Clinicopathological Correlation of Chronic Thromboembolic Pulmonary Hypertension: A Retrospective Study
The pathophysiology of chronic thromboembolic pulmonary hypertension (CTEPH) is largely unknown. Although pulmonary endarterectomy (PEA) is potentially curative, inoperable patients and persistent pulmonary hypertension (PH) following surgery remain a significant problem. In this study, we aim to de...
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MDPI AG
2022-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/22/6659 |
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| author | Ziyi Chang Jixiang Liu Bei Wang Honglei Zhang Ling Zhao Yunchao Su Wanmu Xie Qiang Huang Yanan Zhen Fan Lin Min Liu Qian Gao Wenyi Pang Zhu Zhang Han Tian Yishan Li Peiran Yang Zhenguo Zhai Dingrong Zhong |
| author_facet | Ziyi Chang Jixiang Liu Bei Wang Honglei Zhang Ling Zhao Yunchao Su Wanmu Xie Qiang Huang Yanan Zhen Fan Lin Min Liu Qian Gao Wenyi Pang Zhu Zhang Han Tian Yishan Li Peiran Yang Zhenguo Zhai Dingrong Zhong |
| author_sort | Ziyi Chang |
| collection | DOAJ |
| description | The pathophysiology of chronic thromboembolic pulmonary hypertension (CTEPH) is largely unknown. Although pulmonary endarterectomy (PEA) is potentially curative, inoperable patients and persistent pulmonary hypertension (PH) following surgery remain a significant problem. In this study, we aim to describe the histopathological characteristics of CTEPH and explore the potential relationship between pulmonary arterial lesions, radiological parameters, and clinical manifestations. Endarterectomized tissues from 81 consecutive patients of CTEPH were carefully collected, sectioned, and examined by experienced pathologists. Pertinent clinical and radiological data were obtained from medical records and operative reports. Neointima, fresh/organized thrombi, recanalized regions, and atherosclerotic lesions were microscopically examined as previously described. Thrombi and atherosclerosis were dominant in UCSD classification level I PEA materials, while recanalized neo-vessels were more frequently observed in UCSD classification level III cases. Degenerative changes of the extracellular matrix were also noticed in the vascular bed. Atherosclerotic lesions were more frequently observed in cases with higher ratio of the pulmonary artery diameter to ascending aorta diameter (PA/AA) reflected by computed tomographic pulmonary arterial scanning. Furthermore, the removal of pulmonary artery complex lesions (with the combination of three to four types of lesions) by PEA was associated with lower postoperative mean pulmonary arterial pressure (mPAP) and decreased incidences of persistent PH. Our study demonstrates that the histopathological features of CTEPH are strongly linked with clinical manifestations and the postoperative outcome after PEA. These data may provide possible evidence for further studies in searching for appropriate causal factors underlying this disease. |
| first_indexed | 2024-03-09T18:14:46Z |
| format | Article |
| id | doaj.art-78c8cea9bad745d69c48cc4ef26c259f |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T18:14:46Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-78c8cea9bad745d69c48cc4ef26c259f2023-11-24T08:48:04ZengMDPI AGJournal of Clinical Medicine2077-03832022-11-011122665910.3390/jcm11226659Clinicopathological Correlation of Chronic Thromboembolic Pulmonary Hypertension: A Retrospective StudyZiyi Chang0Jixiang Liu1Bei Wang2Honglei Zhang3Ling Zhao4Yunchao Su5Wanmu Xie6Qiang Huang7Yanan Zhen8Fan Lin9Min Liu10Qian Gao11Wenyi Pang12Zhu Zhang13Han Tian14Yishan Li15Peiran Yang16Zhenguo Zhai17Dingrong Zhong18Department of Pathology, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Pathology, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Pathology, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Pathology, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Pathology, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Radiology, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, ChinaNational Clinical Research Center for Respiratory Diseases, Beijing 100029, ChinaDepartment of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing 100029, ChinaDepartment of Pathology, China-Japan Friendship Hospital, Beijing 100029, ChinaThe pathophysiology of chronic thromboembolic pulmonary hypertension (CTEPH) is largely unknown. Although pulmonary endarterectomy (PEA) is potentially curative, inoperable patients and persistent pulmonary hypertension (PH) following surgery remain a significant problem. In this study, we aim to describe the histopathological characteristics of CTEPH and explore the potential relationship between pulmonary arterial lesions, radiological parameters, and clinical manifestations. Endarterectomized tissues from 81 consecutive patients of CTEPH were carefully collected, sectioned, and examined by experienced pathologists. Pertinent clinical and radiological data were obtained from medical records and operative reports. Neointima, fresh/organized thrombi, recanalized regions, and atherosclerotic lesions were microscopically examined as previously described. Thrombi and atherosclerosis were dominant in UCSD classification level I PEA materials, while recanalized neo-vessels were more frequently observed in UCSD classification level III cases. Degenerative changes of the extracellular matrix were also noticed in the vascular bed. Atherosclerotic lesions were more frequently observed in cases with higher ratio of the pulmonary artery diameter to ascending aorta diameter (PA/AA) reflected by computed tomographic pulmonary arterial scanning. Furthermore, the removal of pulmonary artery complex lesions (with the combination of three to four types of lesions) by PEA was associated with lower postoperative mean pulmonary arterial pressure (mPAP) and decreased incidences of persistent PH. Our study demonstrates that the histopathological features of CTEPH are strongly linked with clinical manifestations and the postoperative outcome after PEA. These data may provide possible evidence for further studies in searching for appropriate causal factors underlying this disease.https://www.mdpi.com/2077-0383/11/22/6659chronic thromboembolic pulmonary hypertensionpathologypersistent pulmonary hypertensionatherosclerosispulmonary endarterectomy |
| spellingShingle | Ziyi Chang Jixiang Liu Bei Wang Honglei Zhang Ling Zhao Yunchao Su Wanmu Xie Qiang Huang Yanan Zhen Fan Lin Min Liu Qian Gao Wenyi Pang Zhu Zhang Han Tian Yishan Li Peiran Yang Zhenguo Zhai Dingrong Zhong Clinicopathological Correlation of Chronic Thromboembolic Pulmonary Hypertension: A Retrospective Study Journal of Clinical Medicine chronic thromboembolic pulmonary hypertension pathology persistent pulmonary hypertension atherosclerosis pulmonary endarterectomy |
| title | Clinicopathological Correlation of Chronic Thromboembolic Pulmonary Hypertension: A Retrospective Study |
| title_full | Clinicopathological Correlation of Chronic Thromboembolic Pulmonary Hypertension: A Retrospective Study |
| title_fullStr | Clinicopathological Correlation of Chronic Thromboembolic Pulmonary Hypertension: A Retrospective Study |
| title_full_unstemmed | Clinicopathological Correlation of Chronic Thromboembolic Pulmonary Hypertension: A Retrospective Study |
| title_short | Clinicopathological Correlation of Chronic Thromboembolic Pulmonary Hypertension: A Retrospective Study |
| title_sort | clinicopathological correlation of chronic thromboembolic pulmonary hypertension a retrospective study |
| topic | chronic thromboembolic pulmonary hypertension pathology persistent pulmonary hypertension atherosclerosis pulmonary endarterectomy |
| url | https://www.mdpi.com/2077-0383/11/22/6659 |
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