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Pulmonary hypertension , CTEPH

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https://www.readbyqxmd.com/read/29776563/chronic-thromboembolic-pulmonary-hypertension-reversal-of-pulmonary-hypertension-but-not-sleep-disordered-breathing-following-pulmonary-endarterectomy
#1
Maria Teresa La Rovere, Francesco Fanfulla, Anna Eugenia Taurino, Claudio Bruschi, Roberto Maestri, Elena Robbi, Rita Maestroni, Caterina Pronzato, Maurizio Pin, Andrea M D'Armini, Gian Domenico Pinna
BACKGROUND: It has been hypothesized that pre-capillary pulmonary hypertension (PH) may trigger sleep disordered breathing (SDB). In patients with chronic thromboembolic PH (CTEPH), pulmonary endarterectomy (PEA) is potentially effective to improve PH. We assessed the pre- and post-operative prevalence of SDB in CTEPH patients submitted to PEA and the relationship between SDB and clinical, pulmonary and hemodynamic factors. METHODS: Unattended cardiorespiratory recording was performed the night before and one month after elective PEA in 50 patients...
August 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29738821/discovery-and-development-of-sgc-stimulators-for-the-treatment-of-pulmonary-hypertension-and-rare-diseases
#2
REVIEW
Peter Sandner, Eva-Maria Becker-Pelster, Johannes Peter Stasch
The NO/sGC/cGMP signaling cascade plays a pivotal role in regulation of cardiovascular, cardiopulmonary and cardiorenal diseases and impairment of this cascade results in severe pathologies. Therefore, pharmacological interventions, targeting this pathway are promising strategies for treating a variety of diseases. Nitrates, supplementing NO and, PDE5 inhibitors preventing cGMP degradation, are used for angina pectoris treatment and the treatment of pulmonary arterial hypertension (PAH), respectively. More recently, a new class of drugs which directly stimulate the sGC enzyme and trigger NO-independent cGMP production was introduced and termed sGC stimulators...
May 5, 2018: Nitric Oxide: Biology and Chemistry
https://www.readbyqxmd.com/read/29730328/poor-subpleural-perfusion-predicts-failure-after-balloon-pulmonary-angioplasty-for-non-operable-chronic-thromboembolic-pulmonary-hypertension
#3
Yu Taniguchi, Philippe Brenot, Xavier Jais, Carlos Garcia, Jason Weatherald, Olivier Planche, Elie Fadel, Marc Humbert, Gérald Simonneau
BACKGROUND: Poor subpleural perfusion (PSP) in the capillary phase of pulmonary angiography predicts worse outcomes after pulmonary endarterectomy in operable chronic thromboembolic pulmonary hypertension (CTEPH). Balloon pulmonary angioplasty (BPA) has emerged for non-operable CTEPH. We assessed the association between PSP and BPA failure. METHOD: Subpleural perfusion was classified as poor (defined as subpleural spaces either not or minimally perfused in all segments) or normal...
May 3, 2018: Chest
https://www.readbyqxmd.com/read/29730148/mri-derived-regional-biventricular-function-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-before-and-after-pulmonary-endarterectomy
#4
Sabine K Maschke, Christian O Schoenfeld, Till F Kaireit, Serghei Cebotari, Karen Olsson, Marius Hoeper, Frank Wacker, Jens Vogel-Claussen
RATIONALE AND OBJECTIVES: The aim of this study was to assess regional myocardial function in patients with chronic thromboembolic hypertension (CTEPH) before and after successful pulmonary endarterectomy (PEA) using magnetic resonance imaging. METHODS: Twenty-two patients with CTEPH underwent cardiac magnetic resonance imaging before and 12 (11, 17) days after PEA. Mean pulmonary artery pressure was evaluated preoperatively by right heart catheterization and during post-PEA intensive care unit-stay using a Swan-Ganz catheter...
