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Chronic thromboembolic pulmonary hypertension

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https://www.readbyqxmd.com/read/28742187/pulmonell-hypertension-vanligt-vid-kronisk-lungsjukdom-europeiska-riktlinjer-kring-utredning-och-behandling
#1
David Kylhammar, Göran Rådegran
Pulmonary hypertension due to lung diseases In 2015 the European Society of Cardiology and European Respiratory Society published new guidelines on the diagnosis and treatment of pulmonary hypertension (PH). PH due to lung diseases and/or hypoxia was classified as a separate entity. PH is common in lung diseases, but seldom severe. Nevertheless, the presence of PH in a patient with lung disease is associated with worse outcome. If there is clinical suspicion of PH in a patient with lung disease, echocardiography is recommended, and if there are signs of severe PH and/or severe right ventricular dysfunction the patient should be referred to a PH expert centre...
July 21, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28732819/individual-dose-adjustment-of-riociguat-in-patients-with-pulmonary-arterial-hypertension-and-chronic-thromboembolic-pulmonary-hypertension
#2
REVIEW
Nicholas S Hill, Franck F Rahaghi, Namita Sood, Reiner Frey, Hossein-Ardeschir Ghofrani
Riociguat is a soluble guanylate cyclase stimulator that has been approved for the treatment of pulmonary arterial hypertension and inoperable chronic thromboembolic pulmonary hypertension or persistent/recurrent pulmonary hypertension following pulmonary endarterectomy. Riociguat is administered using an 8-week individual dose-adjustment scheme whereby a patient initially receives riociguat 1.0 mg three times daily (tid), and the dose is then increased every 2 weeks in the absence of hypotension, indicated by systolic blood pressure measurements and symptoms, up to a maximum dose of 2...
August 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28717116/novel-predictor-of-lung-injury-after-balloon-pulmonary-angioplasty-in-patients-with-chronic-thromboembolic-pulmonary-hypertension
#3
Satoshi Akagi
No abstract text is available yet for this article.
July 14, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28715904/considerations-for-optimal-management-of-patients-with-pulmonary-arterial-hypertension-a-multi-stakeholder-roundtable-discussion
#4
Sean M Studer, Martha Kingman, Luis Calo, H Eric Cannon, Jeffrey D Dunn, Thomas James, Sonya J Lewis, Robert J Gilkin, Janis A Pruett
A roundtable panel of national and regional managed care decision makers and providers met to discuss pulmonary arterial hypertension (PAH) and strategies for management. As a rare, complex disease with high economic costs and potentially devastating outcomes, PAH necessitates that managed care providers balance optimal care with efficient use of healthcare resources. PAH specialists are recognized by health plans as knowledgeable experts and integral partners in managing patients and resources. The diagnosis of PAH must be confirmed by a right heart catheterization...
May 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28712579/the-importance-of-capillary-density-stroke-work-mismatch-for-right-ventricular-adaptation-to-chronic-pressure-overload
#5
Pierre-Emmanuel Noly, François Haddad, Jennifer Arthur-Ataam, Nathaniel Langer, Peter Dorfmüller, Fanny Loisel, Julien Guihaire, Benoit Decante, Lilia Lamrani, Elie Fadel, Olaf Mercier
OBJECTIVE: Mechanisms of right ventricular (RV) adaptation to chronic pressure overload are not well understood. We hypothesized that a lower capillary density (CD) to stroke work ratio would be associated with more fibrosis and RV maladaptive remodeling. METHODS: We induced RV chronic pressure overload over a 20-week period in 2 piglet models of pulmonary hypertension; that is, a shunt model (n = 5) and a chronic thromboembolic pulmonary hypertension model (n = 5)...
