Хроническая тромбоэмболическая легочная гипертензия: от патогенеза к выбору тактики лечения

Валиева З.С., Мартынюк Т.В. Хроническая тромбоэмболическая легочная гипертензия: от патогенеза к выбору тактики лечения. Терапевтический архив. 2022;94(7):791–796.
DOI: 10.26442/00403660.2022.07.201741

________________________________________________

Valieva ZS, Martynyuk TV. Chronic thromboembolic pulmonary hypertension: from pathogenesis to the choice of treatment tactics. Terapevticheskii Arkhiv (Ter. Arkh.). 2022;94(7):791–796.
DOI: 10.26442/00403660.2022.07.201741

Читать PDF

Аннотация

Представлены данные о патогенезе хронической тромбоэмболической легочной гипертензии (ХТЭЛГ), которые служат обоснованием подходов к выбору терапии. ХТЭЛГ обычно начинается со стойкой обструкции крупных и/или средних легочных артерий организованными тромбами. Нарушение лизиса тромбов может быть связано с аномальным фибринолизом, гематологическими или аутоиммунными заболеваниями. Молекулярные процессы, лежащие в основе поражения мелких сосудов, до конца не изучены. Степень поражения мелких сосудов оказывает существенное влияние на тяжесть ХТЭЛГ и послеоперационные исходы. Лечение ХТЭЛГ эволюционировало с развитием трех направлений – легочной эндартерэктомии, баллонной ангиопластики легочных артерий и специфической терапии, применяемой при легочной артериальной гипертензии. В статье продемонстрированы возможности мультимодального подхода в лечении этой категории пациентов.

Ключевые слова: хроническая тромбоэмболическая легочная гипертензия, патогенез, специфическая терапия, легочная эндартерэктомия, баллонная ангиопластика легочных артерий, мультимодальный подход

________________________________________________

Presents data on the pathogenesis of chronic thromboembolic pulmonary hypertension (CTEPH), which serve as a rationale for approaches to the choice of treatment. CTEPH usually begins with persistent obstruction of the large and/or medium pulmonary arteries by organized thrombi. Impaired lysis of thrombi may be associated with abnormal fibrinolysis, hematological or autoimmune diseases. The molecular processes underlying the lesions of small vessels are not fully understand. The degree of small-vessel disease has a significant impact on the severity of CTEPH and postoperative outcomes. The CTEPH treatment has evolved with the development of three directions – pulmonary endarterectomy, balloon angioplasty of pulmonary arteries and the use of specific therapy used for pulmonary arterial hypertension. The paper demonstrates the possibilities of a multimodal approach in the treatment of this category of patients.

Keywords: chronic thromboembolic pulmonary hypertension, pathogenesis, specific therapy, pulmonary endarterectomy, balloon angioplasty of the pulmonary arteries, multimodal approach

Полный текст

Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.