May 2, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29704099/usefulness-of-scoring-right-ventricular-function-for-assessment-of-prognostic-factors-in-patients-with-chronic-thromboembolic-pulmonary-hypertension
#5
Yoshihiro Kamimura, Naoki Okumura, Shiro Adachi, Shigetake Shimokata, Fumitaka Tajima, Yoshihisa Nakano, Akihiro Hirashiki, Toyoaki Murohara, Takahisa Kondo
Right ventricular (RV) function is associated with prognosis in chronic thromboembolic pulmonary hypertension (CTEPH). This study aimed to establish an RV dysfunction score using RV echocardiographic parameters to clarify the clinical characteristics in patients with CTEPH and to compare RV dysfunction score with parameters such as World Health Organization (WHO) functional class, hemodynamics, exercise capacity, and plasma BNP level. We enrolled 35 inpatients with CTEPH (mean age, 62 ± 15 years, 15 males)...
April 27, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29688945/quantitation-of-perfused-lung-volume-using-hybrid-spect-ct-allows-refining-the-assessment-of-lung-perfusion-and-estimating-disease-extent-in-chronic-thromboembolic-pulmonary-hypertension
#6
Thorsten Derlin, Catharina Kelting, Katja Hueper, Desiree Weiberg, Katrin Meyer, Karen M Olsson, James T Thackeray, Tobias Welte, Frank M Bengel, Marius M Hoeper
BACKGROUND: We evaluated the feasibility of perfusion SPECT/CT for providing quantitative data for estimation of perfusion defect extent in chronic thromboembolic pulmonary hypertension (CTEPH). METHODS: Thirty patients with CTEPH underwent Tc-human serum albumin lung perfusion SPECT/CT. Perfusion defects were quantified using 3 different methods: (1) visual, semiquantitative scoring of perfusion defect extent in each lung segment, (2) threshold-based segmentation of perfused lung volumes, and (3) threshold-based segmentation of perfused lung volumes divided by segmented lung volumes at CT (perfusion index)...
June 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29678648/determinants-of-health-related-quality-of-life-1-year-after-pulmonary-thromboendarterectomy
#7
Oksana Kamenskaya, Asya Klinkova, Irina Loginova, Alexander Chernyavskiy, Alexander Edemskiy, Vladimir V Lomivorotov, Alexander Karaskov
AIM: Pulmonary thromboendarterectomy (PTE) is a recognized treatment for patients with chronic thromboembolic pulmonary hypertension (CTEPH), with good long-term haemodynamic results. The aim of this study was to test the hypothesis that the dynamics of health-related quality of life (QoL), 1 year after PTE, depends both on the clinical determinants associated with the underlying disease and the adverse events occurring in the early postoperative period. METHODS: This prospective cohort study included 136 patients with CTEPH...
April 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29674186/pulmonary-hypertension-real-world-data-from-a-portuguese-expert-referral-centre
#8
A Gomes, C Cruz, J Rocha, M Ricardo, M Vicente, A Melo, M Santos, L Carvalho, F Gonçalves, A Reis
BACKGROUND: Pulmonary hypertension (PH) is a heterogeneous, debilitating condition with highly relevant impact on functional capacity, quality of life, and life-expectancy. OBJECTIVES: This study aims to provide long-term data on the Portuguese PH population, by characterising the clinical presentation, evolution, and outcomes of PH patients in a specialised referral centre. METHODS: Retrospective analysis of a cohort of 101 patients with pre-capillary PH (pcPH) referenced to an expert tertiary care referral centre in northern Portugal from 2002 to 2013...
April 16, 2018: Pulmonology
https://www.readbyqxmd.com/read/29669971/after-the-dawn-balloon-pulmonary-angioplasty-for-patients-with-chronic-thromboembolic-pulmonary-hypertension
#9
Aiko Ogawa, Hiromi Matsubara
In the past 5 years, balloon pulmonary angioplasty (BPA) for patients with chronic thromboembolic pulmonary hypertension (CTEPH) who are deemed inoperable has undergone significant refinement. As a result, the procedure is now used worldwide and has become a promising therapeutic option for those patients. However, pulmonary endarterectomy remains the gold standard treatment for patients with CTEPH because the techniques and strategies for BPA are not yet unified. The best therapeutic option for each patient should be determined based on discussion among a multidisciplinary team of experts...
