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Chronic thromboembolic pulmonary hypertension

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https://www.readbyqxmd.com/read/27903659/pulmonary-hypertension-the-importance-of-correctly-diagnosing-the-cause
#1
Sanjay Mehta, Jean-Luc Vachiéry
Pulmonary hypertension (PH) is a complex condition that can occur as a result of a wide range of disorders, including left heart disease, lung disease and chronic pulmonary thromboembolism. Contemporary PH patients are older and frequently have a multitude of comorbidities that may contribute to or simply coincide with their PH. Identifying the cause of PH in these complicated patients can be challenging but is essential, given that the aetiology of the disease has a significant impact on the management options available...
December 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/27903027/-esc-guidelines-2015-pulmonary-hypertension-diagnosis-and-treatment
#2
Christian Opitz, Stephan Rosenkranz, Hossein Ardeschir Ghofrani, Ekkehard Grünig, Hans Klose, Horst Olschewski, Marius Hoeper
Pulmonary hypertension (PH) is characterized by an increase in PAPmean > 25 mmHg associated with a reduced life expectancy. Recent advances in the management of these patients provided the basis for the updated recommendations of the 2015 joint guidelines of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS) on the diagnosis and treatment of pulmonary hypertension. The updated version includes important modifications with regards to hemodynamic definitions, clinical classification and diagnostic assessment of patients with PH...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27869893/-anmco-position-paper-recommendations-for-the-follow-up-of-patients-with-pulmonary-thromboembolism
#3
Carlo D'Agostino, Pietro Zonzin, Iolanda Enea, Michele Massimo Gulizia, Walter Ageno, Piergiuseppe Agostoni, Michele Azzarito, Cecilia Becattini, Amedeo Bongarzoni, Francesca Bux, Franco Casazza, Nicoletta Corrieri, Michele D'Alto, Nicola D'Amato, Andrea Maria D'Armini, Maria Grazia De Natale, Giovanni Di Minno, Giuseppe Favretto, Lucia Filippi, Valentina Grazioli, Gualtiero Palareti, Raffaele Pesavento, Loris Roncon, Laura Scelsi, Antonella Tufano
Venous thromboembolism (VTE), including deep venous thrombosis and pulmonary embolism, is the third most common cause of cardiovascular death. The management of the acute phase of VTE is well described in several papers and guidelines, whereas the management of the follow-up of the patients affected from VTE is less defined. This position paper of the Italian Association of Hospital Cardiologists (ANMCO) tries to fill the gap using currently available evidence and the opinion of the experts to suggest the most useful way to manage patients in the chronic phase...
September 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27865192/effect-of-targeted-therapy-on-circulating-progenitor-cells-in-precapillary-pulmonary-hypertension
#4
Jéssica García-Lucio, Olga Tura-Ceide, Roberto Del Pozo, Isabel Blanco, Sandra Pizarro, Elisabet Ferrer, Marta Díez, Núria Coll-Bonfill, Lucilla Piccari, Víctor I Peinado, Joan Albert Barberà
BACKGROUND: Endothelial dysfunction is key in the development of pulmonary hypertension (PH) and is associated with reduced number of circulating progenitor cells. Studies to date evaluating levels of circulating progenitor cells in PH have provided conflicting results. Current treatment of pulmonary arterial hypertension (PAH) and medical treatment of chronic thromboembolic pulmonary hypertension (CTEPH) targets endothelium dependent signalling pathways. The effect of PAH-targeted therapy on circulating progenitor cells has not been clearly established...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27865180/detection-of-right-ventricular-myocardial-fibrosis-using-quantitative-ct-attenuation-of-the-right-ventricular-myocardium-in-the-late-phase-on-320-slice-ct-in-subjects-with-pulmonary-hypertension
#5
Koya Ozawa, Nobusada Funabashi, Hiroyuki Takaoka, Nobuhiro Tanabe, Koichiro Tatsumi, Yoshio Kobayashi
PURPOSE: Right ventricular myocardial (RVM) fibrosis may be a significant indicator of prognosis in pulmonary hypertension (PH). To detect the presence of RVM fibrosis in PH subjects, we employed ECG gated 320-slice CT. METHODS: 62 confirmed PH subjects (16 males; 55±16years; 45 chronic thromboembolic PH (CTEPH) who underwent conventional non-surgical medical therapy; and 17 pulmonary arterial hypertension (PAH)) underwent ECG-gated 320-slice CT. On CT, RV fibrosis was defined as contrast defect in the early phase and conversely abnormal enhancement in the late phase...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27852365/-the-study-of-growth-differentiation-factor-15-in-chronic-thromboembolic-pulmonary-hypertension-following-acute-pulmonary-thromboembolism
#6
J X Xu, H Z Yu, Q Wu, J Mi
Objective: To evaluate the incidence of chronic thromboembolic pulmonary hypertension (CTEPH) secondary to acute pulmonary thromboembolism (PTE) and the serum level of growth differentiation factor-15(GDF-15). Methods: Ninety-six acute PTE patients were recruited in the study. Clinical data, Wells score, blood gas analysis, D-dimmer level, GDF-15 level, atrial and ventricular sizes, pulmonary arterial systolic pressure (PASP) and pulmonary artery CT (CTPA) data were collected. Patients were followed up to evaluate the cardiac function (WHO class), ultrasonic cardiogram and CTPA to confirm the incidence of CTEPH...
