Predominant thrombus in right upper lung might induce hypoxemia in chronic thromboembolic pulmonary hypertension

In this study, we assessed the association of hypoxemia and localization of thrombus in order to clarify the adequate management for hypoxemic patients with CTEPH.Method: We performed a retrospective study of 132 CTEPH patients consecutively diagnosed between 2009 and 2017. Eleven patients with missing data, ventilatory impairment (FEV1.0 %predicted
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Pulmonary hypertension Source Type: research

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Backgrounds: Chronic thromboembolic disease (CTED) is characterized by similar symptoms and perfusion defect as chronic thromboembolic pulmonary hypertension (CTEPH), but without pulmonary hypertension at rest. Recently, successful pulmonary endarterectomy (PEA) and balloon pulmonary angioplasty (BPA) for symptomatic patients with CTED has been reported. However, it remains unclear whether CTED evolves to CTEPH. The aim of this study is to clarify the natural history of CTED.Methods: Consecutive patients diagnosed as CTED between 1986 and 2017 were retrospective enrolled. CTED was defined as follows: a mean pulmonary arterial pressure at rest
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Pulmonary hypertension Source Type: research
We present the case report of a 26-year-old woman who became pregnant following the successful treatment of severe CTEPH by utilizing BPA. We conclude that patients undergoing effective BPA for CTEPH can consider becoming pregnant if followed closely by a multidisciplinary team, including experts in thrombosis, pulmonary hypertension and obstetrics.
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
Abstract BACKGROUND: Although cardiac troponin and natriuretic peptide have been shown to decrease after balloon pulmonary angioplasty (BPA) with improved right ventricular afterload in chronic thromboembolic pulmonary hypertension (CTEPH), biomarkers to evaluate the effects of BPA independently of heart failure status remain to be developed. METHODS: In 39 consecutive CTEPH patients including 31 who underwent BPA, we measured plasma levels of cyclophilin A (CyPA), which we demonstrated is secreted from pulmonary vascular smooth muscle cells in response to mechanical stretch and hypoxia. RESULTS: CyPA le...
Source: Journal of Cardiology - Category: Cardiology Authors: Tags: J Cardiol Source Type: research
Etiology of Exercise-Induced Pulmonary Hypertension Can Be Differentiated by Echocardiography - Insight From Patients With Chronic Pulmonary Thromboembolism With Normal Resting Hemodynamics by Balloon Pulmonary Angioplasty. Circ J. 2019 Oct 02;: Authors: Goda A, Takeuchi K, Kikuchi H, Finger M, Inami T, Sakata K, Soejima K, Satoh T Abstract BACKGROUND: Exercise-induced pulmonary hypertension (PH) is often seen in chronic thromboembolic PH (CTEPH) patients with normalized resting hemodynamics, but it is difficult to differentiate precapillary PH as pulmonary vascular dysfunction and post-capillary PH...
Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
This article introduces recent updates in patient selection and interventional procedures for this chronic and devastating disease. PMID: 30808072 [PubMed]
Source: Korean Circulation Journal - Category: Cardiology Tags: Korean Circ J Source Type: research
We have read the letter “Experience Does Matter for Pulmonary Endarterectomy Surgery” by Yıldızel1 and agree that pulmonary endarterectomy (PEA) is indeed a complex procedure that requires not only good surgical expertise but also a competent multidisciplinary team to manage the patient preoperatively, perioperativel y, and postoperatively. Recognizing the lack of such a service within Southeast Asia and the inability of patients with chronic thromboembolic pulmonary hypertension (CTEPH) to seek adequate workup and management, our center has set up the first multidisciplinary CTEPH service within Southea...
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Adult: Pulmonary Thromboembolism: Letter to the Editor Source Type: research
Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by one or more of the following features: intraluminal thrombus organization, fibrous stenosis and complete obliteration of major pulmonary arteries, amenable to significant improvement by pulmonary endarterectomy (PEA) or balloon pulmonary angioplasty (BPA), and medical treatments with vasodilators. Because treatment practices and outcomes differ in Europe versus Japan, we hypothesized that population-based characteristics of pulmonary vascular phenotypes may exist in Austria compared with Japan.
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Source Type: research
AbstractPulmonary hypertension (PH), a serious disorder with a high morbidity and mortality rate, is known to occur in a number of unrelated systemic diseases. β-Thalassaemia, among other haematological disorders, develop PH which is not an infrequent finding and worsens the prognosis. Haemolysis, iron overload and hypercoagulable state are among the main pathogenetic mechanisms. Haemoglobinopathies and congenital haemolytic anaemia constitute a unique pa tients population more predisposed to developing chronic thromboembolic pulmonary hypertension (CTEPH). Although pulmonary endarterectomy is accepted as the best tre...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
Chronic thromboembolic pulmonary hypertension (CTEPH) is a progressive disorder with a poor prognosis. Recently, balloon pulmonary angioplasty (BPA) has been reported to be an effective treatment for inoperable patients with CTEPH. However, this catheter-based treatment has potentially life-threatening vascular complications. To improve the efficacy and safety of BPA, we assessed the morphological evaluation of organised thrombus and the vascular injury by BPA procedure.
Source: Heart, Lung and Circulation - Category: Cardiology Authors: Tags: Brief Communication Source Type: research
Authors: Minatsuki S, Hatano M, Kiyosue A, Saito A, Maki H, Takimoto E, Komuro I Abstract Riociguat, a soluble guanylate cyclase stimulator, induces pulmonary artery dilatation through blood flow and is effective in treating chronic thromboembolic pulmonary hypertension (CTEPH). There are two types of vasculopathies in CTEPH based upon its location, in other words, proximal or distal to the thrombus-medicated obstruction. Distal vasculopathy is characterized by intrapulmonary shunts due to diminished blood flow. While other therapeutic interventions for CTEPH including pulmonary endarterectomy and balloon pulmonary...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
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