Список литературы

1. Galie N, Humbert M, Vachiery JL, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). Eur Respir J. 2015;46(4):903-75. DOI:10.1183/13993003.01032-2015
2. Lang M, Pesavento R, Bonderman D. Risk factors and basic mechanisms of chronic thromboembolic pulmonary hypertension: a current understanding. Eur Respir J. 2013;41:462-8. DOI:10.1183/09031936.00049312
3. Azarian R, Wartski M, Colligon MA, et al. Lung perfusion scans and hemodynamics in acute and chronic pulmonary embolism. J Nucl Med. 1997;38:980-3.
4. Чазова И.Е., Мартынюк Т.В., Валиева З.С., и др. Евразийские рекомендации по диагностике и лечению хронической тромбоэмболической легочной гипертензии (2020). Евразийский кардиологический журнал. 2021;1:6-43 [Chazova IE, Martynyuk V, Valieva ZS, et al. Eurasian Guidelines for the diagnosis and treatment of chronic thromboembolic pulmonary hypertension (2020). Eurasian Heart Journal. 2021;1:6-43 (in Russian)]. DOI:10.38109/2225-1685-2021-1-6-43
5. Bonderman D, Jakowitsch J, Redwan B, et al. Role for staphylococci in misguided thrombus resolution of chronic thromboembolic pulmonary hypertension. Arterioscler Thromb Vasc Biol. 2008;28:678-84. DOI:10.1161/ATVBAHA.107.156000
6. Frey MK, Alias S, Winter MP, et al. Splenectomy is modifying the vascular remodeling of thrombosis. J Am Heart Assoc. 2014;3:e000772. DOI:10.1161/JAHA.113.000772
7. Chibana H, Tahara N, Itaya N, et al. Pulmonary artery dysfunction in chronic thromboembolic pulmonary hypertension. Int J Cardiol Heart Vasc. 2017;17:30-2. DOI:10.1016/j.ijcha.2017.09.001
8. Humbert M, Guignabert C, Bonnet S, et al. Pathology and pathobiology of pulmonary hypertension: state of the art and research perspectives. Eur Respir J. 2019;53:1801887. DOI:10.1183/13993003.01887-2018
9. Loscalzo J. Nitric oxide insufficiency, platelet activation, and arterial thrombosis. Circ Res. 2001;88:756-62. DOI:10.1161/hh0801.089861
10. Garg UC, Hassid A. Nitric oxide-generating vasodilators and 8-bromo-cyclic guanosine monophosphate inhibit mitogenesis and proliferation of cultured rat vascular smooth muscle cells. J Clin Invest. 1989;83:1774-7. DOI:10.1172/JCI114081
11. Kariya K, Kawahara Y, Araki S, et al. Antiproliferative action of cyclic GMP-elevating vasodilators in cultured rabbit aortic smooth muscle cells. Atherosclerosis. 1989;80:143-7. DOI:10.1016/0021-9150(89)90022-1
12. Kothapalli D, Stewart SA, Smyth EM, et al. Prostacylin receptor activation inhibits proliferation of aortic smooth muscle cells by regulating cAMP response element binding protein- and pocket protein-dependent cyclin a gene expression. Mol Pharmacol. 2003;64:249-58. DOI:10.1124/mol.64.2.249
13. Chaumais MC, Guignabert C, Savale L, et al. Clinical pharmacology of endothelin receptor antagonists used in the treatment of pulmonary arterial hypertension. Am J Cardiovasc Drugs. 2015;15:13-26. DOI:10.1007/s40256-014-0095-y
14. Reesink HJ, Meijer RC, Lutter R, et al. Hemodynamic and clinical correlates of endothelin-1 in chronic thromboembolic pulmonary hypertension. Circ J. 2006;70:1058-63. DOI:10.1253/circj.70.1058
15. Bauer M, Wilkens H, Langer F, et al. Selective upregulation of endothelin B receptor gene expression in severe pulmonary hypertension. Circulation. 2002;105:1034-6. DOI:10.1161/hc0902.105719
16. Thistlethwaite PA, Mo M, Madani MM, et al. Operative classification of thromboembolic disease determines outcome after pulmonary endarterectomy. J Thorac Cardiovasc Surg. 2002;124:1203-11. DOI:10.1067/mtc.2002.127313
