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M R Kuznetsov1, I V Reshetov, B B Orlov

  • 1Pirogov Russian National Research Medical University (RNRMU). mrkuznetsov@mail.ru.

Kardiologiia
|January 10, 2019
PubMed
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Predictors for chronic thromboembolic pulmonary hypertension (CTEPH) after acute pulmonary artery thromboembolism (PTE) were identified. Factors like thrombosis duration and location, initial pulmonary hypertension, and certain comorbidities increase CTEPH risk.

Area of Science:

  • Cardiology
  • Pulmonology
  • Vascular Medicine

Background:

  • Acute pulmonary artery thromboembolism (PTE) can lead to chronic thromboembolic pulmonary hypertension (CTEPH).
  • Identifying predictors of CTEPH development is crucial for timely intervention and improved patient outcomes.

Purpose of the Study:

  • To elucidate predictors of chronic thromboembolic pulmonary hypertension (CTEPH) development following acute pulmonary artery thromboembolism (PTE).

Main Methods:

  • A cohort of 210 patients hospitalized with submassive and massive PTE were followed for 1-3 years.
  • Diagnostic tools included multislice computed tomography (MSCT) angiography, lung scintigraphy, ultrasound angioscanning, and echocardiography.
  • Patients were categorized into groups with (n=45) and without (n=165) CTEPH signs.

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Main Results:

  • Key risk factors for CTEPH include longer duration of thrombotic history and specific venous thrombosis locations in the lower extremities.
  • Initial degree of pulmonary hypertension, tricuspid insufficiency, and certain comorbidities like hypertensive disease and diabetes mellitus were significant predictors.
  • The effectiveness of thrombolytic and anticoagulant therapies varied, with streptokinase, urokinase, and rivaroxaban showing superior outcomes in certain contexts.

Conclusions:

  • Predictors for CTEPH post-PTE involve thrombotic history, venous thrombosis characteristics, initial hemodynamic status, and specific comorbidities.
  • Understanding these risk factors can guide preventative strategies and treatment decisions for patients at risk of CTEPH.