystemic oxygen extractionExercise capacityVascular distensibilityCardiopulmonary diseaseOxygen extractionDecreased exercise capacityStroke volume augmentationReduced exercise capacityCommon clinical manifestationsRadial arterial catheterConnective tissue diseaseAerobic exercise capacityPulmonary vascular distensibilityCardio-pulmonary diseasePressure-flow plotsPulmonary hypertensionCardiopulmonary exerciseHeart failureArterial catheterExercise intoleranceTissue diseaseClinical manifestationsNormal controlsPatientsDiagnostic utility of sub‐maximum cardiopulmonary exercise testing in the ambulatory setting for heart failure with preserved ejection fraction
Oakland HT, Joseph P, Elassal A, Cullinan M, Heerdt PM, Singh I. Diagnostic utility of sub‐maximum cardiopulmonary exercise testing in the ambulatory setting for heart failure with preserved ejection fraction. Pulmonary Circulation 2020, 10: 1-10. PMID: 33282205, PMCID: PMC7691918, DOI: 10.1177/2045894020972273.Peer-Reviewed Original ResearchIsolated post-capillary pulmonary hypertensionPost-capillary pulmonary hypertensionCardiopulmonary exercise testRight heart catheterizationPulmonary vascular capacitanceVE/VCOPulmonary hypertensionEnd-tidal carbon dioxideEjection fractionHeart failureExercise testHeart catheterizationVascular capacitanceCombined preElevated left-sided filling pressuresLeft-sided filling pressuresGender-matched control subjectsOxygen uptake efficiency slopeCarbon dioxide slopeCardiopulmonary exercise testingPulmonary artery complianceEnd-tidal COAdjunct diagnostic toolMaximum oxygen uptakeGreater ventilatoryDynamic right ventricular function response to incremental exercise in pulmonary hypertension
Singh I, Oliveira RKF, Heerdt P, Brown MB, Faria‐Urbina M, Waxman AB, Systrom DM. Dynamic right ventricular function response to incremental exercise in pulmonary hypertension. Pulmonary Circulation 2020, 10: 1-8. PMID: 33062259, PMCID: PMC7534091, DOI: 10.1177/2045894020950187.Peer-Reviewed Original ResearchRight ventricle functionRight ventricle stroke work indexStroke work indexPulmonary hypertensionVentricle functionPeak oxygen uptakePeak VOIncremental exerciseArterial elastanceWork indexInvasive cardiopulmonary exercise testingGender-matched normal controlsExercise pulmonary hypertensionMaximum incremental exercisePulmonary arterial elastancePulmonary hypertension groupRight ventricle adaptationVentricular function responseCardiopulmonary exercise testingPulmonary hypertension patientsRight ventricle dysfunctionPulmonary arterial hypertensionOxygen uptakeArterial hypertensionHypertension groupPrecision Medicine in Pulmonary Hypertension
Singh I, Oldham W, Rahaghi F. Precision Medicine in Pulmonary Hypertension. Respiratory Medicine 2020, 241-255. DOI: 10.1007/978-3-030-31507-8_16.Peer-Reviewed Original ResearchPulmonary hypertensionManagement of patientsMultiple different etiologiesPersonalized medicine approachClinical characteristicsExercise testingDifferent etiologiesInnovative biomarkersComplex pathobiologyMedicine approachHeterogeneous disorderHemodynamic analysisHypertensionPrecision medicineImaging techniquesCurrent classificationPatientsHemodynamicsEtiologyPathobiologyBiomarkers
2019
Dynamic right ventricular–pulmonary arterial uncoupling during maximum incremental exercise in exercise pulmonary hypertension and pulmonary arterial hypertension
