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Pulmonary hypertension , CTEPH

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https://www.readbyqxmd.com/read/28641836/late-outcomes-of-pulmonary-embolism-the-post-pe-syndrome
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28612517/two-dimensional-knowledge-based-volumetric-reconstruction-of-the-right-ventricle-documents-short-term-improvement-in-pulmonary-hypertension
#4
Johannes P Schwaiger, Daniel S Knight, Thomas Kaier, Adele Gallimore, Christopher P Denton, Benjamin E Schreiber, Clive Handler, John G Coghlan
BACKGROUND: Data are scarce about short-term right ventricular changes in pulmonary hypertension. Two-dimensional knowledge-based reconstruction of the right ventricle with 2D echocardiography (2DKBR) has been shown to be a valid alternative to Cardiac MRI. PATIENTS AND METHODS: In this longitudinal study 25 pulmonary hypertension patients underwent 2DKBR of the right ventricle, assessment of NT-proBNP levels and functional class at baseline and after a mean follow-up of 6...
June 2017: Echocardiography
https://www.readbyqxmd.com/read/28610669/riociguat-for-pulmonary-arterial-hypertension-and-chronic-thromboembolic-pulmonary-hypertension-results-from-a-phase-ii-long-term-extension-study
#5
Michael Halank, Marius M Hoeper, Hossein-Ardeschir Ghofrani, F Joachim Meyer, Gerd Stähler, Jürgen Behr, Ralf Ewert, Monique Fletcher, Pablo Colorado, Sylvia Nikkho, Friedrich Grimminger
BACKGROUND: Riociguat was well tolerated and improved exercise and functional capacity in patients with pulmonary arterial hypertension (PAH) and inoperable chronic thromboembolic pulmonary hypertension (CTEPH) in a 12-week Phase II trial. We present final data from the long-term extension phase of this study. METHODS: During this multicenter, open-label, uncontrolled long-term extension study, riociguat dose could be changed at the physician's discretion (range 0...
July 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28603047/tadalafil-induces-antiproliferation-apoptosis-and-phosphodiesterase-type-5-downregulation-in-idiopathic-pulmonary-arterial-hypertension-in-vitro
#6
Aya Yamamura, Eri Fujitomi, Naoki Ohara, Kikuo Tsukamoto, Motohiko Sato, Hisao Yamamura
Idiopathic pulmonary arterial hypertension (IPAH) is a fatal disease of the pulmonary artery resulting from a currently unidentified etiology. IPAH is pathologically characterized as sustained vasoconstriction and vascular remodeling of the pulmonary artery. Vascular remodeling is mediated by enhanced proliferation and reduced apoptosis in pulmonary arterial smooth muscle cells (PASMCs). Based on its pathological mechanism, specific phosphodiesterase type 5 (PDE5) inhibitors have been used in the treatment of IPAH...
June 8, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28597773/prostacyclins-have-no-direct-inotropic-effect-on-isolated-atrial-strips-from-the-normal-and-pressure-overloaded-human-right-heart
#7
Sarah Holmboe, Asger Andersen, Rebekka V Jensen, Hans Henrik Kimose, Lars B Ilkjær, Lei Shen, Lucie H Clapp, Jens Erik Nielsen-Kudsk
Prostacyclins are vasodilatory agents used in the treatment of pulmonary arterial hypertension. The direct effects of prostacyclins on right heart function are still not clarified. The aim of this study was to investigate the possible direct inotropic properties of clinical available prostacyclin mimetics in the normal and the pressure-overloaded human right atrium. Trabeculae from the right atrium were collected during surgery from chronic thromboembolic pulmonary hypertension (CTEPH) patients with pressure-overloaded right hearts, undergoing pulmonary thromboendarterectomy (n = 10) and from patients with normal right hearts operated by valve replacement or coronary bypass surgery (n = 9)...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28596435/balloon-pulmonary-angioplasty-for-inoperable-patients-with-chronic-thromboembolic-pulmonary-hypertension-the-initial-german-experience
#8
Karen M Olsson, Christoph B Wiedenroth, Jan-Christopher Kamp, Andreas Breithecker, Jan Fuge, Gabriele A Krombach, Moritz Haas, Christian Hamm, Thorsten Kramm, Stefan Guth, Hossein Ardeschir Ghofrani, Jan B Hinrichs, Serghei Cebotari, Katrin Meyer, Marius M Hoeper, Eckhard Mayer, Christoph Liebetrau, Bernhard C Meyer
Balloon pulmonary angioplasty (BPA) is an emerging treatment for patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH).We report on a prospective series of 56 consecutive patients who underwent 266 BPA interventions (median, five per patient) at two German institutions. All patients underwent a comprehensive diagnostic work-up including right heart catheterisation at baseline and 24 weeks after their last intervention.BPA resulted in improvements in WHO functional class, 6 min walk distance (mean change, +33 m), right ventricular function and haemodynamics, including a decline in mean pulmonary artery pressure by 18% and in pulmonary vascular resistance by 26%...
