Your browser doesn't support javascript.
loading
Natural history of chronic thromboembolic pulmonary disease with no or mild pulmonary hypertension.
Reddy, Sathineni A; Swietlik, Emilia M; Robertson, Lucy; Michael, Alice; Boyle, Sonja; Polwarth, Gary; Screaton, Nick J; Ruggiero, Alessandro; Nethercott, Sarah L; Taboada, Dolores; Sheares, Karen K; Hadinnapola, Charaka; Cannon, John E; Bunclark, Katherine; Jenkins, David; Ng, Choo; Toshner, Mark R; Pepke-Zaba, Joanna.
Afiliación
  • Reddy SA; Pulmonary Vascular Disease Unit, Royal Papworth Hospital, Cambridge, UK. Electronic address: ashwin.reddy@cantab.net.
  • Swietlik EM; Pulmonary Vascular Disease Unit, Royal Papworth Hospital, Cambridge, UK.
  • Robertson L; Pulmonary Vascular Disease Unit, Royal Papworth Hospital, Cambridge, UK.
  • Michael A; Pulmonary Vascular Disease Unit, Royal Papworth Hospital, Cambridge, UK.
  • Boyle S; Pulmonary Vascular Disease Unit, Royal Papworth Hospital, Cambridge, UK.
  • Polwarth G; Pulmonary Vascular Disease Unit, Royal Papworth Hospital, Cambridge, UK.
  • Screaton NJ; Department of Radiology, Royal Papworth Hospital, Cambridge, UK.
  • Ruggiero A; Department of Radiology, Royal Papworth Hospital, Cambridge, UK.
  • Nethercott SL; Addenbrookes Hospital, Cambridge, UK.
  • Taboada D; Pulmonary Vascular Disease Unit, Royal Papworth Hospital, Cambridge, UK.
  • Sheares KK; Pulmonary Vascular Disease Unit, Royal Papworth Hospital, Cambridge, UK.
  • Hadinnapola C; Pulmonary Vascular Disease Unit, Royal Papworth Hospital, Cambridge, UK.
  • Cannon JE; Pulmonary Vascular Disease Unit, Royal Papworth Hospital, Cambridge, UK.
  • Bunclark K; Pulmonary Vascular Disease Unit, Royal Papworth Hospital, Cambridge, UK.
  • Jenkins D; Department of Cardiothoracic Surgery, Royal Papworth Hospital, Cambridge, UK.
  • Ng C; Department of Cardiothoracic Surgery, Royal Papworth Hospital, Cambridge, UK.
  • Toshner MR; Pulmonary Vascular Disease Unit, Royal Papworth Hospital, Cambridge, UK; Addenbrookes Hospital, Cambridge, UK.
  • Pepke-Zaba J; Pulmonary Vascular Disease Unit, Royal Papworth Hospital, Cambridge, UK.
J Heart Lung Transplant ; 42(9): 1275-1285, 2023 09.
Article en En | MEDLINE | ID: mdl-37201688
BACKGROUND: We describe baseline characteristics, disease progression and mortality in chronic thromboembolic pulmonary disease patients as a function of mean pulmonary artery pressure (mPAP) according to new and previous definitions of pulmonary hypertension. METHODS: All patients diagnosed with chronic thromboembolic pulmonary disease between January, 2015 and December, 2019 were dichotomized according to initial mPAP: ≤ 20 mmHg ('normal') vs 21-24 mmHg ('mildly-elevated'). Baseline features were compared between the groups, and pairwise analysis performed to determine changes in clinical endpoints at 1-year, excluding those who underwent pulmonary endarterectomy or did not attend follow-up. Mortality was assessed for the whole cohort over the entire study period. RESULTS: One hundred thirteen patients were included; 57 had mPAP ≤ 20 mmHg and 56 had mPAP 21-24 mmHg. Normal mPAP patients had lower pulmonary vascular resistance (1.6 vs 2.5WU, p < 0.01) and right ventricular end-diastolic pressure (5.9 vs 7.8 mmHg, p < 0.01) at presentation. At 3 years, no major deterioration was seen in either group. No patients were treated with pulmonary artery vasodilators. Eight had undergone pulmonary endarterectomy. Over 37 months median follow-up, mortality was 7.0% in the normal mPAP group and 8.9% in the mildly-elevated mPAP group. Cause of death was malignancy in 62.5% of cases. CONCLUSIONS: Chronic thromboembolic pulmonary disease patients with mild pulmonary hypertension have statistically higher right ventricular end-diastolic pressure and pulmonary vascular resistance than those with mPAP ≤ 20 mmHg. Baseline characteristics were otherwise similar. Neither group displayed disease progression on non-invasive tests up to 3 years. Mortality over 37 months follow-up is 8%, and mainly attributable to malignancy. Further prospective study is required to validate these findings.
Asunto(s)
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hipertensión Pulmonar Tipo de estudio: Observational_studies Límite: Humans Idioma: En Revista: J Heart Lung Transplant Asunto de la revista: CARDIOLOGIA / TRANSPLANTE Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hipertensión Pulmonar Tipo de estudio: Observational_studies Límite: Humans Idioma: En Revista: J Heart Lung Transplant Asunto de la revista: CARDIOLOGIA / TRANSPLANTE Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos