Central versus Peripheral CTEPH—Clinical and Hemodynamic Specifications

Central versus Peripheral CTEPH—Clinical and Hemodynamic Specifications

<i>Background and Objectives:</i> Chronic thromboembolic pulmonary hypertension (CTEPH) is a chronic progressive disease, resulting from persistent arterial obstruction combined with small-vessel remodeling. Central and peripheral CTEPH are distinguished, according to the dominant lesion...

Full description

Bibliographic Details
Main Authors: Monika Kaldararova, Iveta Simkova, Marcela Bohacekova, Adriana Reptova, Tereza Hlavata, Jozef Pacak, Jaroslav Lindner, Pavel Jansa
Format: Article
Language:English
Published: MDPI AG 2022-10-01
Series:Medicina
Subjects:
chronic thromboembolic pulmonary hypertension (CTEPH)
central CTEPH
peripheral CTEPH
risk factors
hemodynamic evaluation
Online Access:https://www.mdpi.com/1648-9144/58/11/1538
Description
Summary:<i>Background and Objectives:</i> Chronic thromboembolic pulmonary hypertension (CTEPH) is a chronic progressive disease, resulting from persistent arterial obstruction combined with small-vessel remodeling. Central and peripheral CTEPH are distinguished, according to the dominant lesion’s location. This is important for surgical or percutaneous interventional assessment or for medical treatment. <i>Material and Methods:</i> Eighty-one patients (51 male/30 female) with confirmed CTEPH were analyzed, while the CENTRAL type included 51 patients (63%) and the PERIPHERAL type 30 patients (37%). <i>Results:</i> A significant difference in CENTRAL type vs. PERIPHERAL type was determined in gender (male 72.5% vs. 46.7%; <i>p</i> = 0.0198). No difference was found in age, functional status, or echocardiographic parameters. Invasive hemodynamic parameters showed a significant difference in mean pulmonary arterial pressure (46 vs. 58 mmHg; <i>p</i> = 0.0002), transpulmonary gradient (34 vs. 47 mmHg; <i>p</i> = 0.0005), and cardiac index (2.04 vs. 2.5 L.min.m<sup>2</sup>; <i>p</i> = 0.02) but not in pulmonary vascular resistance. Risk factors showed a significant difference only in acute pulmonary embolism (93.8% vs. 60%; <i>p</i> = 0.0002) and malignancy (2% vs. 13.3%; <i>p</i> = 0.0426). <i>Conclusions:</i> Our study showed hemodynamic differences between CENTRAL type vs. PERIPHERAL type CTEPH with a worse hemodynamic picture in CENTRAL form. This may indicate a different pathophysiological response and/or possible additional influences contributing especially to the peripheral pulmonary bed affection.
ISSN:1010-660X
1648-9144

Similar Items