November 12, 2016: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/27837039/low-risk-for-local-and-systemic-complications-after-primary-repair-of-1626-achilles-tendon-ruptures
#7
Nicholas Rensing, Brian R Waterman, Rachel M Frank, Kenneth A Heida, Justin D Orr
INTRODUCTION: Historically, Achilles tendon repairs and other surgeries about the hindfoot have demonstrated a significantly higher rate of wound healing complications and surgical site morbidity. The purpose of this study was to evaluate the comprehensive complication profile and risk factors for adverse short-term, clinical outcomes after primary repair of Achilles tendon ruptures. METHODS: Between the years 2005 and 2014, all cases of primary Achilles tendon repair (Current Procedural Terminology code 27650) entered into the National Surgical Quality Improvement Project (NSQIP) database were extracted for analysis...
November 10, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27826972/risk-factors-detection-in-chronic-thromboembolic-pulmonary-hypertension-a-tool-for-risk-quantification
#8
M Bohacekova, M Kaldararova, T Valkovicova, A Remkova, J Vesely, I Simkova
BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by chronic thromboembolic obstruction in the pulmonary bed. The definitive pathogenesis remains incompletely explained, although multiple risk factors of CTEPH have been identified. The purpose of the study was to evaluate the risk profile of patients with CTEPH and the representativeness of risk factors, identify possible new CTEPH risk factors and specify the epidemiology of CTEPH in our country. METHODS: In 81 patients with CTEPH, well known risk factors were analyzed, and a detailed analysis of selected hematological parameters was investigated at a specialized hematology laboratory...
2016: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/27817818/clinical-usefulness-of-end-tidal-co2-profiles-during-incremental-exercise-in-patients-with-chronic-thromboembolic-pulmonary-hypertension
#9
R P Ramos, E V M Ferreira, F M Valois, A Cepeda, C M S Messina, R K Oliveira, A T V Araújo, C A Teles, J A Neder, L E Nery, J S Ota-Arakaki
INTRODUCTION: Great ventilation to carbon dioxide output (ΔV˙E/ΔV˙CO2) and reduced end-tidal partial pressures for CO2 (PetCO2) during incremental exercise are hallmarks of chronic thromboembolic pulmonary hypertension (CTEPH) and idiopathic pulmonary arterial hypertension (IPAH). However, CTEPH is more likely to involve proximal arteries, which may lead to poorer right ventricle-pulmonary vascular coupling and worse gas exchange abnormalities. Therefore, abnormal PetCO2 profiles during exercise may be more prominent in patients with CTEPH and could be helpful to indicate disease severity...
November 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27810474/predictors-of-residual-pulmonary-hypertension-after-balloon-pulmonary-angioplasty-in-patients-with-chronic-thromboembolic-pulmonary-hypertension
#10
Akihiro Tsuji, Takeshi Ogo, Jin Ueda, Shigefumi Fukui, Yoshiaki Morita, Tetsuya Fukuda, Norifumi Nakanishi, Hisao Ogawa, Satoshi Yasuda
No abstract text is available yet for this article.