June 15, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28705306/riociguat-for-patients-with-chronic-thromboembolic-pulmonary-hypertension-usefulness-of-transitioning-from-phosphodiesterase-type-5-inhibitor
#6
Keiko Yamamoto, Nobuhiro Tanabe, Rika Suda, Akane Sasaki, Akane Matsumura, Ryogo Ema, Hajime Kasai, Fumiaki Kato, Ayumi Sekine, Rintaro Nishimura, Takayuki Jujo, Toshihiko Sugiura, Ayako Shigeta, Seiichiro Sakao, Koichiro Tatsumi
BACKGROUND: Riociguat, the first approved drug for patients with chronic thromboembolic pulmonary hypertension (CTEPH), is a soluble guanylate cyclase (sGC) Stimulator. It directly stimulates sGC independently of nitric oxide (NO) and increases sGC sensitivity for NO. The safety and efficacy of transitioning from a phosphodiesterase 5 inhibitor (PDE5i) to riociguat is unknown. METHODS AND RESULTS: Twenty-three patients were prospectively enrolled: 8 symptomatic patients with inadequate clinical responses to PDE5i were changed to riociguat (transitioned group); 15 started riociguat anew (new or add-on group)...
July 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28701673/pulmonary-artery-diameter-predicts-lung-injury-after-balloon-pulmonary-angioplasty-in-patients-with-chronic-thromboembolic-pulmonary-hypertension
#7
Koichi Sugimoto, Kazuhiko Nakazato, Nobuo Sakamoto, Takayoshi Yamaki, Hiroyuki Kunii, Akiomi Yoshihisa, Hitoshi Suzuki, Shu-Ichi Saitoh, Yasuchika Takeishi
Balloon pulmonary angioplasty (BPA) has been an attractive strategy for chronic thromboembolic pulmonary hypertension (CTEPH), even though it occasionally causes lung injury. However, predictive factors of lung injury after BPA have not been established. Pulmonary artery (PA) dilatation is often observed in patients with pulmonary hypertension. We investigated the association between PA diameter and complications after BPA.The subjects were 19 CTEPH patients who underwent BPA. Patients were divided into two groups: patients with lung injury including asymptomatic lung infiltration on computed tomography (CT) images or mild hemoptysis (group L, n = 9) and no complications (group N, n = 10)...
July 13, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28691912/stepwise-optimisation-of-balloon-pulmonary-angioplasty-in-a-patient-with-severe-non-operable-chronic-thromboembolic-pulmonary-hypertension
#8
Aleksander Araszkiewicz, Stanislaw Jankiewicz, Tatiana Mularek-Kubzdela, Maciej Lesiak
No abstract text is available yet for this article.
July 11, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28690220/-investigation-and-analysis-for-current-situation-and-pathogenesis-relevant-to-pulmonary-hypertension
#9
Si Lei, Doudou Tang, Nianru Xu, Shangjie Wu
To investigate the demographic characteristics and the causes for pulmonary hypertension (PH) in adult patients.
 Methods: A total of 2 508 adult patients diagnosed as PH, who came from the Second Xiangya Hospital of Central South University from January 2010 to December 2014, were retrospectively investigated. All subjects underwent the clinical diagnosis, or the echocardiographic diagnosis, or thetraditional hemodynamic criteria by right heart catheterization (RHC). The patient's data including hospital numbers, gender, ages, primary diseases, etc, are collected and analyzed...
June 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28682884/microarray-expression-profile-of-circular-rnas-in-chronic-thromboembolic-pulmonary-hypertension
#10
Ran Miao, Ying Wang, Jun Wan, Dong Leng, Juanni Gong, Jifeng Li, Yan Liang, Zhenguo Zhai, Yuanhua Yang
BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare but debilitating and life-threatening complication of acute pulmonary embolism. Circular RNAs (circRNAs), presenting as covalently closed continuous loops, are RNA molecules with covalently joined 3'- and 5'-ends formed by back-splicing events. circRNAs may be significant biological molecules to understand disease mechanisms and to identify biomarkers for disease diagnosis and therapy. The aim of this study was to investigate the potential roles of circRNAs in CTEPH...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28680585/pulmonary-thromboendarterectomy-in-the-setting-of-a-mediastinal-venous-malformation-with-a-congenitally-absent-left-subclavian-vein
#11
Vickram Tejwani, Karunakaravel Karuppasamy, Marcelo P Gomes, Abraham Levitin, James M Luethke, Christopher J Morin, Nicholas G Smedira, Gustavo A Heresi, Wayne F Yakes
Venous malformations have static venous lakes that predispose to spontaneous venous thrombosis within the malformation due to its low-flow static state. Thrombi of varying sizes can then embolize continually into the pulmonary arterial circulation, and occlude and narrow elastic pulmonary arteries causing chronic thromboembolic pulmonary hypertension (CTEPH). Pulmonary thromboendarterectomy (PTE) is potentially curative in CTEPH, but has not been previously reported in the setting of mediastinal and chest wall venous malformations...
