Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension

A 62-year-old woman with persistent chronic thromboembolic pulmonary hypertension (CTEPH) status after pulmonary thromboendarterectomy presented with worsening exercise capacity and continued dyspnea requiring 3 L O2 at home.  Ventilation perfusion scan (Fig 1) demonstrated A high probability of pulmonary embolism. Pulmonary angiography (Fig 2) revealed multifocal subsegmental arterial occlusions and stenoses consistent with CTEPH. Her medications included macitentan, riociguat, and selexipag for CTEPH.
Source: Journal of Vascular and Interventional Radiology : JVIR - Category: Radiology Authors: Tags: Images in IR Source Type: research

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CONCLUSIONS: Increased 4-hydroxynonenal level plays a critical role in the development of HPH. ALDH2 attenuates the development of HPH by regulating mitochondrial fission and smooth muscle cell proliferation suggesting ALDH2 as a potential new therapeutic target for pulmonary hypertension. PMID: 31510791 [PubMed - as supplied by publisher]
Source: Arteriosclerosis, Thrombosis and Vascular Biology - Category: Cardiology Authors: Tags: Arterioscler Thromb Vasc Biol Source Type: research
CONCLUSIONS: Women with CTEPH underwent PEA less frequently than men, especially at low-volume centers. Furthermore, they had a lower prevalence of cardiovascular risk factors and were less often exposed to additional cardiac surgery procedures. Women had better long-term survival. This article is protected by copyright. All rights reserved. PMID: 31479557 [PubMed - as supplied by publisher]
Source: Thrombosis and Haemostasis - Category: Hematology Authors: Tags: J Thromb Haemost Source Type: research
Abstract While the opioid epidemic has garnered significant attention, the use of methamphetamines is growing worldwide independent of wealth or region. Following overdose and accidents, the leading cause of death in methamphetamine users is cardiovascular disease, because of significant effects of methamphetamine on vasoconstriction, pulmonary hypertension, atherosclerotic plaque formation, cardiac arrhythmias, and cardiomyopathy. In this review, we examine the current literature on methamphetamine-induced changes in cardiovascular health, discuss the potential mechanisms regulating these varied effects, and high...
Source: Arteriosclerosis, Thrombosis and Vascular Biology - Category: Cardiology Authors: Tags: Arterioscler Thromb Vasc Biol Source Type: research
Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare but debilitating and life-threatening complication of acute pulmonary embolism (PE). CTEPH is defined as a mean pulmonary artery pressure (mPAP) of at least 25  mmHg at rest, caused by persistent obstruction of pulmonary arteries after PE that has not resolved despite at least 3 months of therapeutic anticoagulation [1]. CTEPH results from persistent obstruction of pulmonary arteries and progressive vascular remodeling [2,3]. Non-dissolution of thrombo embolic material may result in the formation of organized fibrotic scar tissue, webs and bands, which obs...
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Editorial Source Type: research
This study aimed to investigate whether PH is a risk factor for deep vein thrombosis (DVT) of the lower extremities after hip and knee replacement surgery. METHODS A total of 238 patients who received joint replacement of lower extremities in our department of orthopedics from January 2009 to January 2012 were examined by echocardiography and Color Doppler flow imaging (CDFI) of the lower extremities. Based on pulmonary artery pressure (PAP), the patients were divided into a normal PAP group (n=214) and PH group (n=24). All the patients were re-examined by CDFI during post-operative care. RESULTS Among the 238 patients, 18...
Source: Revista da Associacao Medica Brasileira - Category: General Medicine Source Type: research
This study aimed to investigate whether PH is a risk factor for deep vein thrombosis (DVT) of the lower extremities after hip and knee replacement surgery. METHODS A total of 238 patients who received joint replacement of lower extremities in our department of orthopedics from January 2009 to January 2012 were examined by echocardiography and Color Doppler flow imaging (CDFI) of the lower extremities. Based on pulmonary artery pressure (PAP), the patients were divided into a normal PAP group (n=214) and PH group (n=24). All the patients were re-examined by CDFI during post-operative care. RESULTS Among the 238 patients, 18...
Source: Revista da Associacao Medica Brasileira - Category: General Medicine Source Type: research
Systemic lupus erythematosus (SLE) is a systemic inflammatory disease, characterized by an antibody response to nucleic antigens and involvement of any organ system. Pulmonary manifestations are frequent and include pleuritis, acute lupus pneumonitis, chronic interstitial lung disease, alveolar hemorrhage, shrinking lung syndrome, airway disease, pulmonary hypertension (PH), and thromboembolic disease. The antiphospholipid antibody syndrome (APLAS) is a systemic autoimmune disorder where different prothrombotic factors interact to induce arterial and venous thrombosis. The most common pulmonary manifestations are pulmonary...
Source: Clinics in Chest Medicine - Category: Respiratory Medicine Authors: Source Type: research
This investigation evaluated the changes of pulmonary perfusion at 4 different points of follow-up within 1 y in patients with pulmonary embolism (PE) and the factors predictive of complete or incomplete recovery of pulmonary perfusion. Methods: Patients with symptomatic PE underwent perfusion lung scintigraphy and blood gas analysis within 48 h from clinical presentation, after 1 wk, and after 1, 6, and 12 mo; echocardiography was performed at baseline and after 6 and 12 mo. All perfusion lung scintigraphy scans were examined by 2 expert nuclear medicine physicians with a scoring method that attributed a score of 0, 0.5, ...
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Clinical Source Type: research
Cancer patients are at increased risk for pulmonary arterial hypertension (PAH) due to the disease itself, chemo- or radiation therapy, pulmonary embolism, or comorbidities. Several tyrosine kinase inhibitors (TKIs), which are increasingly used in the treatment of various cancers, have been linked with PAH. We aimed to describe the incidence of PAH triggered or worsened by tyrosine kinase inhibitors (TKIs) in patients with chronic myelogenous leukemia (CML).
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: 414 Source Type: research
AbstractMagnetic resonance imaging (MRI) plays an increasingly important role in the non-invasive evaluation of the pulmonary vasculature. MR angiographic (MRA) techniques provide morphological information, while MR perfusion techniques provide functional information of the pulmonary vasculature. Contrast-enhanced MRA can be performed at high spatial resolution using 3D T1-weighted spoiled gradient echo sequence or at high temporal resolution using time-resolved techniques. Non-contrast MRA can be performed using 3D steady state free precession, double inversion fast spin echo, time of flight or phase contrast sequences. M...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research
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