Abstract
Approximately 4% of all individuals that develop pulmonary embolism will go on to have chronic thromboembolic pulmonary hypertension (CTEPH). Patients with severe CTEPH will eventually be evaluated for thrombendarterectomy, the only curative treatment for this disease. However, only a subgroup of these patients is eligible for this invasive procedure. In addition, a number of patients will not benefit tremendously from thrombendarterectomy. Finally, thrombendarterectomy may not be possible for functional reasons. In these situations medical treatment, i.e. diuretics, oxygen and anticoagulation remains and is recommended. However, no proven specific e.g. vasodilating medical treatment has been demonstrated in CTEPH. Patients with CTEPH exhibit the same symptoms and a comparable prognosis compared with pulmonary arterial hypertension (PAH) patients. Although the occlusion of pulmonary vessels in CTEPH is caused by repetitive embolism histological similarities to PAH were observed in the pulmonary vascular bed, possibly a reaction to the developing high vascular pressure. Considering these similarities it would certainly make sense to study medical PAH treatment in patients with CTEPH. A few smaller studies exist, which do suggest beneficial effects of endothelin receptor antagonists, prostanoids and phosphodiesterase-5 antagonists in CTEPH. The evidence for the various forms of treatment of for CTEPH will be reviewed.
Keywords: Pulmonary embolism, pulmonary hypertension, thrombendarterectomy, drug therapy, lung transplantation
Current Respiratory Medicine Reviews
Title: Chronic Thromboembolic Pulmonary Hypertension-Therapeutic Options
Volume: 2 Issue: 4
Author(s): Hans-Jurgen Seyfarth, Stefan Hammerschmidt, Christian Gessner, Michael Halank and Hubert Wirtz
Affiliation:
Keywords: Pulmonary embolism, pulmonary hypertension, thrombendarterectomy, drug therapy, lung transplantation
Abstract: Approximately 4% of all individuals that develop pulmonary embolism will go on to have chronic thromboembolic pulmonary hypertension (CTEPH). Patients with severe CTEPH will eventually be evaluated for thrombendarterectomy, the only curative treatment for this disease. However, only a subgroup of these patients is eligible for this invasive procedure. In addition, a number of patients will not benefit tremendously from thrombendarterectomy. Finally, thrombendarterectomy may not be possible for functional reasons. In these situations medical treatment, i.e. diuretics, oxygen and anticoagulation remains and is recommended. However, no proven specific e.g. vasodilating medical treatment has been demonstrated in CTEPH. Patients with CTEPH exhibit the same symptoms and a comparable prognosis compared with pulmonary arterial hypertension (PAH) patients. Although the occlusion of pulmonary vessels in CTEPH is caused by repetitive embolism histological similarities to PAH were observed in the pulmonary vascular bed, possibly a reaction to the developing high vascular pressure. Considering these similarities it would certainly make sense to study medical PAH treatment in patients with CTEPH. A few smaller studies exist, which do suggest beneficial effects of endothelin receptor antagonists, prostanoids and phosphodiesterase-5 antagonists in CTEPH. The evidence for the various forms of treatment of for CTEPH will be reviewed.
Export Options
About this article
Cite this article as:
Seyfarth Hans-Jurgen, Hammerschmidt Stefan, Gessner Christian, Halank Michael and Wirtz Hubert, Chronic Thromboembolic Pulmonary Hypertension-Therapeutic Options, Current Respiratory Medicine Reviews 2006; 2 (4) . https://dx.doi.org/10.2174/157339806778777186
DOI https://dx.doi.org/10.2174/157339806778777186 |
Print ISSN 1573-398X |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6387 |
Call for Papers in Thematic Issues
Exposure to PM2.5 components is associated with respiratory diseases
Through continuous research on the relationship between risk factors and health, it has been found that air pollution, especially atmospheric particulate matter pollution, has become one of the main sources of global disease burden. From 1990 to 2022, the concentration of atmospheric particulate matter pollution has increased by more than ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Canonical Wnt/Beta-Catenin Signaling Network as Emerging Signaling Cascade for Therapeutic Intervention in Chronic Renal Disease
Current Drug Targets Large Artery Stiffness and Antihypertensive Agents
Current Pharmaceutical Design Genetic Signatures in the Treatment of Stroke
Current Pharmaceutical Design Mitochondrial Dysfunction and Endoplasmic Reticulum Stress in Diabetes
Current Pharmaceutical Design Vascular Reactions of Iodinated X-Ray Contrast Media: Mechanisms and Possible Therapeutic Interventions
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry Potential of Resveratrol in Preventing the Development of Heart Failure
Current Chemical Biology Use of Paediatric Xylometazoline Nasal Drop is not a Child’s Play in Hypertensive Patients on Bisoprolol: A Case Report
Current Drug Safety Gum-Chewing and Headache: An Underestimated Trigger of Headache Pain in Migraineurs?
CNS & Neurological Disorders - Drug Targets Dietary Approaches and Supplements in the Prevention of Cognitive Decline and Alzheimer's Disease
Current Pharmaceutical Design Co-Enzyme Q10 to Treat Neurological Disorders: Basic Mechanisms, Clinical Outcomes, and Future Research Direction
CNS & Neurological Disorders - Drug Targets Subject Index Volume-2
Current Enzyme Inhibition The Possible Role of Infertility Drugs in Later Malignancy: A Review
Current Medicinal Chemistry Phosphodiesterase 4 Inhibitors in Immune-mediated Diseases: Mode of Action, Clinical Applications, Current and Future Perspectives
Current Medicinal Chemistry Metabolic Obesity: The Paradox Between Visceral and Subcutaneous Fat
Current Diabetes Reviews Evaluation of the Influence of Splitting on Content Uniformity of Captopril Tablets
Current Pharmaceutical Analysis The Role of Advanced Technologies Supplemented with Traditional Methods in Pharmacovigilance Sciences
Recent Patents on Biotechnology Self-care improvement after a pharmaceutical intervention in elderly type 2 diabetic patients
Current Diabetes Reviews Lock Stock and Barrel of Wound Healing
Current Pharmaceutical Design Insulin Therapy in Cardiac Surgery
Current Diabetes Reviews The Co-Existence of NASH and Chronic Kidney Disease Boosts Cardiovascular Risk: Are there any Common Therapeutic Options?
Current Vascular Pharmacology