June 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28553870/changing-the-strategy-of-balloon-pulmonary-angioplasty-resulted-in-a-reduced-complication-rate-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-a-single-centre-european-experience
#9
Marcin Kurzyna, Szymon Darocha, Radosław Pietura, Arkadiusz Pietrasik, Justyna Norwa, Rafał Mańczak, Maria Wieteska, Andrzej Biederman, Hiromi Matsubara, Adam Torbicki
BACKGROUND: To assess the safety and efficacy of a refined balloon pulmonary angioplasty (BPA) strategy in patients with chronic thromboembolic pulmonary hypertension (CTEPH). METHODS: There were 157 BPA sessions performed in 56 CTEPH patients (47 non-operable, 9 after pulmonary endarterectomy; aged 58.6 ± 17.9 years; 28 females) with severely impaired pulmonary haemodynamics (mean pulmonary artery pressure [mPAP]: 51.3 ± 12.2 mmHg, pulmonary vascular resistance [PVR]: 10...
May 29, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28536427/role-of-foxo1-and-apoptosis-in-pulmonary-vascular-remolding-in-a-rat-model-of-chronic-thromboembolic-pulmonary-hypertension
#10
Chaosheng Deng, Zhanghua Zhong, Dawen Wu, Yunfei Chen, Ningfang Lian, Haibo Ding, Qiaoxian Zhang, Qichang Lin, Shuang Wu
To explore the role of FoxO1 and apoptosis in a rat model of chronic thromboembolic pulmonary hypertension (CTEPH). Rats were randomly divided into a sham group (n = 45) and an experimental group (n = 45). Autologous blood clots were injected into rats three times to induce CTEPH. Rats were further divided into three subgroups: a 1-week subgroup (n = 15), a 2-week subgroup (n = 15), and a 4-week subgroup (n = 15). Mean pulmonary arterial pressure (mPAP) and histopathology were evaluated at each time point...
May 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28529263/depressive-status-in-patients-with-chronic-thromboembolic-pulmonary-hypertension
#11
Sayaka Funabashi, Masaharu Kataoka, Takumi Inami, Toshiaki Kikuchi, Ryoji Yanagisawa, Chikako Ishiguro, Susumu Okamoto, Hideaki Yoshino, Koichiro Watanabe, Toru Satoh
BACKGROUND: The present comparative study with healthy volunteers was conducted to investigate the depressive status and temperament in patients with chronic thromboembolic pulmonary hypertension (CTEPH).Methods and Results:The results of the temperament and personality scale test, and the Quick Inventory of Depressive Symptomatology-Self Report revealed that CTEPH patients have a significantly higher depressive status than healthy volunteers. CONCLUSIONS: It may be that CTEPH patients are more likely to have a depressive temperament in origin...