17. Moser KM, Auger WR, Fedullo PF, et al. Chronic thromboembolic pulmonary hypertension: clinical picture and surgical treatment. Eur Respir J. 1992;5:334-42. PMID: 1572447.
18. Jenkins D. Pulmonary endarterectomy: the potentially curative treatment for patients with chronic thromboembolic pulmonary hypertension. Eur Respir Rev. 2015;24:263-71. DOI:10.1183/16000617.00000815
19. Delcroix M, Lang I, Pepke-Zaba J, et al. Long-term outcome of patients with chronic thromboembolic pulmonary hypertension: results from an international prospective registry. Circulation. 2016;133:859-71. DOI:10.1161/CIRCULATIONAHA.115.016522
20. Чазова И.Е., Валиева З.С., Наконечников С.Н., и др. Особенности клинико-функционального и гемодинамического профиля, лекарственной терапии и оценка прогноза у пациентов с неоперабельной хронической тромбоэмболической и идиопатической легочной гипертензией по данным Российского регистра. Терапевтический архив. 2019;88(10):77-87 [Chazova IE, Valieva ZS, Nakonechnikov SN. Features of clinical, functional and hemodynamics profile, medical treatment and prognosis evaluation in patients with inoperable chronic thromboembolic pulmonary hypertension and idiopathic pulmonary arterial hypertension according to the Russian registry. Terapevticheskii Arkhiv (Ter. Arkh.). 2019;88(10):77-87 (in Russian)]. DOI:10.26442/00403660.2019.09.000343
21. Fukuda K, Date H, Doi S, et al. Guidelines for the Treatment of Pulmonary Hypertension (JCS 2017/JPCPHS 2017). Circ J. 2019;83(4):842-5. DOI:10.1253/circj.CJ-66-0158
22. Wilkens H, Lang I, Behr J, et al. Chronic thromboembolic pulmonary hypertension: Recommendations from the Cologne Consensus Conference 2010. Dtsch Med Wochenschr. 2010;135(3):125-30. DOI:10.1016/S0167-5273(11)70493-4
23. Легочная гипертензия, в том числе хроническая тромбоэмболическая легочная гипертензия. Российские клинические рекомендации, 2020. Режим доступа: http://cr.rosminzdrav.ru/#!/recomend/137. Ссылка активна на 11.04.2022 [Pulmonary hypertension, including chronic thromboembolic pulmonary hypertension. Russian clinical guidelines, 2020. Available at: http://cr.rosminzdrav.ru/#!/recomend/137. Accessed: 04.11.2022 (in Russian)].
24. Farber HW, Humbert M, Hoeper MM, et al. Riociguat in Chronic Thromboembolic Pulmonary Hypertension (CTEPH): evaluation of abbreviated versions of the ESC/ERS risk assessment tool in CHEST-2. Am J Respir Crit Care Med. 2018;197:A3787.
25. Simonneau G, D’Armini AM, Ghofrani HA, et al. Predictors of long-term outcomes in patients treated with riociguat for chronic thromboembolic pulmonary hypertension: data from the CHEST-2 open-label, randomised, long-term extension trial. Lancet Respir Med. 2016;4(5):372-80. DOI:10.1016/S2213-2600(16)30022-4
26. Suntharalingam J, Treacy CM, Doughty NJ, et al. Long-term use of sildenafil in inoperable chronic thromboembolic pulmonary hypertension. Chest. 2008;134:229-36. DOI:10.1378/chest.07-2681
27. Jais X, D'Armini AM, Jansa P, et al. Bosentan for treatment of inoperable chronic thromboembolic pulmonary hypertension: BENEFiT (Bosentan Effects in iNopErable Forms of chronIc Thromboembolic pulmonary hypertension), a randomized, placebo-controlled trial. J Am Coll Cardiol. 2008;52:2127-34. DOI:10.1016/j.jacc.2008.08.059