October 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27802345/circulating-angiopoietin-1-is-not-a-biomarker-of-disease-severity-or-prognosis-in-pulmonary-hypertension
#11
Manuel Jonas Richter, Svenja Lena Tiede, Natascha Sommer, Thomas Schmidt, Werner Seeger, Hossein Ardeschir Ghofrani, Ralph Schermuly, Henning Gall
BACKGROUND: Circulating angiopoietin-1 (Ang-1) has been linked to pulmonary hypertension (PH) in experimental studies. However, the clinical relevance of Ang-1 as a biomarker in PH remains unknown. We aimed to investigate the prognostic and clinical significance of Ang-1 in PH using data from the prospectively recruiting Giessen PH Registry. METHODS: Patients with suspected PH (without previous specific pulmonary arterial hypertension [PAH] therapy) who underwent initial right heart catheterization (RHC) in our national referral center between July 2003 and May 2012 and who agreed to optional biomarker analysis were included if they were diagnosed with idiopathic PAH, connective tissue disease-associated PAH (CTD-PAH), PH due to left heart disease (PH-LHD), or chronic thromboembolic PH (CTEPH), or if PH was excluded by RHC (non-PH controls)...
2016: PloS One
https://www.readbyqxmd.com/read/27801422/-clinical-guidelines-for-the-diagnosis-and-treatment-of-chronic-thromboembolic-pulmonary-hypertension-part-2
#12
I E Chazova, T V Martynyuk
The paper gives current approaches to treating chronic thromboembolic pulmonary hypertension (CTEPH) from the document «Federal Guidelines for the Diagnosis and Treatment of CTEPH» approved at the Third Russian Congress on Pulmonary Hypertension on December 11, 2015. The guidelines had been elaborated to optimize the treatment of patients with CTEPH on the basis of an analysis of the data of the present-day registries and multicenter randomized clinical trials, national and international guidelines and consensus documents, and documents published in recent years...
2016: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/27793518/abnormal-pulmonary-endothelial-cells-may-underlie-the-enigmatic-pathogenesis-of-chronic-thromboembolic-pulmonary-hypertension
#13
Olaf Mercier, Jennifer Arthur Ataam, Nathaniel B Langer, Peter Dorfmüller, Lilia Lamrani, Florence Lecerf, Benoit Decante, Philippe Dartevelle, Saadia Eddahibi, Elie Fadel
BACKGROUND: Chronic thromboembolic pulmonary hypertension results from chronic mechanical obstruction of the pulmonary arteries after acute venous thromboembolism. However, the mechanisms that result in the progression from unresolved thrombus to fibrotic vascular remodeling are unknown. We hypothesized that pulmonary artery endothelial cells contribute to this phenomenon via paracrine growth factor and cytokine signaling. METHODS: Using enzyme-linked immunosorbent assay and cell migration assays, we investigated the circulating growth factors and cytokines of chronic thromboembolic pulmonary hypertension patients as well as the cross talk between pulmonary endothelial cells and pulmonary artery smooth muscle cells and monocytes from patients with chronic thromboembolic pulmonary hypertension in vitro...
August 20, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27784118/c-arm-computed-tomography-adds-diagnostic-information-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-and-a-positive-v-q-spect
#14
J B Hinrichs, T Werncke, T Kaireit, M M Hoeper, K M Olsson, J C Kamp, F K Wacker, F Bengel, C von Falck, I Schatka, B C Meyer
Purpose: To determine if C-Arm computed tomography (CACT) has added diagnostic value in patients suffering from chronic thromboembolic pulmonary hypertension (CTEPH) with a positive mismatch pattern in ventilation/perfusion single photon emission computed tomography (V/Q SPECT). Materials and Methods: 28 patients (23 men, 5 women, 62 ± 18 years) with CTEPH who had undergone SPECT, followed by CACT and right heart catheterization (RHC) were included. Two independent readers reviewed SPECT and CACT. Findings indicating CTEPH and their location (segmental or sub-segmental) were identified (V/Q mismatch in SPECT and vascular pathologies in CACT)...
October 26, 2016: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/27783357/three-dimensional-phase-contrast-magnetic-resonance-imaging-validated-to-assess-pulmonary-artery-flow-in-patients-with-chronic-thromboembolic-pulmonary-hypertension
#15
Masateru Kawakubo, Hiroshi Akamine, Yuzo Yamasaki, Atsushi Takemura, Kohtaro Abe, Kazuya Hosokawa, Junji Morishita, Michinobu Nagao
In this study, three-dimensional phase contrast magnetic resonance imaging (3D-PC MRI), a novel technique, was validated to assess pulmonary artery (PA) flow in patients with chronic thromboembolic pulmonary hypertension (CTEPH). The MR data of PAs from 3D-PC and two-dimensional PC (2D-PC) from before and after treatment for 3 patients with CTEPH were retrospectively analyzed. Additionally, 3D- and 2D-PC MR scans of PA were performed in 5 healthy volunteers. Correlation of stroke volumes (SVs) obtained by 3D-PC and 2D-PC was analyzed using Pearson's correlation coefficients...
