Document Detail


Improved Survival in Medically Treated Chronic Thromboembolic Pulmonary Hypertension.
MedLine Citation:
PMID:  23615047     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: The surgical indication for chronic thromboembolic pulmonary hypertension (CTEPH) has been modified due to recognition of peripheral type CTEPH and changes in surgical methods and skill. Bosentan and sildenafil are used as modern oral therapy (mod Tx) in patients with inoperable CTEPH, although it remains unknown whether they have positive effects on survival. Methods and Results: A total of 202 patients were diagnosed with CTEPH at Chiba University Hospital between 1986 and 2010, 100 of whom underwent pulmonary endarterectomy. Seven medically treated patients with pulmonary vascular resistance (PVR) ≤300dyn·s·cm(-5) were regarded as having mild disease. Survival rate was stratified by date of diagnosis (group 1, 1986-1998; group 2, 1999-2004; group 3, 2005-2010), and prognostic factors in the remaining 95 medically treated patients were investigated. Group 3 included the most patients treated with mod Tx (group 1, 9.1%; group 2, 24.2%; group 3, 65.0%) and had significantly better survival than either group 1 or 2 (5-year survival: group 1, 54.6%; group 2, 69.7%; group 3, 87.3%). Patients receiving mod Tx had significantly better survival than those not on mod Tx (5-year survival: 88.9% vs. 60.2%). Multivariate analysis showed that mod Tx, lower PVR, and lack of comorbidity were significant predictors of better outcome. Conclusions: Medically treated patients with CTEPH had a better survival rate, and the use of mod Tx contributed to improved survival.
Authors:
Rintaro Nishimura; Nobuhiro Tanabe; Toshihiko Sugiura; Ayako Shigeta; Takayuki Jujo; Ayumi Sekine; Seiichiro Sakao; Yasunori Kasahara; Koichiro Tatsumi
Related Documents :
23096357 - Angiogenic potential of the cerebrospinal fluid (csf) of patients with high-grade gliom...
17585447 - Unusual recurrence after chemoirradiation and surgery for squamous cell carcinoma of th...
20606537 - Clinicopathologic characteristics of 12 patients with vulvar sweat gland carcinoma.
24490037 - Protons offer reduced bone marrow, small bowel, and urinary bladder exposure for patien...
23248257 - Phase ii study of the mek1/mek2 inhibitor trametinib in patients with metastatic braf-m...
25245037 - Effectiveness and toxicity of high-dose cyclophosphamide in obese versus non-obese pati...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-4-25
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  -     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-4-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Respirology, Graduate School of Medicine, Chiba University.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Predictive and prognostic role of BRAF mutation in metastatic colorectal cancer patients treated wit...
Next Document:  Predictive Score for Survival After Percutaneous Cardiopulmonary Support in Cardiovascular Disease P...