28. Ghofrani HA, Simonneau G, D'Armini AM, et al. Macitentan for the treatment of inoperable chronic thromboembolic pulmonary hypertension (MERIT-1): results from the multicentre, phase 2, randomised, double blind, placebo-controlled study. Lancet Respir Med. 2017;5:785-94. DOI:10.1016/S2213-2600(17)30305-3
29. Olschewski H, Simonneau G, Galiè N, et al. Inhaled iloprost for severe pulmonary hypertension. N Engl J Med. 2002;347:322-9. DOI:10.1056/NEJMoa020204
30. Sadushi-Kolici R, Jansa P, Kopec G, et al. Subcutaneous treprostinil for the treatment of severe non-operable chronic thromboembolic pulmonary hypertension (CTREPH): a double-blind, phase 3, randomised controlled trial. Lancet Respir Med. 2019;7:239-48. DOI:10.1016/S2213-2600(18)30367-9
31. Ghofrani HA, D'Armini AM, Grimminger F, et al. Riociguat for the treatment of chronic thromboembolic pulmonary hypertension. N Engl J Med. 2013;369:319-29. DOI:10.1056/NEJMoa1209657
32. Simonneau G, D'Armini AM, Ghofrani HA, et al. Riociguat for the treatment of chronic thromboembolic pulmonary hypertension: a long-term extension study (CHEST-2). Eur Respir J. 2015;45(5):1293-302. DOI:10.1183/09031936.00087114
33. Ghofrani HA, Gomez Sanchez MA, Humbert M, et al. Riociguat treatment in patients with chronic thromboembolic pulmonary hypertension: Final safety data from the EXPERT registry. Respir Med. 2020;178:106220. DOI:10.1016/j.rmed.2020.106220
34. Halank M, Hoeper MM, Ghofrani HA, et al. Riociguat for pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: results from a phase II long-term extension study. Respir Med. 2017;12:850-56.
35. Fukui S, Ogo T, Morita Y, et al. Right ventricular reverse remodelling after balloon pulmonary angioplasty. Eur Respir J. 2014;43:1394-402. DOI:10.1183/09031936.00012914
36. Lang I, Meyer BC, Ogo T, et al. Balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension. Eur Respir Rev. 2017;26:160119.
DOI:10.1183/16000617.0119-2016
37. Delcroix M, Torbicki A, Gopalan D, et al. ERS Statement on Chronic Thromboembolic Pulmonary Hypertension. Eur Respir J. 2021;57(6):2002828.
DOI:10.1183/13993003.02828- 2020
38. Ghofrani HA, D’Armini AM, Kim NH, et al. Interventional and pharmacological management of chronic thromboembolic pulmonary hypertension. Respir Med. 2021;177:106293. DOI:10.1016/j.rmed.2020.106293
39. Mayer E, Jenkins D, Lindner J, et al. Surgical management and outcome of patients with chronic thromboembolic pulmonary hypertension: results from an international prospective registry. J Thorac Cardiovasc Surg. 2011;141:702-10. DOI:10.1016/j.jtcvs.2010.11.024
40. Bresser P, Fedullo PF, Auger WR, et al. Continuous intravenous epoprostenol for chronic thromboembolic pulmonary hypertension. Eur Respir J. 2004;23:595-600. DOI:10.1183/09031936.04.00020004
41. Jais X, Brenot P, Bouvaist H, et al. BPA and Riociguat for the Management of Inoperable CTEPH: Results of the Extension Study Following the RACE Randomized Controlled Trial (RCT). Am J Respir Crit Care Med. 2021;203:A1182. DOI:10.1164/ajrccmconference.2021.203.1_MeetingAbstracts.A1182
42. Jensen KW, Kerr KM, Fedullo PF, et al. Pulmonary hypertensive medical therapy in chronic thromboembolic pulmonary hypertension before pulmonary thromboendarterectomy. Circulation. 2009;120(13):1248-54. DOI:10.1161/CIRCULATIONAHA.109.865881
43. Nagaya N, Sasaki N, Ando M, et al. Prostacyclin therapy before pulmonary thromboendarterectomy in patients with chronic thromboembolic pulmonary hypertension. Chest. 2003;123(2):338-43. DOI:10.1378/chest.123.2.338

