Right Ventricular Load and Function in Chronic Thromboembolic Pulmonary Hypertension: Differences between Proximal and Distal Chronic Thromboembolic Pulmonary Hypertension

According to computed tomography-pulmonary angiography, CTEPH was classified as either proximal (level I/II disease: lesions starting in the main or lobar arteries) or distal (level III-IV disease: lesions starting in the segmental and subsegmental) (3) for each side separately. [...]Zc may be a rel...

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Published in:American journal of respiratory and critical care medicine 2019-05, Vol.199 (9), p.1163-1166
Main Authors: Ruigrok, Dieuwertje, Meijboom, Lilian J, Westerhof, Berend E, In 't Veld, Anna Huis, van der Bruggen, Cathelijne E E, Marcus, J Tim, Nossent, Esther J, Vonk Noordegraaf, Anton, Symersky, Petr, Bogaard, Harm-Jan
Format: Article
Language:English
Subjects:
Aged
Chronic Disease
Computed Tomography Angiography
Female
Humans
Hypertension, Pulmonary - diagnostic imaging
Hypertension, Pulmonary - etiology
Hypertension, Pulmonary - physiopathology
Magnetic Resonance Imaging
Male
Middle Aged
Pulmonary Artery - diagnostic imaging
Pulmonary Artery - physiopathology
Pulmonary Embolism - complications
Pulmonary Embolism - diagnostic imaging
Pulmonary Embolism - physiopathology
Retrospective Studies
Ventricular Dysfunction, Right - diagnostic imaging
Ventricular Dysfunction, Right - physiopathology
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Summary:According to computed tomography-pulmonary angiography, CTEPH was classified as either proximal (level I/II disease: lesions starting in the main or lobar arteries) or distal (level III-IV disease: lesions starting in the segmental and subsegmental) (3) for each side separately. [...]Zc may be a relevant additional component of afterload that was not accounted for in the current or any prior studies on load in CTEPH, which all focus on PVR and compliance. [...]RV function in CTEPH may be critically dependent on proximal vascular properties and wave propagations, which are not reflected in the three-component windkessel. [...]although patients with proximal and distal CTEPH present with similar resistance and compliance, we observed important differences in cardiac function.
ISSN:1073-449X
1535-4970
DOI:10.1164/rccm.201808-1562le