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...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-10-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/58/11/1538 |
| _version_ | 1797467298069479424 |
|---|---|
| author | Monika Kaldararova Iveta Simkova Marcela Bohacekova Adriana Reptova Tereza Hlavata Jozef Pacak Jaroslav Lindner Pavel Jansa |
| author_facet | Monika Kaldararova Iveta Simkova Marcela Bohacekova Adriana Reptova Tereza Hlavata Jozef Pacak Jaroslav Lindner Pavel Jansa |
| author_sort | Monika Kaldararova |
| collection | DOAJ |
| description | <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. |
| first_indexed | 2024-03-09T18:51:38Z |
| format | Article |
| id | doaj.art-2238a7bfd8c349f78cb584a5bfc8c583 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T18:51:38Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-2238a7bfd8c349f78cb584a5bfc8c5832023-11-24T05:46:26ZengMDPI AGMedicina1010-660X1648-91442022-10-015811153810.3390/medicina58111538Central versus Peripheral CTEPH—Clinical and Hemodynamic SpecificationsMonika Kaldararova0Iveta Simkova1Marcela Bohacekova2Adriana Reptova3Tereza Hlavata4Jozef Pacak5Jaroslav Lindner6Pavel Jansa7Department of Cardiology and Angiology, CTEPH Expert Centre, Medical Faculty, The National Institute of Cardiovascular Diseases, Slovak Medical University, Pod Krasnou horkou 1, 833 48 Bratislava, SlovakiaDepartment of Cardiology and Angiology, CTEPH Expert Centre, Medical Faculty, The National Institute of Cardiovascular Diseases, Slovak Medical University, Pod Krasnou horkou 1, 833 48 Bratislava, SlovakiaDepartment of Cardiology and Angiology, CTEPH Expert Centre, Medical Faculty, The National Institute of Cardiovascular Diseases, Slovak Medical University, Pod Krasnou horkou 1, 833 48 Bratislava, SlovakiaDepartment of Cardiology and Angiology, CTEPH Expert Centre, Medical Faculty, The National Institute of Cardiovascular Diseases, Slovak Medical University, Pod Krasnou horkou 1, 833 48 Bratislava, SlovakiaDepartment of Cardiology and Angiology, CTEPH Expert Centre, Medical Faculty, The National Institute of Cardiovascular Diseases, Slovak Medical University, Pod Krasnou horkou 1, 833 48 Bratislava, SlovakiaDepartment of Cardiology and Angiology, CTEPH Expert Centre, Medical Faculty, The National Institute of Cardiovascular Diseases, Slovak Medical University, Pod Krasnou horkou 1, 833 48 Bratislava, Slovakia2nd Department of Surgery—Department of Cardiovascular Surgery, 1st Faculty of Medicine, General University Hospital, Charles University, U nemocnice 2, 128 02 Prague, Czech RepublicCenter for Pulmonary Hypertension, 1st Faculty of Medicine, General University Hospital, Charles University, U nemocnice 2, 128 02 Prague, Czech Republic<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.https://www.mdpi.com/1648-9144/58/11/1538chronic thromboembolic pulmonary hypertension (CTEPH)central CTEPHperipheral CTEPHrisk factorshemodynamic evaluation |
| spellingShingle | Monika Kaldararova Iveta Simkova Marcela Bohacekova Adriana Reptova Tereza Hlavata Jozef Pacak Jaroslav Lindner Pavel Jansa Central versus Peripheral CTEPH—Clinical and Hemodynamic Specifications Medicina chronic thromboembolic pulmonary hypertension (CTEPH) central CTEPH peripheral CTEPH risk factors hemodynamic evaluation |
| title | Central versus Peripheral CTEPH—Clinical and Hemodynamic Specifications |
| title_full | Central versus Peripheral CTEPH—Clinical and Hemodynamic Specifications |
| title_fullStr | Central versus Peripheral CTEPH—Clinical and Hemodynamic Specifications |
| title_full_unstemmed | Central versus Peripheral CTEPH—Clinical and Hemodynamic Specifications |
| title_short | Central versus Peripheral CTEPH—Clinical and Hemodynamic Specifications |
| title_sort | central versus peripheral cteph clinical and hemodynamic specifications |
| topic | chronic thromboembolic pulmonary hypertension (CTEPH) central CTEPH peripheral CTEPH risk factors hemodynamic evaluation |
| url | https://www.mdpi.com/1648-9144/58/11/1538 |
| work_keys_str_mv | AT monikakaldararova centralversusperipheralctephclinicalandhemodynamicspecifications AT ivetasimkova centralversusperipheralctephclinicalandhemodynamicspecifications AT marcelabohacekova centralversusperipheralctephclinicalandhemodynamicspecifications AT adrianareptova centralversusperipheralctephclinicalandhemodynamicspecifications AT terezahlavata centralversusperipheralctephclinicalandhemodynamicspecifications AT jozefpacak centralversusperipheralctephclinicalandhemodynamicspecifications AT jaroslavlindner centralversusperipheralctephclinicalandhemodynamicspecifications AT paveljansa centralversusperipheralctephclinicalandhemodynamicspecifications |