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Pulmonary Hypertension

Abstract

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Advances in therapeutic interventions for patients with pulmonary arterial hypertension Prognostic Effect and Longitudinal Hemodynamic Assessment of Borderline Pulmonary Hypertension Pulmonary artery denervation to treat pulmonary arterial hypertension: the single-center, prospective, first-in-man PADN-1 study (first-in-man pulmonary artery denervation for treatment of pulmonary artery hypertension) Microvascular disease in chronic thromboembolic pulmonary hypertension: a role for pulmonary veins and systemic vasculature Right ventricular stroke work correlates with outcomes in pediatric pulmonary arterial hypertension Haemodynamic definitions and updated clinical classification of pulmonary hypertension Pulmonary artery denervation for treatment of a patient with pulmonary hypertension secondary to left heart disease Medical Therapy for CTEPH: Is There Still Space for More?
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Review Article2017 Dec 20;26(146).

JOURNAL：Eur Respir Rev. Article Link

The changing landscape of chronic thromboembolic pulmonary hypertension management

Madani M, Ogo T, Simonneau G. Keywords: chronic thromboembolic pulmonary hypertension; treatment

Abstract

For patients with chronic thromboembolic pulmonary hypertension (CTEPH), the current standard of care involves surgical removal of fibro-thrombotic obstructions by pulmonary endarterectomy. While this approach has excellent outcomes, significant proportions of patients are not eligible for surgery or suffer from persistent/recurrent pulmonary hypertension after the procedure. The availability of balloon pulmonary angioplasty and the approval of the first medical therapy for use in CTEPH have significantly improved the outlook for patients ineligible for pulmonary endarterectomy. In this comprehensive review, we discuss the latest developments in the rapidly evolving field of CTEPH. These include improvements in imaging modalities and advances in surgical and interventional techniques, which have broadened the range of patients who may benefit from such procedures. The efficacy and safety of targeted medical therapies in CTEPH patients are also discussed, particularly the encouraging data from the recent MERIT-1 trial, which demonstrated the beneficial impact of using macitentan to treat patients with inoperable CTEPH, including those on background therapy. As the treatment options for CTEPH improve, hybrid management involving more than one intervention in the same patient may become a viable option in the near future.

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