________________________________________________

1. Galie N, Humbert M, Vachiery JL, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). Eur Respir J. 2015;46(4):903-75. DOI:10.1183/13993003.01032-2015
2. Lang M, Pesavento R, Bonderman D. Risk factors and basic mechanisms of chronic thromboembolic pulmonary hypertension: a current understanding. Eur Respir J. 2013;41:462-8. DOI:10.1183/09031936.00049312
3. Azarian R, Wartski M, Colligon MA, et al. Lung perfusion scans and hemodynamics in acute and chronic pulmonary embolism. J Nucl Med. 1997;38:980-3.
4. Чазова И.Е., Мартынюк Т.В., Валиева З.С., и др. Евразийские рекомендации по диагностике и лечению хронической тромбоэмболической легочной гипертензии (2020). Евразийский кардиологический журнал. 2021;1:6-43 [Chazova IE, Martynyuk V, Valieva ZS, et al. Eurasian Guidelines for the diagnosis and treatment of chronic thromboembolic pulmonary hypertension (2020). Eurasian Heart Journal. 2021;1:6-43 (in Russian)]. DOI:10.38109/2225-1685-2021-1-6-43
5. Bonderman D, Jakowitsch J, Redwan B, et al. Role for staphylococci in misguided thrombus resolution of chronic thromboembolic pulmonary hypertension. Arterioscler Thromb Vasc Biol. 2008;28:678-84. DOI:10.1161/ATVBAHA.107.156000
6. Frey MK, Alias S, Winter MP, et al. Splenectomy is modifying the vascular remodeling of thrombosis. J Am Heart Assoc. 2014;3:e000772. DOI:10.1161/JAHA.113.000772
7. Chibana H, Tahara N, Itaya N, et al. Pulmonary artery dysfunction in chronic thromboembolic pulmonary hypertension. Int J Cardiol Heart Vasc. 2017;17:30-2. DOI:10.1016/j.ijcha.2017.09.001
8. Humbert M, Guignabert C, Bonnet S, et al. Pathology and pathobiology of pulmonary hypertension: state of the art and research perspectives. Eur Respir J. 2019;53:1801887. DOI:10.1183/13993003.01887-2018
9. Loscalzo J. Nitric oxide insufficiency, platelet activation, and arterial thrombosis. Circ Res. 2001;88:756-62. DOI:10.1161/hh0801.089861
10. Garg UC, Hassid A. Nitric oxide-generating vasodilators and 8-bromo-cyclic guanosine monophosphate inhibit mitogenesis and proliferation of cultured rat vascular smooth muscle cells. J Clin Invest. 1989;83:1774-7. DOI:10.1172/JCI114081
11. Kariya K, Kawahara Y, Araki S, et al. Antiproliferative action of cyclic GMP-elevating vasodilators in cultured rabbit aortic smooth muscle cells. Atherosclerosis. 1989;80:143-7. DOI:10.1016/0021-9150(89)90022-1
12. Kothapalli D, Stewart SA, Smyth EM, et al. Prostacylin receptor activation inhibits proliferation of aortic smooth muscle cells by regulating cAMP response element binding protein- and pocket protein-dependent cyclin a gene expression. Mol Pharmacol. 2003;64:249-58. DOI:10.1124/mol.64.2.249
13. Chaumais MC, Guignabert C, Savale L, et al. Clinical pharmacology of endothelin receptor antagonists used in the treatment of pulmonary arterial hypertension. Am J Cardiovasc Drugs. 2015;15:13-26. DOI:10.1007/s40256-014-0095-y
14. Reesink HJ, Meijer RC, Lutter R, et al. Hemodynamic and clinical correlates of endothelin-1 in chronic thromboembolic pulmonary hypertension. Circ J. 2006;70:1058-63. DOI:10.1253/circj.70.1058
15. Bauer M, Wilkens H, Langer F, et al. Selective upregulation of endothelin B receptor gene expression in severe pulmonary hypertension. Circulation. 2002;105:1034-6. DOI:10.1161/hc0902.105719
16. Thistlethwaite PA, Mo M, Madani MM, et al. Operative classification of thromboembolic disease determines outcome after pulmonary endarterectomy. J Thorac Cardiovasc Surg. 2002;124:1203-11. DOI:10.1067/mtc.2002.127313
