2024
The metabolic and physiologic impairments underlying long COVID associated exercise intolerance
Leitner B, Joseph P, Quast A, Ramirez M, Heerdt P, Villalobos J, Singh I. The metabolic and physiologic impairments underlying long COVID associated exercise intolerance. Pulmonary Circulation 2024, 14: e70009. PMID: 39544193, PMCID: PMC11560803, DOI: 10.1002/pul2.70009.Peer-Reviewed Original ResearchPeak VO<sub>2</sub>Long COVID patientsCOVID patientsReduced peak VOSeverity of SARS-CoV-2 infectionSystemic oxygen extractionSARS-CoV-2 infectionLong COVIDArterial blood samplesQuantitative metabolomicsPeak VOVenous lactateCardiac outputImpaired mitochondrial ATP productionMild infectionExercise capacityPatientsMitochondrial ATP productionExercise intoleranceArteriovenous gradientBlood samplesOxygen extractionDependent mannerMetabolomicsPhysiological impairmentDyspnea in a Patient With Metastatic Breast Cancer
Tarras E, Sen S, Wang H, Singh I. Dyspnea in a Patient With Metastatic Breast Cancer. CHEST Pulmonary 2024, 2: 100074. DOI: 10.1016/j.chpulm.2024.100074.Peer-Reviewed Original ResearchThe casting of invasive cardiopulmonary exercise testing: towards a common goal.
Singh I, Waxman A. The casting of invasive cardiopulmonary exercise testing: towards a common goal. European Respiratory Journal 2024, 64: 2400783. PMID: 38991723, DOI: 10.1183/13993003.00783-2024.Peer-Reviewed Original ResearchRight Ventricular Pressure Waveform Analysis—Clinical Relevance and Future Directions
Heerdt P, Kheyfets V, Oakland H, Joseph P, Singh I. Right Ventricular Pressure Waveform Analysis—Clinical Relevance and Future Directions. Journal Of Cardiothoracic And Vascular Anesthesia 2024, 38: 2433-2445. PMID: 39025682, PMCID: PMC11580041, DOI: 10.1053/j.jvca.2024.06.022.Peer-Reviewed Original ResearchRight ventricular pressureRight ventricular functionVentricular pressureVentricular functionMeasuring right ventricular pressureMeasurements of right ventricular pressurePeak right ventricular pressurePulmonary artery pressureEvaluate cardiac functionPulmonary arteryStroke volume measurementsRight atriumCardiac functionDiastolic fillingSurgical patientsArterial pressureClinical valueDemonstrating utilityVolume measurementsMeasurements of pressurePressure waveformAccurate surrogateContinuous measurement of pressurePhysiological factorsEchocardiographyStiffening of the human proximal pulmonary artery with increasing age
Manning E, Mishall P, Ramachandra A, Hassab A, Lamy J, Peters D, Murphy T, Heerdt P, Singh I, Downie S, Choudhary G, Tellides G, Humphrey J. Stiffening of the human proximal pulmonary artery with increasing age. Physiological Reports 2024, 12: e16090. PMID: 38884325, PMCID: PMC11181131, DOI: 10.14814/phy2.16090.Peer-Reviewed Original ResearchConceptsProximal pulmonary arteriesPulmonary arteryAge-related stiffeningRight ventricular ejection fractionVentricular ejection fractionMean wall thicknessEjection fractionNo significant differenceSystemic circulationLuminal caliberDiffusing capacityArterial stiffeningIncreasing ageSignificant differenceDistensionArteryWall thicknessAdverse effectsWall strainVessel diameterCyclic biaxial strainOrgan donorsAgeMicrostructural remodelingThree-dimensional (3D) Right Ventricular Surface Strain Computed From 3D Echocardiography Correlates With RVEF and Reveals Differences in Deformation Based on Severity of Pulmonary Arterial Hypertension Symptoms
Oakland H, Bellumkonda L, Sugeng L, Joseph P, Izzi D, Zalik F, McCabe S, Raza A, Amendola R, Heerdt P, Singh I, Hunter K. Three-dimensional (3D) Right Ventricular Surface Strain Computed From 3D Echocardiography Correlates With RVEF and Reveals Differences in Deformation Based on Severity of Pulmonary Arterial Hypertension Symptoms. 2024, a7381-a7381. DOI: 10.1164/ajrccm-conference.2024.209.1_meetingabstracts.a7381.Peer-Reviewed Original ResearchTumoral 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
Differential cardiopulmonary haemodynamic phenotypes in PASC-related exercise intolerance
Kahn P, Joseph P, Heerdt P, Singh I. Differential cardiopulmonary haemodynamic phenotypes in PASC-related exercise intolerance. ERJ Open Research 2023, 10: 00714-2023. PMID: 38348243, PMCID: PMC10860209, DOI: 10.1183/23120541.00714-2023.Peer-Reviewed Original ResearchInvasive cardiopulmonary exercise testingRight heart catheterizationPASC patientsExertional intoleranceCardiac outputPulmonary artery wedge pressurePeak VO 2Supranormal cardiac outputPeak exercise capacityCardiopulmonary exercise testingMaximal voluntary ventilationPost-acute sequelaeBody mass indexSystemic oxygen extractionMild acute illnessSARS-CoV-2Exercise hemodynamicsHFpEF patientsHFpEF phenotypeHeart catheterizationWedge pressureAcute illnessExercise capacityExercise testingHemodynamic abnormalitiesRight Heart Failure in the Intensive Care Unit: Etiology, Pathogenesis, Diagnosis, and Treatment.
