New possibilities in the treatment of chronic thromboembolic pulmonary hypertension

Česká verzia

Authors: M. Škvařilová ¹; P. Jansa ¹; J. Lindner ²; J. Kunstýř ³; E. Mayer ⁴; S. Heller ¹; T. Paleček ¹; M. Aschermann ¹; J. Tošovský ²
Authors place of work: II. interní klinika kardiologie a angiologie 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Michal Aschermann, DrSc., FESC ¹; II. chirurgická klinika kardiovaskulární chirurgie 1. lékařské fakulty UK a VFN, Praha, přednosta doc. MUDr. Jan Tošovský, CSc. ²; Klinika anesteziologie a resuscitace 1. lékařské fakulty UK a VFN, Praha, přednosta MUDr. Martin Stříteský, CSc. ³; Klinik für Herz-, Torax- und Gefäßchirurgie, Johanes Gutenberg Universität Mainz, Německo, direktor prof. Dr. Med. Christian-F. Vahl ⁴
Published in the journal: Vnitř Lék 2005; 51(11): 1289-1296
Category: Review

Summary

Pulmonary arterial hypertension (PAH) has a multifactorial pathobiology. Vasoconstriction, remodeling of the pulmonary vessel wall, and thrombosis contribute to increased pulmonary vascular resistance in PAH. Prostanoids have played a prominent role in the treatment of PAH. They improves exercise capacity, hemodynamics, and survival in patients with idiopathic pulmonary arterial hypertension (IPAH). Several interventional and surgical approaches are available for treatment of PAH - atrial septostomy, lung or heart-lung transplantation. Pulmonary endarterectomy is the accepted method of treatment for patients with chronic thromboembolic pulmonary hypertension (CTEPH). Establishing the diagnosis and the classification of the type of lesions by pulmonary angiography is crucial for optimal patients selection. Fewer then 3,000 PEA operations have been performed worldwide, although it is potentially curative treatment option patients with CTEPH. Pulmonary endarterectomy have been performed successfully in the Czech Republic in the Clinic of Cardiovascular Surgery at the General Teaching Hospital in Prague in September 2004.

Key words:
chronic tromboembolic pulmonary hypertension - pulmonary endarterectomy

Zdroje

1. Pineda LA, Hathwar VS, Grant BJ. Clinical suspection of fatal pulmonary embolism. Chest 2001; 120: 791-795.

2. Rich S, Levitsky S, Brundage BH. Pulmonary hypertension from chronic thromboembolism. Ann Intern Med 1988; 108: 425-434.

3. Jansa P, Aschermann M, Linhart A. Primární plicní hypertenze. Nakladatelství Target MD 2003.

4. Martinuzzo ME, Pombo G, Azarian R et al. Lupus anticoagulant, high level of anticardiolipin, and anti-β2-glykoprotein I antibodies are associated with chronic thromboembolic pulmonary hypertension. J Rheumatol 1998; 25: 1313-1319.

5. Lupi E, Dumont C, Tejada VM et al. A radiologic index of pulmonary arterial hypertension. Chest 1975; 68: 28-31.

6. Rich S, Dantzker DR, Ayres SM et al. Primary pulmonary hypertension: a national prospective study. Ann Intern Med 1987; 107: 216-223.

7. Bossone E, Paciocco G, Iarussi D et al. The prognostic role of the ECG in primary pulmonary hypertension. Chest 2002; 121: 513-518.

8. Linhart A, Paleček T, Aschermann M. Echokardiografie pro praxi. Praha: Audioscan 2002.

9. Sahn DJ, DeMaria A, Kisslo J et al. Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements. Circulation 1978; 58: 1072-1083.

10. Daniels LB, Krummen DE, Blanchard DG. Echocardiography in pulmonary vascular disease. Cardiol Clin 2004; 22: 383-399.

11. Kaul S, Tei C, Hopkins JM et al. Assessment of right ventricular function using two-dimensional echocardiography. Am Heart J 1984; 107: 526-531.

12. Shapira Y, Porter A, Wurzel M et al. Evaluation of tricuspid regurgitation severity: echocardiographic and clinical correlation. J Am Soc Echocardiogr 1998; 11: 652-659.

13. Masuyama T, Kodama K, Kitabatake A et al. Continuous-wave Doppler echocardiographic detection of pulmonary regurgitation and its application to noninvasive estimation of pulmonary artery pressure. Circulation 1986; 74: 484-492.

14. Yock PG, Popp RL. Noninvasive estimation of right ventricular systolic pressure by Doppler ultrasound in patients with tricuspid regurgitation. Circulation 1984; 70: 657-662.

15. Kircher BJ, Himelman RB, Schiller NB. Noninvasive estimation of right atrial pressure from the inspiratory collapse of the inferior vena cava. Am J Cardiol 1990; 66: 493-496.

16. Nakayama Y, Sugimachi M, Nakanishi N et al. Noninvasive differential diagnosis between chronic pulmonary thromboembolism and primary pulmonary hypertension by means of Doppler ultrasound measurement. J Am Coll Cardiol 1998; 31: 1367-1371.

17. Ghio S, Raineri C, Scelsi L et al. Usefulness and limits of transthoracic echocardiography in the evaluation of patients with primary and chronic thromboembolic pulmonary hypertension. J Am Soc Echocardiogr 2002; 15: 1374-1380.

