2023
Integrating Right Ventricular Pressure Waveform Analysis With Two-Point Volume Measurement for Quantification of Systolic and Diastolic Function: Experimental Validation and Clinical Application
Heerdt P, Martin-Flores M, Oakland H, Joseph P, Singh I. Integrating Right Ventricular Pressure Waveform Analysis With Two-Point Volume Measurement for Quantification of Systolic and Diastolic Function: Experimental Validation and Clinical Application. Journal Of Cardiothoracic And Vascular Anesthesia 2023, 37: 1929-1937. PMID: 37422337, PMCID: PMC10529383, DOI: 10.1053/j.jvca.2023.06.011.Peer-Reviewed Original ResearchConceptsRight heart catheterizationHeart catheterizationDiastolic functionRV volumesBeat measuresDiagnostic right heart catheterizationReference standardRight ventricular contractilityEnd-diastolic pressurePressure waveform analysisEnd-systolic elastancePotential clinical utilityClinical applicationRV volume measurementsVolume measurementsRV contractilityRV systolicVentricular contractilityRV pressureBland-Altman analysisClinical utilityAnesthetized swineNitric oxideExperimental modelContractility
2022
Pressure‐based estimation of right ventricular ejection fraction
Heerdt PM, Singh I, Elassal A, Kheyfets V, Richter MJ, Tello K. Pressure‐based estimation of right ventricular ejection fraction. ESC Heart Failure 2022, 9: 1436-1443. PMID: 35150211, PMCID: PMC8934966, DOI: 10.1002/ehf2.13839.Peer-Reviewed Original ResearchConceptsRight ventricular ejection fractionCardiac magnetic resonance imagingRight heart catheterizationPulmonary arterial hypertensionMagnetic resonance imagingRV pressure waveformsVentricular ejection fractionRV responseEjection fractionMale PAH patientsCardiac MRI measurementsReceiver operator characteristic curvePressure waveformROC curve analysisClinical reference standardOperator characteristic curveSignificant reductionMeasurements of RVEFPAH patientsArterial hypertensionHeart catheterizationSecondary outcomesStudy cohortLimits of agreementBland-Altman analysis
2021
Persistent Exertional Intolerance After COVID-19 Insights From Invasive Cardiopulmonary Exercise Testing
Singh I, Joseph P, Heerdt PM, Cullinan M, Lutchmansingh DD, Gulati M, Possick JD, Systrom DM, Waxman AB. Persistent Exertional Intolerance After COVID-19 Insights From Invasive Cardiopulmonary Exercise Testing. CHEST Journal 2021, 161: 54-63. PMID: 34389297, PMCID: PMC8354807, DOI: 10.1016/j.chest.2021.08.010.Peer-Reviewed Original ResearchConceptsInvasive cardiopulmonary exercise testingCardiopulmonary exercise testingCardiopulmonary diseaseExercise testingControl participantsPeak VOExertional limitationCOVID-19Greater ventilatory inefficiencyPeak cardiac indexSex-matched control participantsCohort of patientsSystemic oxygen extractionDead space ventilationOnly mild symptomsExertional intoleranceCardiac indexPulmonary hemodynamicsAcute infectionVentilatory inefficiencyExercise intolerancePathophysiologic mechanismsMild symptomsHyperventilatory responseOxygen extractionPressure-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 hypertensionSex-Related Differences in Dynamic Right Ventricular-Pulmonary Vascular Coupling in Heart Failure With Preserved Ejection Fraction
Singh I, Oliveira RKF, Heerdt PM, Pari R, Systrom DM, Waxman AB. Sex-Related Differences in Dynamic Right Ventricular-Pulmonary Vascular Coupling in Heart Failure With Preserved Ejection Fraction. CHEST Journal 2021, 159: 2402-2416. PMID: 33388286, DOI: 10.1016/j.chest.2020.12.028.Peer-Reviewed Original ResearchMeSH KeywordsAgedCardiac CatheterizationEchocardiographyExercise ToleranceFemaleFollow-Up StudiesHeart FailureHeart VentriclesHumansIncidenceMalePulmonary ArteryPulmonary Wedge PressureRetrospective StudiesSex DistributionSex FactorsStroke VolumeSystoleUnited StatesVascular ResistanceVentricular Function, RightVentricular PressureConceptsRV-PA couplingRV-PA uncouplingFemale patientsMale patientsPeak VORV contractilityEjection fractionHeart failureRight ventricular-pulmonary vascular couplingRV-pulmonary arterial couplingAge-matched control subjectsInvasive pulmonary hemodynamicsMaximum incremental exercisePulmonary arterial elastanceRV pressure waveformsPeak exercise capacityRight ventricular dysfunctionSingle-beat analysisEnd-systolic elastanceSex-related differencesPA elastanceRV afterloadVentricular dysfunctionAfterload mismatchContractile impairment
2019
A pressure-based single beat method for estimation of right ventricular ejection fraction: proof of concept
Heerdt PM, Kheyfets V, Charania S, Elassal A, Singh I. A pressure-based single beat method for estimation of right ventricular ejection fraction: proof of concept. European Respiratory Journal 2019, 55: 1901635. PMID: 31771999, PMCID: PMC7885179, DOI: 10.1183/13993003.01635-2019.Peer-Reviewed Original ResearchConceptsSingle-beat methodEjection fractionEnd-systolic ventricular elastanceRight ventricular ejection fractionRV pressure waveformsRight ventricular contractilityVentricular ejection fractionRV ejection fractionEes/EaVentricular contractilityCardiovascular decompensationVentricular elastancePressure waveformPulmonary 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 ventricularRight Ventricular-Arterial Uncoupling During Exercise in Heart Failure With Preserved Ejection Fraction Role of Pulmonary Vascular Dysfunction
Singh I, Rahaghi FN, Naeije R, Oliveira RKF, Systrom DM, Waxman AB. Right Ventricular-Arterial Uncoupling During Exercise in Heart Failure With Preserved Ejection Fraction Role of Pulmonary Vascular Dysfunction. CHEST Journal 2019, 156: 933-943. PMID: 31103695, DOI: 10.1016/j.chest.2019.04.109.Peer-Reviewed Original ResearchConceptsEes/EaRV-PA uncouplingPulmonary vascular dysfunctionResistive afterloadHeart failureVascular dysfunctionRight ventricular-pulmonary artery couplingLower pulmonary artery complianceRight ventricular-arterial uncouplingInvasive pulmonary hemodynamicsPulmonary arterial elastanceRV contractile reserveRV pressure waveformsVentricular-arterial uncouplingRight ventricular dysfunctionExercise-induced decreasePulmonary artery complianceExercise-induced increaseGroup of patientsLower peak VOLower stroke volumePeak oxygen consumptionSingle-beat analysisEnd-systolic elastancePVR response