Chest
Original Research: Pulmonary HypertensionChronic Thromboembolic and Pulmonary Arterial Hypertension Share Acute Vasoreactivity Properties
Section snippets
Patient Population
Thirty-five patients with PAH and 22 patients with CTEPH were included in the study after obtaining written informed consent. The study was approved by the local ethics committee. PAH was diagnosed as idiopathic (n = 25) if the evaluation performed before catheterization did not reveal any other causes of elevated pulmonary pressure and was associated with other conditions such as congenital heart disease (n = 6), connective tissue disease (n = 2), and HIV (n = 2) that were diagnosed by medical
Patient Characteristics
A total of 57 patients, 35 with PAH and 22 with CTEPH, were included in the study. Patient characteristics are presented in Table 1. Patients with CTEPH were on average older than those with PAH, and had lower CI, Sao2, and mixed venous saturation (S o2). Other parameters did not vary significantly between the two groups.
Acute Vasoreactivity Testing
iNO and iILO significantly decreased MPAP and PVR in both PAH and CTEPH patients, and to a comparable extent. The response to iNO and iILO, as well as the response
DISCUSSION
We found that the inhalation of iNO and/or iILO during the initial diagnostic right heart catheterization decreased MPAP and increased CI in patients with CTEPH and PAH who were in WHO functional classes III to IV, with the magnitude of the response as well as the number of responders being not different between CTEPH and PAH patients. Patients with PAH and CTEPH also had similar indexes of proximal pulmonary arterial compliance. These results suggest that CTEPH and PAH may share some
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Oxygen inhalation can selectively dilate pulmonary arteries in patients with chronic thromboembolic pulmonary hypertension before balloon angioplasty
2022, Journal of CardiologyCitation Excerpt :However, their study mainly included subjects with pulmonary arterial hypertension, and no patient with CTEPH was involved. Although it was reported that CTEPH and pulmonary arterial hypertension share acute vasoreactivity properties [11], actual data on the acute effects of oxygen administration on patients with CTEPH are scant. Hence, in this study, we aimed to determine how oxygen affects hemodynamics in patients with CTEPH before BPA.
Acute hemodynamic changes by breathing hypoxic and hyperoxic gas mixtures in pulmonary arterial and chronic thromboembolic pulmonary hypertension
2018, International Journal of CardiologyCitation Excerpt :A limitation of our study is the fact that the control group did not consist of healthy subjects but of patients with dyspnea undergoing RHC that ruled out PH However, we considered performing RHC in healthy subjects as ethically inacceptable in the current investigation. We also included a relatively small number of PH-patients, which might have reduced the power of the results and we included patients with PAH or CTEPH, However, PH is a rare disease and in this paper, we focused on the vasoreactivity response in PH, which largely is shared in PAH and CTEPH [33]. A 10-min exposure time to hypoxia/hyperoxia is relatively short.
Chronic thromboembolic pulmonary hypertension
2013, Clinics in Chest MedicineCitation Excerpt :Acknowledging that 16 of the 20 patients were already receiving one or more PAH-specific medical therapies at the time, the investigators’ observation of an acute hemodynamic response to inhaled iloprost suggested there might be a component of vasoconstriction in this subgroup of patients with CTEPH. This finding supports a similar observation made by Ulrich and colleagues124 in which acute vasoreactivity to 10 μg of inhaled iloprost was shown in 22 patients with CTEPH. Riociguat, a soluble guanylate cyclase stimulator, has been trialed in patients with pulmonary hypertension and inoperable CTEPH.
Chronic thromboembolic and pulmonary arterial hypertension share right ventricular and pulmonary artery CMR features
2019, PulmonologyCitation Excerpt :PA characteristics were also similar in both groups despite the fact that CTEPH has a major vessel involvement. Altogether, these findings suggest that the RV response is mainly a consequence of the overall imposed afterload, instead of a predominance of proximal or distal disease.10 Our study demonstrated that age- and gender-matched PAH and CTEPH patients displayed similar values of the CMR indices of RV and PA morphology and function, suggesting that the RV response is similar in both groups, mostly related to the overall increase in after load.
Safety of inhaled nitric oxide withdrawal in severe chronic pulmonary hypertension
2024, Pulmonary Circulation
Drs. Ulrich, Fischler, Speich, Popov, and Maggiorini have been supported in attending research meetings by Actelion/Switzerland and Schering/Switzerland. Dr. Popov worked for 6 months (2002) at Actelion/Switzerland. Dr. Speich has received educational grants from Roche/Switzerland, Actelion/Switzerland, and Schering/Switzerland, and receives financial support for a study nurse from Actelion/Switzerland and Schering/Switzerland.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).