May 20, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28528258/epidemiology-and-management-of-chronic-thromboembolic-pulmonary-hypertension-experience-from-two-expert-centers
#12
Maria Anna Bazmpani, Alexandra Arvanitaki, Maria Toumpourleka, Georgia Pitsiou, Evaggelia Panagiotidou, Sophia Anastasia Mouratoglou, Georgios Sianos, Stavros Hadjimiltiades, Antonios Pitsis, Eckhard Mayer, Ioannis Stanopoulos, Haralambos Karvounis, George Giannakoulas
BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare, distinct pulmonary vascular disease, and, therefore, there is lack of data regarding its clinical presentation, diagnosis and management at a national basis. Our objective was to describe the demographics and management of CTEPH patients in Northern Greece. METHODS: We conducted a retrospective, observational study with a joint collaboration from two pulmonary hypertension expert centers in Greece and included patients diagnosed with CTEPH...
May 17, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28526539/diagnostic-accuracy-of-lung-subtraction-iodine-mapping-ct-for-the-evaluation-of-pulmonary-perfusion-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-correlation-with-perfusion-spect-ct
#13
Masashi Tamura, Yoshitake Yamada, Takashi Kawakami, Masaharu Kataoka, Yu Iwabuchi, Hiroaki Sugiura, Masahiro Hashimoto, Tadaki Nakahara, Shigeo Okuda, Seishi Nakatsuka, Fumiya Sano, Takayuki Abe, Yuichiro Maekawa, Keiichi Fukuda, Masahiro Jinzaki
BACKGROUND: For treatment of chronic thromboembolic pulmonary hypertension (CTEPH), the evaluation of segmental pulmonary perfusion is important. There are no previous reports about lung subtraction iodine mapping (LSIM) computed tomography (CT) for evaluation of segmental pulmonary perfusion in patients with CTEPH, using lung perfusion SPECT/CT (LPS) as the reference. METHODS: 50 patients (age, 60.7±16.7years) with known or suspected CTEPH were enrolled in this study...
May 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28523175/a-chronic-thromboembolic-pulmonary-hypertension-catch-22-situation-inferior-vena-caval-filter-plays-a-pivotal-role-in-an-unlikely-situation
#14
Karthik Seetharam, Elbert E Williams, Elizabeth Oswald, Ramachandra Reddy
Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare clinical entity that occurs in a small subset of acute pulmonary embolism (PE) cases and is surgically cured by pulmonary endarterectomy. We report a case of a 44-year-old female with a complex history of CTEPH treated by thromboendarterectomy who presented with a subdural hematoma while on warfarin. The patient eventually recovered by a multidisciplinary approach, use of inferior vena caval filter, and effective anticoagulation management.
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28514393/-subtraction-ct-angiopulmonographic-assessment-of-the-vascular-bed-and-lung-perfusion-in-patients-with-chronic-thromboembolic-pulmonary-hypertension-a-pilot-study
#15
T N Veselova, A Yu Demchenkova, T V Martynyuk, N M Danilov, S K Ternovoy, I E Chazova
AIM: To evaluate the vascular bed and lung perfusion in patients with chronic thromboembolic pulmonary hypertension (CTEPH) by computed tomography (CT) and to compare the severity of pulmonary arterial (PA) thrombotic lesions concurrent with parenchymal perfusion disorders with angiopulmonographic findings and clinical and hemodynamic characteristics. SUBJECTS AND METHODS: In the period from November 2015 to May 2016, 22 patients (7 men, 15 women) aged 27 to 67 years with a verified diagnosis of CTEPH were examined using an Aquilion ONE VISION Edition 640 (Toshiba Medical Systems, Japan) CT scanner with a 320-row detector...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28513869/transition-of-intravenous-treprostinil-to-oral-therapy-in-a-patient-with-functional-class-iv-chronic-thromboembolic-pulmonary-hypertension
#16
Kristina M Thurber, Breann M Williams, Ruth E Bates, Robert P Frantz
Chronic thromboembolic pulmonary hypertension (CTEPH) occurs when pulmonary emboli fail to resolve with anticoagulation. For patients with inoperable or residual CTEPH, riociguat is currently the only therapy approved by the United States Food and Drug Administration. However, some patients with CTEPH may require therapy beyond riociguat, such as intravenous prostacyclins, which can present significant administration challenges in patients with complex comorbid conditions. We describe a 42-year-old man with T12 paraplegia complicated by CTEPH (functional class IV with substantial right ventricular dysfunction) and severe pressure ulcers...