18. Bergin CJ, Haudchildt J, Rios G et al. Accuracy of MR angiography compared with radionuclide scanning in identifying the cause of pulmonary arterial hypertension. Am J Roentgenol 1997; 168: 1549-1555.

19. Hull RD, Hirsch J, Carter CJ et al. Pulmonary angiography, ventilation lung scanning, and venography for clinically suspected pulmonary embolism with abnormal perfusion lung scan. Ann Intern Med 1983; 98: 891-899.

20. Rich S, D´Alonzo GE, Dantzker et al. Magnitude and implications of spontaneous hemodynamic variability in primary pulmonary hypertension. Am J Cardiol 1985; 55: 159-163.

21. D´Alonzo GE, Bower JS, Dantzker DR. Differentiation of patients with primary and trombembolic pulmonary hypertension. Chest 1984; 85: 457-461.

22. Nagaya N, Nishikimi T, Okano Y et al. Plasma brain natriuretic peptide levels increase in portion to the extent of right ventricular dysfunction in pulmonary hypertension. J Am Cardiol 1998; 31: 202-208.

23. Ogata M, Ohe M, Shirato K et al. Effects off a combination therapy of anticoagulant and vasodilator on the long-term prognosis of primary pulmonary hypertension. Jpc Circ J 1993; 57: 63-69.

24. Weitzenblum E, Sautegeau A, Ehrhart M et al. Long-term oxygen therapy can reverse the progression of pulmonary hypertension in patients with chronic obstructive pulmonary disease. Am Rev Resp Dis 1985; 131: 493-498.

25. Barst RJ, Rubin LJ, Long WA et al. A comparison of continuous intravenous epoprostenol (prostacyklin) with convential therapy for primary pulmonary hypertension. N Enng J Med 1996; 334: 296-301.

26. Sandaloval J, Gaspar J, Pulido T et al. Graded balloon dilatation atrial septostomy in severe primary pulmonary hypertension: a therapeutic alternative for patients nonresposive to vasodilatator treatment. J Am Coll Cardiol 1998; 32: 297-304.

27. Nehill MR, O´Laughlin MP, Mullins CE. Effects of atrial septostomy in patients with terminal cor pulmonale due to pulmonary vascular disease. Cathet Cardiovasc Diagn 1991; 24: 166-172.

28. Kothari SS, Yusuf A, Juneja R et al. Graded balloon dilatation atrial septostomy in severe primary pulmonary hypertension. Indian Heart J 2002; 54: 164-169.

29. Lischke R, Šimonek J, Stolz A et al. Transplantac plic u primární plicní hypertenze. Vnitř Lék 2004; 50: 695-697.

30. Doyle RL, McCrory D, Channick RN et al. Surgical treatments/interventions for pulmonary arterial hypertension. Chest 2004; 126: 63S-71S.

31. ASTP, ATS, ERS, ISHLT Joint statement international guidelines for the selection of lung transplant patients. Am J Respir Crit Care Med 1998; 158: 335-339.

32. Archibald CJ, Auger WR, Fedullo PF et al. Long-term outcome after pulmonary thromboendarterectomy. Am J Respir Critic Care 1999; 160: 523-528.

33. Ando M, Okita Y, Tagusari O et al. Surgical treatment for chronic thromboembolic pulmonary hypertension under profound hypotermia and circulatory arest in 24 patients. J Card Surg 1996; 14: 377-385.

34. Synder WH, Kent DC, Baesch BF et al. Successful endarterectomy of chronically occluded pulmonary artery; clinical report and physiologic. J Thorac Surg 1964; 45: 482.

35. Jamieson SW, Kapelanski DP, Sakakibara N et al. Pulmonary thromboendarterectomy. Experience and results in 1,500 cases. Ann Thorac Surg 2003; 76: 1457-1464.

36. Jamieson SW, Auger WR, Cedulko PF et al. Experience and results with 150 pulmonary thromboendarterectomy operations over a 29-month period. J Thorac Cardiovasc Surg 1993; 106: 116-127.

37. Mayer E, Dahm M, Hake U et al. Mid-term results of pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension. Ann Thorac Surg 1996; 62: 1788-1792.

38. Lewcuzuk J, Piszko P, Jagas J et al. Prognostic factors in medically treated patients with chronic pulmonary embolism. Chest 2001; 119: 818-823.

39. Thistlethwaite PA, Mo A, Madami MM et al. Operative classification of thromboembolic disease determines outcome after pulmonary endarterectomy. J Thorac Cardiovasc Surg 2002; 124: 1203-1211.

40. Kim NHS, Fesler P, Channick RN et al. Preoperative partitioning of pulmonary vascular resistence correlates with early outcome after thromboendarterectomy for chronic thromboembolic pulmonary hypertension. Circulation 2004; 109: 18-22.

41. Klepetko W, Mayer E, Sandoval J et al. Interventional and surgical modalities of treatment for pulmonary arterial hypertension. J Am Coll Cardiol 2004; 43: 73S-80S.

42. Jansa P, Aschermann M, Riedel M. Doporučení pro diagnostiku a léčbu plicní arteriální hypertenze v ČR. Vnitř Lék 2004; 50: 698-708.

43. McLaughlin VV, Presberg KW, Doyle RL et al. Prognosis of pulmonary arterial hypertension, ACCP Evidence-based Clinical Practice Guidelines. Chest 2004; 126: 78S-92S