17. Moser KM, Auger WR, Fedullo PF, et al. Chronic thromboembolic pulmonary hypertension: clinical picture and surgical treatment. Eur Respir J. 1992;5:334-42. PMID: 1572447.
18. Jenkins D. Pulmonary endarterectomy: the potentially curative treatment for patients with chronic thromboembolic pulmonary hypertension. Eur Respir Rev. 2015;24:263-71. DOI:10.1183/16000617.00000815
19. Delcroix M, Lang I, Pepke-Zaba J, et al. Long-term outcome of patients with chronic thromboembolic pulmonary hypertension: results from an international prospective registry. Circulation. 2016;133:859-71. DOI:10.1161/CIRCULATIONAHA.115.016522
20. Chazova IE, Valieva ZS, Nakonechnikov SN. Features of clinical, functional and hemodynamics profile, medical treatment and prognosis evaluation in patients with inoperable chronic thromboembolic pulmonary hypertension and idiopathic pulmonary arterial hypertension according to the Russian registry. Terapevticheskii Arkhiv (Ter. Arkh.). 2019;88(10):77-87 (in Russian). DOI:10.26442/00403660.2019.09.000343
21. Fukuda K, Date H, Doi S, et al. Guidelines for the Treatment of Pulmonary Hypertension (JCS 2017/JPCPHS 2017). Circ J. 2019;83(4):842-5. DOI:10.1253/circj.CJ-66-0158
22. Wilkens H, Lang I, Behr J, et al. Chronic thromboembolic pulmonary hypertension: Recommendations from the Cologne Consensus Conference 2010. Dtsch Med Wochenschr. 2010;135(3):125-30. DOI:10.1016/S0167-5273(11)70493-4
23. Pulmonary hypertension, including chronic thromboembolic pulmonary hypertension. Russian clinical guidelines, 2020. Available at: http://cr.rosminzdrav.ru/#!/recomend/137. Accessed: 04.11.2022 (in Russian).
24. Farber HW, Humbert M, Hoeper MM, et al. Riociguat in Chronic Thromboembolic Pulmonary Hypertension (CTEPH): evaluation of abbreviated versions of the ESC/ERS risk assessment tool in CHEST-2. Am J Respir Crit Care Med. 2018;197:A3787.
25. Simonneau G, D’Armini AM, Ghofrani HA, et al. Predictors of long-term outcomes in patients treated with riociguat for chronic thromboembolic pulmonary hypertension: data from the CHEST-2 open-label, randomised, long-term extension trial. Lancet Respir Med. 2016;4(5):372-80. DOI:10.1016/S2213-2600(16)30022-4
26. Suntharalingam J, Treacy CM, Doughty NJ, et al. Long-term use of sildenafil in inoperable chronic thromboembolic pulmonary hypertension. Chest. 2008;134:229-36. DOI:10.1378/chest.07-2681
27. Jais X, D'Armini AM, Jansa P, et al. Bosentan for treatment of inoperable chronic thromboembolic pulmonary hypertension: BENEFiT (Bosentan Effects in iNopErable Forms of chronIc Thromboembolic pulmonary hypertension), a randomized, placebo-controlled trial. J Am Coll Cardiol. 2008;52:2127-34. DOI:10.1016/j.jacc.2008.08.059
28. Ghofrani HA, Simonneau G, D'Armini AM, et al. Macitentan for the treatment of inoperable chronic thromboembolic pulmonary hypertension (MERIT-1): results from the multicentre, phase 2, randomised, double blind, placebo-controlled study. Lancet Respir Med. 2017;5:785-94. DOI:10.1016/S2213-2600(17)30305-3
29. Olschewski H, Simonneau G, Galiè N, et al. Inhaled iloprost for severe pulmonary hypertension. N Engl J Med. 2002;347:322-9. DOI:10.1056/NEJMoa020204
30. Sadushi-Kolici R, Jansa P, Kopec G, et al. Subcutaneous treprostinil for the treatment of severe non-operable chronic thromboembolic pulmonary hypertension (CTREPH): a double-blind, phase 3, randomised controlled trial. Lancet Respir Med. 2019;7:239-48. DOI:10.1016/S2213-2600(18)30367-9
