Chronic Thromboembolic Pulmonary Hypertension: the Bedside

Matusov, Yuri; Singh, Inderjit; Yu, Yen-Rei Andrea; Chun, Hyung J.; Maron, Bradley A.; Tapson, Victor F.; Lewis, Michael I.; Rajagopal, Sudarshan

doi:10.1007/s11886-021-01573-5

Cited by 9 publications

(7 citation statements)

References 134 publications

(169 reference statements)

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“…10 Patients who suffer from PE find that dyspnea and poor physical performance is very common after "adequately treated PE" along with the development of chronic thromboembolic pulmonary hypertension (CTEPH). 11 The burden of VTE disease has been recognized, with the Surgeon General's call to action against VTE in 2008, yet the overall incidence of VTE and development of complications has not decreased.…”

Section: Unme T Needs In C Are Of the P Os T Dv T Patientmentioning

confidence: 99%

P‐ and E‐ selectin in venous thrombosis and non‐venous pathologies

Purdy

Obi

Myers

et al. 2022

Journal of Thrombosis and Haemostasis

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Venous thromboembolism is a very common and costly health problem worldwide. Anticoagulant treatment for VTE is imperfect: all have the potential for significant bleeding, and none prevent the development of post thrombotic syndrome after deep vein thrombosis or chronic thromboembolic pulmonary hypertension after pulmonary embolism. For these reasons, alternate forms of therapy with improved efficacy and decreased bleeding are needed. Selectins are a family (P‐selectin, E‐selectin, L‐selectin) of glycoproteins that facilitate and augment thrombosis, modulating neutrophil, monocyte, and platelet activity. P‐ and E‐selectin have been investigated as potential biomarkers for thrombosis. Inhibition of P‐selectin and E‐selectin decrease thrombosis and vein wall fibrosis, with no increase in bleeding. Selectin inhibition is a promising avenue of future study as either a stand‐alone treatment for VTE or as an adjunct to standard anticoagulation therapies.

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Section: Unme T Needs In C Are Of the P Os T Dv T Patientmentioning

confidence: 99%

P‐ and E‐ selectin in venous thrombosis and non‐venous pathologies

Purdy

Obi

Myers

et al. 2022

Journal of Thrombosis and Haemostasis

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“… ↑ small vessel muscularization (like those in group 2 PH) [33] . Plexiform lesions [47] . Shunting between systemic and pulmonary vasculature [48] .…”

Section: Cmd and Pmd Across Who Groupsmentioning

confidence: 99%

A review of cardio-pulmonary microvascular dysfunction in pulmonary hypertension

Vahdatpour¹,

Epstein²,

Jones³

et al. 2023

American Heart Journal Plus: Cardiology Research and Practice

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“… 10 For patients ineligible for surgery, BPA can improve pulmonary haemodynamics, 6 min walk distance and WHO functional class (FC). 5 11 For the treatment of CTEPH in patients with distal disease or residual PH post-PEA, riociguat, an oral soluble guanylate cyclase stimulator, and treprostinil, a subcutaneous prostacyclin analogue, are approved by the European Medicines Agency. 3 12–14 Pulmonary arterial hypertension (PAH)-targeted therapies, such as phosphodiesterase type 5 inhibitors (PDE-5i) and endothelin receptor antagonists (ERA), are also often used off-label for treating CTEPH.…”

Section: Introductionmentioning

confidence: 99%

Risk assessment and real-world outcomes in chronic thromboembolic pulmonary hypertension: insights from a UK pulmonary hypertension referral service

Kiely,

Hamilton,

Wood

et al. 2024

BMJ Open

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ObjectivesThis study was conducted to evaluate the ability of risk assessment to predict healthcare resource utilisation (HCRU), costs, treatments, health-related quality of life (HRQoL) and survival in patients diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH).DesignRetrospective observational study.SettingPulmonary hypertension referral centre in the UK.ParticipantsAdults diagnosed with CTEPH between 1 January 2012 and 30 June 2019 were included. Cohorts were retrospectively defined for operated patients (received pulmonary endarterectomy (PEA)) and not operated; further subgroups were defined based on risk score (low, intermediate or high risk for 1-year mortality) at diagnosis.Primary and secondary outcome measuresDemographics, clinical characteristics, comorbidities, treatment patterns, HRQoL, HCRU, costs and survival outcomes were analysed.ResultsOverall, 683 patients were analysed (268 (39%) operated; 415 (61%) not operated). Most patients in the operated and not-operated cohorts were intermediate risk (63%; 53%) or high risk (23%; 31%) at diagnosis. Intermediate-risk and high-risk patients had higher HCRU and costs than low-risk patients. Outpatient and accident and emergency visits were lower postdiagnosis for both cohorts and all risk groups versus prediagnosis. HRQoL scores noticeably improved in the operated cohort post-PEA, and less so in the not-operated cohort at 6–18 months postdiagnosis. Survival at 5 years was 83% (operated) and 49% (not operated) and was lower for intermediate-risk and high-risk patients compared with low-risk patients.ConclusionsFindings from this study support that risk assessment at diagnosis is prognostic for mortality in patients with CTEPH. Low-risk patients have better survival and HRQoL and lower HCRU and costs compared with intermediate-risk and high-risk patients.

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Chronic Thromboembolic Pulmonary Hypertension: the Bedside

Cited by 9 publications

References 134 publications

P‐ and E‐ selectin in venous thrombosis and non‐venous pathologies

P‐ and E‐ selectin in venous thrombosis and non‐venous pathologies

A review of cardio-pulmonary microvascular dysfunction in pulmonary hypertension

Risk assessment and real-world outcomes in chronic thromboembolic pulmonary hypertension: insights from a UK pulmonary hypertension referral service

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