Tarras E, Khosla A, Heerdt P, Singh I. Right Heart Failure in the Intensive Care Unit: Etiology, Pathogenesis, Diagnosis, and Treatment. Journal Of Intensive Care Medicine 2023, 8850666231216889. PMID: 38031338, DOI: 10.1177/08850666231216889.Peer-Reviewed Original ResearchRight heart failureFailure patientsHeart failureTreatment optionsIntensive care unit settingMechanical circulatory support devicesIntensive care unitCirculatory support devicesCardio-pulmonary physiologyCare unitDifferent pharmacotherapiesUnit settingClinical guidancePathophysiological manifestationsCirculatory physiologyIntensivistsPatientsSupport devicesSupport optionsCirculatory systemHigh rateTreatmentDiagnosisFailureOptionsPost-Acute Sequelae of SARS-CoV-2 More Than Deconditioning
Joseph P, Singh I. Post-Acute Sequelae of SARS-CoV-2 More Than Deconditioning. CHEST Journal 2023, 164: 583-584. PMID: 37689472, DOI: 10.1016/j.chest.2023.03.014.Peer-Reviewed Original ResearchCognitive impairment in pulmonary arterial hypertension
Heller S, See C, Singh I, Fredericks C. Cognitive impairment in pulmonary arterial hypertension. Annals Of Clinical And Translational Neurology 2023, 10: 1899-1903. PMID: 37550957, PMCID: PMC10578884, DOI: 10.1002/acn3.51867.Peer-Reviewed Original ResearchConceptsPulmonary arterial hypertensionCognitive impairmentArterial hypertensionPulmonary artery pressureRight heart dysfunctionPulmonary vascular remodelingCognitive impairment syndromeVascular cognitive impairmentArtery pressureCardiopulmonary exerciseHeart dysfunctionNoninvasive markerCognitive dysfunctionVascular remodelingAdult subjectsImpairmentHypertensionUnderlying mechanismAbnormal increaseDysfunctionSyndromeCognitive evaluationSubjectsHigh-Risk Pulmonary Embolism: Management for the Intensivist
Khosla A, Zhao Y, Mojibian H, Pollak J, Singh I. High-Risk Pulmonary Embolism: Management for the Intensivist. Journal Of Intensive Care Medicine 2023, 38: 1087-1098. PMID: 37455352, DOI: 10.1177/08850666231188290.Peer-Reviewed Original ResearchConceptsHigh-risk pulmonary embolismHigh-risk PE patientsPulmonary embolismRisk stratificationPE patientsTreatment optionsRisk pulmonary embolismMassive pulmonary embolismIntensivist’s perspectiveReperfusion therapySupportive careAcute managementPatientsIntensivistsSupport optionsEmbolismHigh rateCarePhysiological consequencesOutcomesTreatmentOptionsStratificationMorbidityTherapyIntegrating 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 modelContractilityThe Extracellular Matrix of the Human Proximal Pulmonary Artery Regulates Gene Expression of Resident Cells Responsible for Remodeling During Aging
Yuan Y, Khoury J, Ramachandra A, Singh I, Tellides G, Humphrey J, Kaminski N, Manning E. The Extracellular Matrix of the Human Proximal Pulmonary Artery Regulates Gene Expression of Resident Cells Responsible for Remodeling During Aging. 2023, a2680-a2680. DOI: 10.1164/ajrccm-conference.2023.207.1_meetingabstracts.a2680.Peer-Reviewed Original ResearchAge-related Changes in Structure, Function, and Transcriptomics of the Human Proximal Pulmonary Artery
Manning E, Ramachandra A, Cavinato C, Schupp J, Justet A, Lee P, Heerdt P, Singh I, Murphy T, Gill T, Tellides G, Kaminski N, Humphrey J. Age-related Changes in Structure, Function, and Transcriptomics of the Human Proximal Pulmonary Artery. 2023, a4656-a4656. DOI: 10.1164/ajrccm-conference.2023.207.1_meetingabstracts.a4656.Peer-Reviewed Original ResearchPulmonary Hypertension-related Changes in Structure and Function of the Human Proximal Pulmonary Artery
