scholarly journals Pulmonary Hypertension Roundtable: CTEPH Experiences and Expertise

2014 ◽  
Vol 12 (4) ◽  
pp. 199-205
Keyword(s):  
Pulmonary Hypertension ◽  
Clinical Medicine ◽  
Massachusetts General Hospital ◽  
Medical Center ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Vascular Diseases ◽  
Pulmonary Vascular Disease ◽  
Thromboembolic Pulmonary Hypertension ◽  
Duke University ◽  
The University

On February 6, 2014, a group of physicians with expertise related to Chronic Thromboembolic Pulmonary Hypertension (CTEPH) met on a conference call to discuss topics related to the disease. The call was hosted by the guest editor of this issue, Richard Channick, MD, the Director of the Pulmonary Hypertension and Thromboendarterectomy Program at Massachusetts General Hospital. Dr. Channick was joined by Victor Tapson, MD, Professor of Medicine in the Division of Pulmonary and Critical Care Medicine at Duke University Medical Center and Director of the Duke Pulmonary Vascular Disease Center; Joanna Pepke-Zaba, PhD, FRCP, Lead Physician and Director, National Pulmonary Vascular Diseases Unit at the Papworth Hospital, University of Cambridge, UK; Vallerie McLaughlin, MD, Professor of Internal Medicine at the University of Michigan; and Bill Auger, MD, Professor of Clinical Medicine and Director of Academic Affairs of the PTE Program at University of California-San Diego.

Assisting Pulmonary Hypertension Patients and Families With Treatment Decisions

2010 ◽  
Vol 8 (4) ◽  
pp. 239-243
Author(s):  
Karen Frutiger ◽  
Martha Kingman ◽  
Abby Poms ◽  
Glenna Traiger
Keyword(s):  
North Carolina ◽  
Pulmonary Hypertension ◽  
Los Angeles ◽  
Medical Center ◽  
Pulmonary Vascular Disease ◽  
University Of Texas ◽  
Program Manager ◽  
Nurse Coordinator ◽  
Duke University ◽  
Pulmonary Arterial

To complement this issue's theme, “Living With Pulmonary Hypertension,” a discussion on assisting patients with therapy decisions was led by guest editor Glenna Traiger, RN, MSN, Pulmonary Hypertension CNS, University of California, Los Angeles. The panelists included Karen Frutiger, RN, Clinical Nurse Coordinator, University of Rochester Pulmonary Arterial Hypertension Program, Rochester, NY; Martha Kingman, Nurse Practitioner, University of Texas Southwestern Medical Center, Dallas; and Abby Poms, RRT, Duke University Pulmonary Vascular Disease Program Manager, Duke University Medical Center, Durham, North Carolina.

Sickle Cell Disease and Pulmonary Hypertension: Addressing the Mixed Pathology and Special Considerations in Diagnosis and Treatment

2007 ◽  
Vol 6 (1) ◽  
pp. 39-44
Author(s):  
Harrison W. Farber ◽  
Mark Gladwin ◽  
Evelyn M. Horn ◽  
Myung H. Park
Keyword(s):  
New York ◽  
Pulmonary Hypertension ◽  
Vascular Disease ◽  
Clinical Medicine ◽  
Medical Center ◽  
Associate Professor ◽  
Pulmonary Vascular Disease ◽  
Vascular Medicine ◽  
Blood Institute ◽  
School Of Medicine

This discussion was moderated by Evelyn M. Horn, MD, Associate Professor of Clinical Medicine and Director, Pulmonary Vascular Disease, Center for Advanced Cardiac Care, Columbia University Medical Center, New York, New York. Panel members included Harrison W. Farber, MD, Director, Pulmonary Hypertension Center, Boston Medical Center, Boston University School of Medicine; Mark Gladwin, MD, Chief, Vascular Medicine Branch, National Heart, Lung, and Blood Institute, Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD; Myung H. Park, MD, Director, Pulmonary Vascular Disease Program, University of Maryland School of Medicine.

scholarly journals Pulmonary Hypertension Roundtable: New Invasive Technologies in Pulmonary Hypertension

2020 ◽  
Vol 19 (1) ◽  
pp. 25-32
Keyword(s):  
Pulmonary Hypertension ◽  
Los Angeles ◽  
University Hospital ◽  
Pulmonary Vascular Disease ◽  
State University ◽  
Cardiovascular Medicine ◽  
School Of Medicine ◽  
Duke University ◽  
The Ohio State University ◽  
The University

This spring, Guest Editor Richard A. Krasuski, MD, Professor of Medicine at Duke University School of Medicine in Durham, North Carolina, convened a group of experts to discuss the present and future of invasive technologies in the diagnosis and treatment of pulmonary hypertension. The guests included Jamil A. Aboulhosn, MD, Professor of Medicine at the University of California Los Angeles David Geffen School of Medicine in Los Angeles, California; Raymond Benza, MD, Director of the Division of Cardiovascular Medicine and Professor of Medicine at The Ohio State University College of Medicine in Columbus, Ohio; and J. Eduardo Rame, MD, FACC, Louis R. Dinon MD Professor of Cardiovascular Medicine and Physiology and Chief for Advanced Cardiac and Pulmonary Vascular Disease at Thomas Jefferson University Hospital in Philadelphia, Pennsylvania.