April 17, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29659150/chronic-obstructive-pulmonary-disease-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-prevalence-and-implications-for-surgical-treatment-outcome
#10
Oksana Kamenskaya, Irina Loginova, Alexander Chernyavskiy, Aleksander Edemskiy, Vladimir V Lomivorotov, Aleksander Karaskov
OBJECTIVE: The aim of our study was to investigate the prevalence of chronic obstructive pulmonary disease (COPD) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) and examine their impact on the results of pulmonary thrombendarterectomy (PEA). METHODS: We enrolled 136 patients with CTEPH who scheduled for elective PEA. Pulmonary function tests (PFTs) including full-body plethysmography with bronchodilation test and lung diffusion capacity assessment were performed in all patients prior to surgery treatment...
April 16, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29649782/balloon-pulmonary-angioplasty-in-a-patient-with-prostate-cancer-and-chronic-thromboembolic-pulmonary-hypertension
#11
Yolanda Bryce, Ernesto Santos
Chronic thromboembolic pulmonary hypertension (CTEPH) is a subtype of pulmonary hypertension characterized by a mean pulmonary artery pressure ≥25 mm Hg due to obstructive fibrotic thromboembolic material in the pulmonary arteries. Malignancy is a significant risk for developing CTEPH. The option for inoperable CTEPH is largely medical with variable outcomes. Balloon pulmonary angioplasty (BPA) is a promising option for inoperable patients given distal-type CTEPH, co-morbidities, or residual pulmonary hypertension after surgery...
April 6, 2018: Clinical Imaging
https://www.readbyqxmd.com/read/29608809/chronic-thromboembolic-pulmonary-hypertension-from-the-perspective-of-patients-with-pulmonary-embolism
#12
REVIEW
Frederikus A Klok, Marion Delcroix, Harm Jan Bogaard
Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare but feared long-term complication of acute pulmonary embolism (PE), although CTEPH may occur in patients with no history of symptomatic venous thromboembolism. It represents the most severe presentation of the so-called 'post-PE syndrome', a phenomenon of permanent functional limitations after PE caused by deconditioning after PE or ventilatory or circulatory impairment due to unresolved pulmonary artery thrombi. Because the post-PE syndrome may occur in up to 50% of PE survivors, and CTEPH tends to have an insidious and non-specific clinical presentation, CTEPH is often not diagnosed or diagnosed after very long delay...
April 2, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29593574/the-use-of-biophysical-flow-models-in-the-surgical-management-of-patients-affected-by-chronic-thromboembolic-pulmonary-hypertension
#13
Martina Spazzapan, Priya Sastry, John Dunning, David Nordsletten, Adelaide de Vecchi
Introduction: Chronic Thromboembolic Pulmonary Hypertension (CTEPH) results from progressive thrombotic occlusion of the pulmonary arteries. It is treated by surgical removal of the occlusion, with success rates depending on the degree of microvascular remodeling. Surgical eligibility is influenced by the contributions of both the thrombus occlusion and microvasculature remodeling to the overall vascular resistance. Assessing this is challenging due to the high inter-individual variability in arterial morphology and physiology...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29580746/reveal-risk-score-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-receiving-riociguat
#14
Raymond L Benza, Harrison W Farber, Adaani Frost, Ekkehard Grünig, Marius M Hoeper, Dennis Busse, Christian Meier, Sylvia Nikkho, Hossein-Ardeschir Ghofrani
BACKGROUND: The REVEAL risk score (RRS) was developed to predict survival in patients with pulmonary arterial hypertension (PAH), based on multiple patient characteristics. Herein we calculated RRS for patients in the randomized CHEST-1 study and open-label CHEST-2 extension study of riociguat in inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH). We investigated the effect of riociguat vs placebo on RRS in the CHEST-1 study, and the relationship between RRS and long-term outcomes in the CHEST-2 study...
March 1, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29563354/adiponectin-in-chronic-thromboembolic-pulmonary-hypertension
#15
Sarasa Isobe, Masaharu Kataoka, Takashi Kawakami, Keiichi Fukuda
BACKGROUND: The correlation between serum adiponectin concentration and hemodynamics or certain metabolic markers in patients with chronic thromboembolic pulmonary hypertension (CTEPH) is unknown.Methods and Results:We enrolled 30 CTEPH patients who underwent interventional therapy of balloon pulmonary angioplasty or pulmonary endarterectomy. Serum adiponectin concentrations positively correlated with B-type natriuretic peptide (BNP) concentrations, pulmonary vascular resistance, and mean pulmonary arterial pressure...