Manning E, Ramachandra A, Cavinato C, Lee P, Heerdt P, Singh I, Tellides G, Kaminski N, Humphrey J. Pulmonary Hypertension-related Changes in Structure and Function of the Human Proximal Pulmonary Artery. 2023, a6133-a6133. DOI: 10.1164/ajrccm-conference.2023.207.1_meetingabstracts.a6133.Peer-Reviewed Original ResearchProteomic profiling demonstrates inflammatory and endotheliopathy signatures associated with impaired cardiopulmonary exercise hemodynamic profile in Post Acute Sequelae of SARS‐CoV‐2 infection (PASC) syndrome
Singh I, Leitner B, Wang Y, Zhang H, Joseph P, Lutchmansingh D, Gulati M, Possick J, Damsky W, Hwa J, Heerdt P, Chun H. Proteomic profiling demonstrates inflammatory and endotheliopathy signatures associated with impaired cardiopulmonary exercise hemodynamic profile in Post Acute Sequelae of SARS‐CoV‐2 infection (PASC) syndrome. Pulmonary Circulation 2023, 13: e12220. PMID: 37091121, PMCID: PMC10113513, DOI: 10.1002/pul2.12220.Peer-Reviewed Original ResearchInvasive cardiopulmonary exercise testPASC patientsPost-acute sequelaeAcute sequelaeInfection syndromeUnexplained exertional intoleranceCardiopulmonary exercise testSystemic oxygen deliveryPersistent inflammatory stateVenous blood plasmaExertional intolerancePeak exerciseEndothelial dysfunctionHemodynamic profileInflammatory stateExercise testFibrotic processPathophysiological hallmarkAberrant protein expressionExpression of proteinsOxygen deliveryOxygen extractionProteomic profilingPatientsPhysiologic responsesExercise Pathophysiology in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Postacute Sequelae of SARS-CoV-2 More in Common Than Not?
Joseph P, Singh I, Oliveira R, Capone C, Mullen M, Cook D, Stovall M, Squires J, Madsen K, Waxman A, Systrom D. Exercise Pathophysiology in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Postacute Sequelae of SARS-CoV-2 More in Common Than Not? CHEST Journal 2023, 164: 717-726. PMID: 37054777, PMCID: PMC10088277, DOI: 10.1016/j.chest.2023.03.049.Peer-Reviewed Original ResearchConceptsMyalgic encephalomyelitis/chronic fatigue syndromeME/CFSChronic fatigue syndromeSARS-CoV-2Fatigue syndromePostacute sequelaeCardiopulmonary exercise testingSystemic blood flowExercise pathophysiologyExertional intoleranceIntractable fatigueExercise testingAcute infectionPostexertional malaiseExercise intoleranceOrthostatic intoleranceVentilatory controlLong-term consequencesBlood flowClinical overlapSuch symptomsIntoleranceSequelaeCOVID-19SyndromeResponse 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 ResearchSystemic Thrombolysis in Acute Pulmonary Embolism: Dose Considerations in Administration of Thrombolytics
Savarimuthu S, Singh I, Khosla A. Systemic Thrombolysis in Acute Pulmonary Embolism: Dose Considerations in Administration of Thrombolytics. 2023, 59-69. DOI: 10.1142/9781800612778_0005.Peer-Reviewed Original ResearchHigh-risk pulmonary embolismHalf-dose thrombolysisAcute pulmonary embolismPulmonary embolismMajor bleeding eventsAdministration of thrombolyticsBleeding eventsMajor bleedsSystemic thrombolysisRespiratory failureCardiopulmonary effectsHaemodynamic collapseClinical outcomesThrombolytic therapyCardiac arrestSelect populationThrombolysisEmbolismSubstantial riskLarge-scale studiesDose considerationsOutcomesRiskThrombolyticsTherapy