scholarly journals Peripheral microangiopathy in precapillary pulmonary hypertension: a nailfold video capillaroscopy prospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Alexandra Arvanitaki ◽  
George Giannakoulas ◽  
Eva Triantafyllidou ◽  
Christos Feloukidis ◽  
Afroditi K. Boutou ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Structural Changes ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Multiple Comparisons ◽  
Capillary Density ◽  
Pulmonary Vascular Disease ◽  
Healthy Controls ◽  
Continuous Variables ◽  
Thromboembolic Pulmonary Hypertension ◽  
Bonferroni Test

Abstract Background Although pulmonary vascular bed has been the main subject of research for many years in pulmonary hypertension (PH), interest has recently started to divert towards the possibility of a co-existing peripheral microangiopathy. The aim of the current study was to investigate the presence of nailfold video-capillaroscopic (NVC) structural changes in patients with precapillary PH and to identify possible associations of NVC measurements with markers of disease severity. Methods Α prospective case–control study was performed in 28 consecutive patients with precapillary PH [14 with idiopathic pulmonary arterial hypertension (IPAH) and 14 with chronic thromboembolic pulmonary hypertension (CTEPH)] and 30 healthy controls. NVC quantitative and qualitative parameters were evaluated using Optilia Digital Capillaroscope. To ensure inter-observer repeatability capillaroscopic images were reviewed by two independent investigators. For multiple comparisons among continuous variables, one-way ANOVA or the Kruskal–Wallis test were used. Differences between the groups were tested with post-hoc analysis with adjustment for multiple comparisons (Bonferroni test). Results Both IPAH (71.4% were women, mean age 53.1 ± 13.4 years) and CTEPH (64.3% women, mean age 60.9 ± 14.4 years) groups presented reduced capillary density compared to healthy controls (8.4 ± 1.2 loops/mm and 8.0 ± 1.2 loops/mm vs. 9.7 ± 0.81 loops/mm, p < 0.001) and increased loop width (15.7 ± 3.9 μm and 15.8 ± 1.9 μm vs. 11.5 ± 2.3 μm, p < 0.001). More than half of patients with IPAH presented microhaemorrhages on capillary nailfold, while increased shape abnormalities in capillary morphology and more capillary thrombi per linear mm were detected in patients with CTEPH compared to patients with IPAH and healthy controls. All PH patients presented a non-specific NVC pattern compared to controls (p < 0.001). Conclusion The findings of the study reveal a degree of significant peripheral microvascular alterations in patients with IPAH and CTEPH, suggesting a generalized impairment of peripheral microvasculature in pulmonary vascular disease.

scholarly journals The pathophysiology of chronic thromboembolic pulmonary hypertension

2017 ◽  
Vol 26 (143) ◽  
pp. 160112 ◽  
Author(s):  
Gérald Simonneau ◽  
Adam Torbicki ◽  
Peter Dorfmüller ◽  
Nick Kim
Keyword(s):  
Pulmonary Hypertension ◽  
Small Vessel Disease ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Small Vessel ◽  
Treatment Modalities ◽  
Pulmonary Vasculature ◽  
Pulmonary Vascular Disease ◽  
Substantial Impact ◽  
Vessel Disease ◽  
Thromboembolic Pulmonary Hypertension

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare, progressive pulmonary vascular disease that is usually a consequence of prior acute pulmonary embolism. CTEPH usually begins with persistent obstruction of large and/or middle-sized pulmonary arteries by organised thrombi. Failure of thrombi to resolve may be related to abnormal fibrinolysis or underlying haematological or autoimmune disorders. It is now known that small-vessel abnormalities also contribute to haemodynamic compromise, functional impairment and disease progression in CTEPH. Small-vessel disease can occur in obstructed areas, possibly triggered by unresolved thrombotic material, and downstream from occlusions, possibly because of excessive collateral blood supply from high-pressure bronchial and systemic arteries. The molecular processes underlying small-vessel disease are not completely understood and further research is needed in this area. The degree of small-vessel disease has a substantial impact on the severity of CTEPH and postsurgical outcomes. Interventional and medical treatment of CTEPH should aim to restore normal flow distribution within the pulmonary vasculature, unload the right ventricle and prevent or treat small-vessel disease. It requires early, reliable identification of patients with CTEPH and use of optimal treatment modalities in expert centres.