March 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28671932/associations-of-exercise-tolerance-with-hemodynamic-parameters-for-pulmonary-arterial-hypertension-and-for-chronic-thromboembolic-pulmonary-hypertension
#12
Yasunori Tsuboi, Hidekazu Tanaka, Ryo Nishio, Takuma Sawa, Daisuke Terashita, Kazuhiko Nakayama, Seimi Satomi-Kobayashi, Yoshitada Sakai, Noriaki Emoto, Ken-Ichi Hirata
PURPOSE: Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are the main subgroups of pulmonary hypertension (PH). Despite differences in their etiologies, both diseases are characterized by vascular remodeling, resulting in progressive right heart failure. Noninvasive periodic evaluation of exercise tolerance has become increasingly important. Cardiopulmonary exercise testing (CPET) and a 6-minute walk test (6MWT) are now both recommended for evaluating exercise tolerance, but there is insufficient knowledge about possible differences in the associations of exercise tolerance with right heart catheterization (RHC) data for patients with PAH and CTEPH...
June 30, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28671280/impact-of-obstructive-sleep-apnea-in-transsphenoidal-pituitary-surgery-an-analysis-of-inpatient-data
#13
Sei Y Chung, Michael J Sylvester, Varesh R Patel, Michael Zaki, Soly Baredes, James K Liu, Jean Anderson Eloy
OBJECTIVES/HYPOTHESIS: Although previous studies have reported increased perioperative complications among obstructive sleep apnea (OSA) patients undergoing any surgery requiring general anesthesia, there is a paucity of literature addressing the impact of OSA on postoperative transsphenoidal surgery (TSS) complications. The aim of this study was to analyze postoperative outcomes in transsphenoidal pituitary surgery patients with OSA. Secondarily, we examined patient characteristics and comorbidities...
July 3, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28666570/dead-space-ventilation-is-linked-to-exercise-capacity-and-survival-in-distal-chronic-thromboembolic-pulmonary-hypertension
#14
Laurent Godinas, Caroline Sattler, Edmund M Lau, Xavier Jaïs, Yu Taniguchi, Mitja Jevnikar, Jason Weatherald, Olivier Sitbon, Laurent Savale, David Montani, Gérald Simonneau, Marc Humbert, Pierantonio Laveneziana, Gilles Garcia
BACKGROUND: Cardiopulmonary exercise testing (CPET) is frequently used for the evaluation of patients with pulmonary hypertension (PH). Non-operable distal chronic thromboembolic pulmonary hypertension (CTEPH) represents a unique subgroup of PH where microvascular disease resembling pulmonary arterial hypertension (PAH) may predominate and efficacious medical therapy is now available. However, little is known regarding the detailed CPET profile of patients with distal CTEPH, and whether ventilation and gas exchange responses are different from PAH...
May 22, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28666564/the-dilatation-of-main-pulmonary-artery-and-right-ventricle-observed-by-enhanced-chest-computed-tomography-predict-poor-outcome-in-inoperable-chronic-thromboembolic-pulmonary-hypertension
#15
Ryogo Ema, Toshihiko Sugiura, Naoko Kawata, Nobuhiro Tanabe, Hajime Kasai, Rintaro Nishimura, Takayuki Jujo, Ayako Shigeta, Seiichiro Sakao, Koichiro Tatsumi
BACKGROUND: Dilatation of the pulmonary artery and right ventricle on chest computed tomography images is often observed in patients with pulmonary hypertension. The clinical significance of these image findings has not been defined in chronic thromboembolic pulmonary hypertension. We investigated whether the pulmonary arterial and right ventricle dilatation was associated with poor outcome in chronic thromboembolic pulmonary hypertension. METHODS: This was a retrospective cohort investigation in 60 subjects with inoperable chronic thromboembolic pulmonary hypertension diagnosed consecutively between 1997 and 2010 at Chiba University Hospital...
