Cardiac MRI in the assessment of chronic thromboembolic pulmonary hypertension and response to treatment

Chronic thromboembolic pulmonary disease (CTEPD) arises in patients with prior pulmonary embolism who do not clear the obstructive material from the pulmonary circulation and may experience persistently raised pulmonary pressures (chronic thromboembolic pulmonary hypertension, CTEPH) and right heart failure. CTEPH affects between 1% and 9% of patients following a single episode of pulmonary embolism.1 The diagnosis of CTEPD requires characteristic radiological appearances, at least 3 months of anticoagulation therapy, and the diagnosis of concomitant pulmonary hypertension requires mean pulmonary artery pressure (mPAP)>20 mm Hg and pulmonary vascular resistance (PVR)>2 Wood units with a pulmonary capillary wedge pressure≤15 mm Hg.2 3 The literature included in this review is based on the previous threshold of mPAP>25 mm Hg for the diagnosis of CTEPH4 The role of cardiovascular MR in CTEPH Surgical pulmonary endarterectomy (PEA) has offered a breakthrough by improving the 3-year survival to 89%...

Source: Thorax - December 15, 2023 Category: Respiratory Medicine Authors: Bartnik, A., Pepke-Zaba, J., Bunclark, K., Ruggiero, A., Jenkins, D., Taghavi, J., Tsui, S., Screaton, N., DErrico, L., Weir-McCall, J. Tags: Thorax State of the art review Source Type: research