Chronic thromboembolic pulmonary hypertension

ESC CardioMed ◽  
2018 ◽  
pp. 2550-2554
Author(s):  
Yu Taniguchi ◽  
Xavier Jaïs ◽  
Gérald Simonneau ◽  
Marc Humbert
Keyword(s):  
Pulmonary Hypertension ◽  
Small Vessel Disease ◽  
Pulmonary Arteries ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Flow Distribution ◽  
Small Vessel ◽  
Pulmonary Vasculature ◽  
Pulmonary Vascular Disease ◽  
Vessel Disease ◽  
Thromboembolic Pulmonary Hypertension

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare and progressive pulmonary vascular disease that is usually the consequence of prior acute pulmonary embolism. CTEPH usually begins with persistent obstruction of large and/or middle-sized pulmonary arteries by organized thrombi. Failure of thrombi to resolve may be related to abnormal fibrinolysis, and underlying haematological or autoimmune disorders, including splenectomy and antiphospholipid antibodies. Small pulmonary vessel remodelling also contributes to haemodynamic compromise, functional impairment, and disease progression in CTEPH. Small vessel disease can occur in non-obstructed areas as well as downstream from occlusions (possibly because of excessive collateral blood supply from high-pressure bronchial and systemic arteries). The degree of small vessel disease has a substantial impact on the severity of CTEPH and post-surgical outcomes. Surgical, interventional, and medical treatment of CTEPH aim to restore normal flow distribution within the pulmonary vasculature, unload the right ventricle, and prevent or treat small vessel disease.

scholarly journals Bench to Bedside: Principles and Practice of Epoprostenol Therapy, from Maximizing Benefit to Minimizing Side Effects

2002 ◽  
Vol 1 (3) ◽  
pp. 22-25
Author(s):  
Ivan Robbins ◽  
David Langleben ◽  
Michael McGoon ◽  
Abby Krichman
Keyword(s):  
North Carolina ◽  
Pulmonary Hypertension ◽  
Side Effects ◽  
Mayo Clinic ◽  
Medical Center ◽  
Pulmonary Vascular Disease ◽  
Jewish General Hospital ◽  
Mcgill University ◽  
Duke University ◽  
Vanderbilt University

Ivan Robbins, MD, Director, Pulmonary Hypertension Center, Vanderbilt University, Nashville, Tennessee, conducted this discussion. The panel included David Langleben, MD, Director, Center for Pulmonary Vascular Disease, Jewish General Hospital, McGill University, Montreal, Quebec, Canada; Michael McGoon, MD, Consultant in Cardiology, Mayo Clinic, Rochester, Minnesota; and Abby Krichman, RRT, Pulmonary Hypertension Coordinator, Duke University Medical Center, Durham, North Carolina.

scholarly journals Pulmonary Hypertension Roundtable

2005 ◽  
Vol 4 (3) ◽  
pp. 26-30 ◽  
Author(s):  
Vallerie V. McLaughlin ◽  
Richard N. Channick ◽  
Ivan M. Robbins ◽  
Victor F. Tapson
Keyword(s):  
Pulmonary Hypertension ◽  
Critical Care ◽  
San Diego ◽  
Medical Center ◽  
Associate Professor ◽  
Response To Therapy ◽  
University Of Michigan ◽  
Ann Arbor ◽  
Thromboembolic Pulmonary Hypertension ◽  
Duke University

In this discussion four experts shared insights on what might be considered the “gestalt” of diagnosing and monitoring pulmonary arterial hypertension. They ranged over a broad spectrum of issues that included thromboembolic pulmonary hypertension, exercise testing, hemodynamics, imaging studies, and response to therapy. The discussion was moderated by Vallerie V. McLaughlin, MD, Associate Professor of Medicine, Director, Pulmonary Hypertension Program, University of Michigan Health System, Ann Arbor, Michigan. The participants included Richard N. Channick, Associate Professor of Medicine, Pulmonary and Critical Care Division, University of California, San Diego Medical Center, San Diego, California; Ivan M. Robbins, MD, Director, Pulmonary Hypertension Center, Vanderbilt University, Nashville, Tennessee; and Victor F. Tapson, MD, Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina.

Pulmonary hypertension: clinical classification

ESC CardioMed ◽  
2018 ◽  
pp. 2500-2502
Author(s):  
Francisca A. Gavilanes Oleas ◽  
Caio J. C. Fernandes ◽  
Rogério Souza
Keyword(s):  
Pulmonary Hypertension ◽  
Management Strategies ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Pulmonary Vascular Disease ◽  
Left Heart ◽  
Clinical Classification ◽  
Current Classification ◽  
Thromboembolic Pulmonary Hypertension ◽  
Pulmonary Arterial ◽  
Clinical Conditions

Pulmonary hypertension is a clinical and haemodynamic condition associated with several baseline clinical conditions or existing as a pure pulmonary vascular disease. The current classification groups aetiologies of pulmonary hypertension that share similarities in terms of clinical presentation, pathological findings, and haemodynamic profiles, in an attempt to guide management strategies in these distinct conditions. As a consequence, pulmonary hypertension is classified into five different groups: pulmonary arterial hypertension, pulmonary hypertension due to left heart disease, pulmonary hypertension due to lung disease and/or hypoxia, chronic thromboembolic pulmonary hypertension, and pulmonary hypertension with unclear multifactorial mechanisms. This chapter reviews the rational supporting the current classification system alluding also to the existing evidence for specific therapies in each one of the groups.

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