May 17, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28474349/refined-balloon-pulmonary-angioplasty-a-therapeutic-option-in-very-elderly-patients-with-chronic-thromboembolic-pulmonary-hypertension
#17
Marek Roik, Dominik Wretowski, Andrzej Łabyk, Katarzyna Irzyk, Barbara Lichodziejewska, Olga Dzikowska-Diduch, Dorota Piotrowska-Kownacka, Piotr Pruszczyk
INTRODUCTION/OBJECTIVES: Balloon pulmonary angioplasty (BPA) is a developing treatment for inoperable chronic thromboembolic pulmonary hypertension (CTEPH). However, to our knowledge there are no published data on BPA in CTEPH subjects aged 75 or over. The aim of the study was to analyze clinical and hemodynamic outcomes of sequential BPA in very elderly patients disqualified from pulmonary endarterectomy (PEA). PATIENTS AND METHODS: We enrolled 10 patients (4 male, 6 female, median age 81 [75-88]) with confirmed CTEPH, mPAP > 30 mmHg, and WHO class > II, disqualified from PEA...
May 5, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28458514/riociguat-a-soluble-guanylate-cyclase-stimulator-for-the-treatment-of-pulmonary-hypertension
#18
REVIEW
Tian-Yu Lian, Xin Jiang, Zhi-Cheng Jing
Despite advances in treatments and improved survival, patients with pulmonary hypertension still experience poor exercise and functional capacity, which has a significant detrimental impact on their quality of life. The nitric oxide (NO)-soluble guanylate cyclase (sGC)-cyclic guanosine 3',5'-monophosphate (cGMP) pathway has been shown to play an important role in cardiovascular physiology, especially in vasodilation and pulmonary vascular tone. The oral sGC stimulator riociguat has a dual mode of action on the NO-sGC-cGMP pathway: direct stimulation of sGC independent of NO and indirect simulation via sensitization of sGC to endogenous NO...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28430738/three-dimensional-fractal-analysis-of-99mtc-maa-spect-images-in-chronic-thromboembolic-pulmonary-hypertension-for-evaluation-of-response-to-balloon-pulmonary-angioplasty-association-with-pulmonary-arterial-pressure
#19
Yasuhiro Maruoka, Michinobu Nagao, Shingo Baba, Takuro Isoda, Yoshiyuki Kitamura, Yuzo Yamazaki, Koichiro Abe, Masayuki Sasaki, Kohtaro Abe, Hiroshi Honda
OBJECTIVE: Balloon pulmonary angioplasty (BPA) is used for inoperable chronic thromboembolic pulmonary hypertension (CTEPH), but its effect cannot be evaluated noninvasively. We devised a noninvasive quantitative index of response to BPA using three-dimensional fractal analysis (3D-FA) of technetium-99m-macroaggregated albumin (Tc-MAA) single-photon emission computed tomography (SPECT). PATIENTS AND METHODS: Forty CTEPH patients who underwent pulmonary perfusion scintigraphy and mean pulmonary arterial pressure (mPAP) measurement by right heart catheterization before and after BPA were studied...
June 2017: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/28420842/the-development-of-marked-collateral-circulation-due-to-inferior-vena-cava-filter-occlusion-in-a-patient-with-chronic-thromboembolic-pulmonary-hypertension-complicated-with-anti-phospholipid-syndrome
#20
Hajime Kasai, Nobuhiro Tanabe, Ken Koshikawa, Yasutaka Hirasawa, Toshihiko Sugiura, Seiichiro Sakao, Koichiro Tatsumi
A 30-year-old Japanese man was diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH) with lupus anticoagulants (LAs) in 2003. He underwent pulmonary endarterectomy after the placement of an inferior vena cava filter (IVCF) in 2004, and treatment with warfarin was continued. In 2014, IVCF occlusion and marked collateral circulation were noted during an examination for transient dyspnea; however, his warfarin level was within the therapeutic range for 88.9% of the time from 2003 to 2014. We herein report a rare case of CTEPH and LAs with IVCF occlusion; in such cases, intense treatment may be required...
2017: Internal Medicine
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