October 25, 2016: Radiological Physics and Technology
https://www.readbyqxmd.com/read/27783213/a-prospective-randomized-study-of-inhaled-prostacyclin-versus-nitric-oxide-in-patients-with-residual-pulmonary-hypertension-after-pulmonary-endarterectomy
#16
Shinichiro Abe, Keiichi Ishida, Masahisa Masuda, Hideki Ueda, Hiroki Kohno, Kaoru Matsuura, Yusaku Tamura, Michiko Watanabe, Goro Matsumiya
OBJECTIVES: Pulmonary endarterectomy (PEA) is an effective treatment for chronic thromboembolic pulmonary hypertension (CTEPH), but postoperative residual hypertension leads to in-hospital mortality. Inhaled epoprostenol sodium (PGI2) and NO are administered for pulmonary hypertension after cardiothoracic surgery. This prospective study provides the first comparative evaluation of the effects of inhaled PGI2 and NO on pulmonary hemodynamics, systemic hemodynamics, and gas exchange in patients developing residual pulmonary hypertension after PEA...
October 25, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27765803/catheter-based-therapy-for-inoperable-chronic-thromboembolic-pulmonary-hypertension
#17
EDITORIAL
Jane A Leopold
No abstract text is available yet for this article.
October 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27760452/-chronic-thromboembolic-pulmonary-hypertension-recommendations-of-the-cologne-consensus-conference-2016
#18
H Wilkens, S Konstantinides, I Lang, A C Bunck, M Gerges, F Gerhardt, A Grgic, C Grohé, S Guth, M Held, J Hinrichs, M M Hoeper, W Klepetko, T Kramm, U Krüger, M Lankeit, B C Meyer, K M Olsson, H-J Schäfers, M Schmidt, H J Seyfarth, S Ulrich, C B Wiedenroth, E Mayer
The 2015 European Guidelines on Pulmonary Hypertension did not cover only pulmonary arterial hypertension (PAH), but also other significant subgroups of pulmonary hypertension (PH). In June 2016, a Consensus Conference organized by the PH working groups of the German Society of Cardiology (DGK), the German Society of Respiratory Medicine (DGP) and the German Society of Pediatric Cardiology (DGPK) was held in Cologne, Germany to discuss open and controversial issues surrounding the practical implementation of the European Guidelines...
October 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27750459/riociguat-for-the-treatment-of-pulmonary-hypertension-a-safety-evaluation
#19
Christina Binder, Caroline Zotter-Tufaro, Diana Bonderman
The development of pulmonary hypertension (PH) has multifactorial underlying pathophysiological causes and can be classified into five groups. While three different classes of therapeutic drugs are licensed for the treatment of pulmonary arterial hypertension (PAH, WHO group 1), specific medical therapies are lacking for other forms of PH, such as PH due to left heart disease. In 2013 riociguat, a first-in class soluble guanylate cyclase stimulator, has also become available for the treatment of PAH. Riociguat was further introduced as the first approved pharmacotherapy for the treatment of patients with chronic thromboembolic PH (WHO group 4, CTEPH)...
November 9, 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27746200/effect-of-balloon-pulmonary-angioplasty-on-respiratory-function-in-patients-with-chronic-thromboembolic-pulmonary-hypertension
#20
Mina Akizuki, Naoki Serizawa, Atsuko Ueno, Taku Adachi, Nobuhisa Hagiwara
RATIONALE: Balloon pulmonary angioplasty (BPA) in chronic thromboembolic pulmonary hypertension (CTEPH) improves hemodynamics and exercise capacity. However, its effect on respiratory function is unclear. OBJECTIVES: To investigate the effect of BPA on respiratory function. METHODS: We enrolled inoperable CTEPH who underwent BPA primarily in lower lobe arteries (first series) and upper and middle lobe arteries (second series). We compared changes in hemodynamics and respiratory function between different BPA fields...
October 13, 2016: Chest
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