June 12, 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28660997/optical-coherence-tomography-reveals-the-mechanisms-of-balloon-pulmonary-angioplasty-in-inoperable-chronic-thromboembolic-pulmonary-hypertension
#16
Aleksander Araszkiewicz, Stanisław Jankiewicz, Magdalena Janus, Magdalena Łanocha, Tatiana Mularek-Kubzdela, Maciej Lesiak
No abstract text is available yet for this article.
2017: Cardiology Journal
https://www.readbyqxmd.com/read/28652963/switching-from-sildenafil-to-riociguat-for-the-treatment-of-pah-and-inoperable-cteph-real-life-experiences
#17
Asger Andersen, Kasper Korsholm, Søren Mellemkjær, Jens Erik Nielsen-Kudsk
Riociguat is a novel soluble guanylate cyclase stimulator that is approved for the treatment of patients with pulmonary arterial hypertension (PAH) and patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) or persistent/recurrent CTEPH after pulmonary endarterectomy (PEA). As riociguat is a relatively new drug, experience of its use in clinical practice is limited, especially in patients who would not have met the inclusion criteria for the pivotal Phase III clinical trials, PATENT-1 and CHEST-1...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28641836/late-outcomes-of-pulmonary-embolism-the-post-pe-syndrome
#18
Akhilesh K Sista, Frederikus A Klok
The post-Pulmonary Embolism (post-PE) syndrome is being increasingly recognized as a long-term consequence of PE. Its most severe manifestation, chronic thromboembolic pulmonary hypertension (CTEPH), affects a small proportion of PE survivors. However, many more with less severe post-PE syndrome have reduced quality of life and functional capacity. The pathophysiology is incompletely understood, but involves unresolved pulmonary artery thrombi, right ventricular damage, and abnormal gas exchange. Treatment has only been established for CTEPH, and further studies are required to determine how less severe forms of the post-PE syndrome should be treated and if preventive strategies can reduce its incidence...
June 16, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28628189/-a-statement-the-polish-cardiac-society-working-group-on-pulmonary-circulation-on-screening-for-cteph-patients-after-acute-pulmonary-embolism
#19
Michał Ciurzyński, Marcin Kurzyna, Grzegorz Kopeć, Piotr Błaszczak, Łukasz Chrzanowski, Karol Kamiński, Katarzyna Mizia-Stec, Tatiana Mularek-Kubzdela, Ewa Mroczek, Andrzej Biederman, Piotr Pruszczyk, Adam Torbicki
Both pharmacological and invasive treatment of chronic thromboembolic pulmonary hypertension (CTEPH) is now available in Poland and the awareness of the disease among physicians is growing. Thus, the Polish Cardiac Society's Working Group on Pulmonary Circulation in cooperation with independent experts in this field, have launched the statement on algorithm to guide a CTEPH diagnosis in patients with previous acute pulmonary embolism (APE). In Poland, every year this disease affects about 250 patients. CTEPH should be suspected in individuals after APE with dyspnea, despite at least 3 months period of effective anticoagulation, particularly when specified risk factors are present...
2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28624155/current-understanding-of-the-pathophysiology-of-chronic-thromboembolic-pulmonary-hypertension
#20
Smriti Sharma, Irene M Lang
Chronic thromboembolic pulmonary hypertension (CTEPH) is a unique form of pulmonary hypertension arising from fibrotic obliteration of major pulmonary arteries. Pro-thrombotic states, large clot burden and impaired dissolution are believed to contribute to the occurrence and progression of thrombosis after an acute pulmonary embolic event. Recent data utilizing several models have facilitated the understanding of clot resolution. This review summarizes current knowledge on pathophysiological mechanisms of major vessel occlusion in CTEPH...
June 12, 2017: Thrombosis Research
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