March 21, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29563171/multicentre-observational-screening-survey-for-the-detection-of-cteph-following-pulmonary-embolism
#16
Nicolas Coquoz, Daniel Weilenmann, Daiana Stolz, Vladimir Popov, Andrea Azzola, Jean-Marc Fellrath, Hans Stricker, Alberto Pagnamenta, Sebastian Ott, Silvia Ulrich, Sandor Györik, Jérôme Pasquier, John-David Aubert
Chronic thromboembolic pulmonary hypertension (CTEPH) is a severe complication of pulmonary embolism. Its incidence following pulmonary embolism is debated. Active screening for CTEPH in patients with acute pulmonary embolism is yet to be recommended.This prospective, multicentre, observational study (Multicentre Observational Screening Survey for the Detection of Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Following Pulmonary Embolism (INPUT on PE); ISRCTN61417303) included patients with acute pulmonary embolism from 11 centres in Switzerland from March 2009 to November 2016...
April 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29550147/neuropsychological-outcomes-after-pulmonary-endarterectomy-using-moderate-hypothermia-and-periodic-circulatory-arrest
#17
Benedetta Vanini, Valentina Grazioli, Antonio Sciortino, Maurizio Pin, Vera N Merli, Anna Celentano, Ilaria Parisi, Catherine Klersy, Lucia Petrucci, Maurizio Salati, Pierluigi Politi, Andrea M D'Armini
BACKGROUND: In this prospective, single-center, observational study, we investigated the association between repeated short periods of circulatory arrest with moderate hypothermia during pulmonary endarterectomy (PEA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) and different neuropsychological dimensions. METHODS: We examined 70 patients with CTEPH, >18 to 80 years of age, who had been treated with PEA. Neuropsychological testing was performed...
February 19, 2018: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/29540628/long-term-outcome-of-chronic-thromboembolic-pulmonary-hypertension-at-a-single-japanese-pulmonary-endarterectomy-center
#18
Hideki Miwa, Nobuhiro Tanabe, Takayuki Jujo, Fumiaki Kato, Rie Anazawa, Keiko Yamamoto, Akira Naito, Hajime Kasai, Rintaro Nishimura, Rika Suda, Toshihiko Sugiura, Seiichiro Sakao, Keiichi Ishida, Masahisa Masuda, Koichiro Tatsumi
BACKGROUND: Several new treatments for chronic thromboembolic pulmonary hypertension (CTEPH) have appeared in recent years, which have led to changes in the treatment algorithm. Changes in survival rates and prognostic factors, however, have not been estimated so far.Methods and Results:Two hundred and eighty patients were diagnosed with CTEPH at Chiba University Hospital between June 1986 and June 2016. Survival rate was investigated by date of treatment initiation (group 1, 1986-1998; group 2, 1999-2008; group 3, 2009-2016)...
April 25, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29536477/follow-up-after-acute-pulmonary-embolism
#19
Frederikus A Klok, Stefano Barco
In addition to among others major bleeding from anticoagulant therapy and recurrent venous thromboembolism (VTE), patients who survived acute pulmonary embolism (PE) face an increased risk of chronic functional limitations and decreased quality of life. In recent years, this latter complications have been better framed within the evolving definition of "post-PE syndrome" of which chronic thromboembolic pulmonary hypertension (CTEPH) represents the most extreme presentation. The post-PE syndrome in all its aspects is a frequent and clinically relevant long-term complication of PE but -except for CTEPH- has been largely understudied...
February 2018: Hämostaseologie
https://www.readbyqxmd.com/read/29526325/prevention-and-treatment-of-the-chronic-thromboembolic-pulmonary-hypertension
#20
Raffaele Pesavento, Paolo Prandoni
Chronic thromboembolic pulmonary hypertension (CTEPH) is an uncommon and late complication of pulmonary embolism resulting from misguided remodelling of residual pulmonary thromboembolic material and small-vessel arteriopathy. CTEPH is the only form of pulmonary hypertension (PH) potentially curable by pulmonary endarterectomy (PEA). Unfortunately, several patients have either an unacceptable risk-benefit ratio for undergoing the surgical intervention or develop persistent PH after PEA. Novel medical and endovascular therapies can be considered for them...
April 2018: Thrombosis Research
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