31. Ghofrani HA, D'Armini AM, Grimminger F, et al. Riociguat for the treatment of chronic thromboembolic pulmonary hypertension. N Engl J Med. 2013;369:319-29. DOI:10.1056/NEJMoa1209657
32. Simonneau G, D'Armini AM, Ghofrani HA, et al. Riociguat for the treatment of chronic thromboembolic pulmonary hypertension: a long-term extension study (CHEST-2). Eur Respir J. 2015;45(5):1293-302. DOI:10.1183/09031936.00087114
33. Ghofrani HA, Gomez Sanchez MA, Humbert M, et al. Riociguat treatment in patients with chronic thromboembolic pulmonary hypertension: Final safety data from the EXPERT registry. Respir Med. 2020;178:106220. DOI:10.1016/j.rmed.2020.106220
34. Halank M, Hoeper MM, Ghofrani HA, et al. Riociguat for pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: results from a phase II long-term extension study. Respir Med. 2017;12:850-56.
35. Fukui S, Ogo T, Morita Y, et al. Right ventricular reverse remodelling after balloon pulmonary angioplasty. Eur Respir J. 2014;43:1394-402. DOI:10.1183/09031936.00012914
36. Lang I, Meyer BC, Ogo T, et al. Balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension. Eur Respir Rev. 2017;26:160119.
DOI:10.1183/16000617.0119-2016
37. Delcroix M, Torbicki A, Gopalan D, et al. ERS Statement on Chronic Thromboembolic Pulmonary Hypertension. Eur Respir J. 2021;57(6):2002828.
DOI:10.1183/13993003.02828- 2020
38. Ghofrani HA, D’Armini AM, Kim NH, et al. Interventional and pharmacological management of chronic thromboembolic pulmonary hypertension. Respir Med. 2021;177:106293. DOI:10.1016/j.rmed.2020.106293
39. Mayer E, Jenkins D, Lindner J, et al. Surgical management and outcome of patients with chronic thromboembolic pulmonary hypertension: results from an international prospective registry. J Thorac Cardiovasc Surg. 2011;141:702-10. DOI:10.1016/j.jtcvs.2010.11.024
40. Bresser P, Fedullo PF, Auger WR, et al. Continuous intravenous epoprostenol for chronic thromboembolic pulmonary hypertension. Eur Respir J. 2004;23:595-600. DOI:10.1183/09031936.04.00020004
41. Jais X, Brenot P, Bouvaist H, et al. BPA and Riociguat for the Management of Inoperable CTEPH: Results of the Extension Study Following the RACE Randomized Controlled Trial (RCT). Am J Respir Crit Care Med. 2021;203:A1182. DOI:10.1164/ajrccmconference.2021.203.1_MeetingAbstracts.A1182
42. Jensen KW, Kerr KM, Fedullo PF, et al. Pulmonary hypertensive medical therapy in chronic thromboembolic pulmonary hypertension before pulmonary thromboendarterectomy. Circulation. 2009;120(13):1248-54. DOI:10.1161/CIRCULATIONAHA.109.865881
43. Nagaya N, Sasaki N, Ando M, et al. Prostacyclin therapy before pulmonary thromboendarterectomy in patients with chronic thromboembolic pulmonary hypertension. Chest. 2003;123(2):338-43. DOI:10.1378/chest.123.2.338

Авторы

З.С. Валиева*1, Т.В. Мартынюк1,2

1 ФГБУ «Национальный медицинский исследовательский центр кардиологии им. акад. Е.И. Чазова» Минздрава России, Москва, Россия;
2 ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава России, Москва, Россия
*v.zarina.v@gmail.com

________________________________________________

Zarina S. Valieva*1, Tamila V. Martynyuk1,2

1 Chazov National Medical Research Center of Cardiology, Moscow, Russia;
2 Pirogov Russian National Research Medical University, Moscow, Russia
*v.zarina.v@gmail.com

Назад к списку

Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.