Source: Annual Congress 2006 - Pulmonary hypertension: thromo-embolic processes
Disease area: Pulmonary vascular diseases

Abstract

Background: Patients with CTEPH and AMC, such as splenectomy, ventriculo-atrial shunt for the treatment of hydrocephalus and chronic inflammation, appear to carry an unfavorable clinical course compared with CTEPH patients without AMC. We hypothesized that this phenomenon is due to secondary pulmonary vascular disease in AMC patients.
Methods: We compared the degree of major vessel obstruction (no thrombus: 0, minor thrombus: 1, stenosis <70%: 2, stenosis >70%: 3, occlusion: 4) in central, lobar and segmental pulmonary arteries scored on the basis of digital subtraction pulmonary angiography and invasively measured PVR in CTEPH patients with (n=17) and without (n=71) AMC.
Results: While there was no difference in the degree of major vessel obstruction in AMC-(52±16) versus non-AMC-patients (58±15, p=0.25), there was a significant difference in PVR (1022±552dynes.s.cm-5 versus 725±332dynes.s.cm-5, p=0.04).
Conclusions: The adverse outcome reported in CTEPH patients with AMC may be attributed to secondary pulmonary vascular disease.

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D. Bonderman, A. Martischnig, R. Hitsch, N. Skoro-Sajer, C. Adlbrecht, W. Klepetko, G. Maurer, M. Kneussl, T. Rand, I. M. Lang (Vienna, Austria). Mismatch of major vessel obstruction and pulmonary vascular resistance (PVR) in chronic thromboembolic pulmonary hypertension (CTEPH) with associated medical conditions (AMC). Eur Respir J 2006; 28: Suppl. 50, 2369

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