Document Detail


Risk factors and basic mechanisms of CTEPH - a current understanding.
MedLine Citation:
PMID:  22700839     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
All available evidence today indicates that chronic thromboembolic pulmonary hypertension (CTEPH) is primarily caused by venous thromboembolism (VTE), as opposed to primary pulmonary vascular in situ thrombosis. Both the initial magnitude of clot and PE recurrences may contribute to the development of CTEPH. Only few specific thrombophilic factors such as phospholipid antibodies, lupus anticoagulant, and elevated factor VIII are statistically associated with CTEPH.A mechanistic view of CTEPH as a disease caused by obliteration of central pulmonary arteries by pulmonary emboli is too simplistic. Based on available data one may speculate that pulmonary embolism may be followed by a pulmonary vascular remodeling process modified by infection, immune phenomena, inflammation, circulating and vascular-resident progenitor cells thyroid hormone replacement or malignancy. Both plasmatic factors (hypercoagulation, "sticky" red blood cells, high platelet counts, uncleavable fibrinogens) and a misguided vascular remodelling process contribute to major vessel and small vessel obliteration. Endothelial dysfunction and endothelial-mesenchymal transition may be important, but their precise roles remain obscure. There exists no animal model for CTEPH, therefore, experimentation in the future must include human tissues and clinical data in parallel.
Authors:
Irene M Lang; Raffaele Pesavento; Diana Bonderman; Jason X-J Yuan
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-14
Journal Detail:
Title:  The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology     Volume:  -     ISSN:  1399-3003     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Cardiology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria.
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