Singh I, Rahaghi F, Naeije R, Oliveira R, Vanderpool RR, Waxman A, Systrom D. Dynamic right ventricular–pulmonary arterial uncoupling during maximum incremental exercise in exercise pulmonary hypertension and pulmonary arterial hypertension. Pulmonary Circulation 2019, 9: 1-10. PMID: 31218910, PMCID: PMC6643191, DOI: 10.1177/2045894019862435.Peer-Reviewed Original ResearchPulmonary arterial hypertensionExercise pulmonary hypertensionRV-PA couplingMaximum incremental exerciseRV-PA uncouplingPulmonary hypertensionExercise pHRV contractilityArterial hypertensionExercise capacityIncremental exerciseInvasive cardiopulmonary exercise testingReduced peak oxygen consumptionPressure-volume loop analysisPulmonary arterial elastanceCardiopulmonary exercise testingRight ventricular functionPeak oxygen consumptionAge-matched controlsEnd-systolic elastanceContractile reserveExercise testingRV functionSuch patientsVentricular functionPulmonary Vascular Distensibility and Early Pulmonary Vascular Remodeling in Pulmonary Hypertension
Singh I, Oliveira RKF, Naeije R, Rahaghi FN, Oldham WM, Systrom DM, Waxman AB. Pulmonary Vascular Distensibility and Early Pulmonary Vascular Remodeling in Pulmonary Hypertension. CHEST Journal 2019, 156: 724-732. PMID: 31121149, DOI: 10.1016/j.chest.2019.04.111.Peer-Reviewed Original ResearchConceptsPulmonary arterial hypertensionAerobic exercise capacityExercise pulmonary hypertensionPulmonary hypertensionPulmonary vascular distensibilityExercise capacityUnexplained dyspneaControl subjectsVascular distensibilitySex-matched normal control subjectsInvasive pulmonary hemodynamicsRV pressure curveRV-PA couplingRV-PA uncouplingPulmonary vascular remodelingExercise stress testingEes/EaPeak oxygen consumptionNormal control subjectsPressure-flow plotsArterial hypertensionPulmonary hemodynamicsEjection fractionHeart failureRight ventricularPulmonary Vascular Distensibility and Early Pulmonary Vascular Remodelling in Pulmonary Hypertension
Singh I, Oliveira R, Naeije R, Rahaghi F, Oldham W, Systrom D, Waxman A. Pulmonary Vascular Distensibility and Early Pulmonary Vascular Remodelling in Pulmonary Hypertension. 2019, a3668-a3668. DOI: 10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a3668.Peer-Reviewed Original Research
2017
Pulmonary extra‐medullary hematopoiesis and pulmonary hypertension from underlying polycythemia vera: a case series
Singh I, Mikita G, Green D, Risquez C, Sanders A. Pulmonary extra‐medullary hematopoiesis and pulmonary hypertension from underlying polycythemia vera: a case series. Pulmonary Circulation 2017, 7: 261-267. PMID: 28680586, PMCID: PMC5448544, DOI: 10.1177/2045893217702064.Peer-Reviewed Original ResearchExtra-medullary hematopoiesisPulmonary hypertensionPolycythemia veraCase seriesJanus kinase 2 mutationRecent clinical classificationKinase 2 mutationRadiological featuresRare complicationHematopoietic precursor cellsClinical classificationIdiopathic myelofibrosisEssential thrombocytosisMyeloproliferative neoplasiaMyeloid phenotypeHeterogeneous groupPrecursor cellsHypertensionGroup fiveDisordersMyelofibrosisVeraHematopoiesisPrimary expressionComplications
2016
Pulmonary Extra-medullary Hematopoiesis and Pulmonary Hypertension From Underlying Polycythemia Vera: A Case Series.
Singh I, Mikita G, Green D, Risquez C, Sanders A. Pulmonary Extra-medullary Hematopoiesis and Pulmonary Hypertension From Underlying Polycythemia Vera: A Case Series. Pulmonary Circulation 2016 DOI: 10.1086/690730.Peer-Reviewed Original Research
2015
Pathophysiology of Pulmonary Hypertension in Chronic Parenchymal Lung Disease
Singh I, Cong K, Berlin DA. Pathophysiology of Pulmonary Hypertension in Chronic Parenchymal Lung Disease. The American Journal Of Medicine 2015, 129: 366-371. PMID: 26706386, DOI: 10.1016/j.amjmed.2015.11.026.Peer-Reviewed Original ResearchConceptsLung disease-associated pulmonary hypertensionChronic obstructive pulmonary diseaseObstructive pulmonary diseasePulmonary hypertensionLung diseasePulmonary diseaseChronic parenchymal lung diseaseNormal pulmonary circulationChronic lung diseaseIdiopathic pulmonary fibrosisInterstitial lung diseaseParenchymal lung diseasePulmonary fibrosisWorse prognosisPathophysiological factorsPulmonary circulationHypertensionDiseasePathophysiologyPhysiological determinantsSarcoidosisPrognosisFibrosis