Pulmonale Hypertonie bei chronischen Lungenerkrankungen

Hoeper, Marius M.; Andreas, Stefan; Bastian, Andreas; Claussen, Michael; Ghofrani, Hossein Ardeschir; Gorenflo, M.; Grohé, Christian; Günther, Andreas; Halank, Michael; Hammerl, Peter; Held, M; Krüger, Stefan; Lange, Tobias; Reichenberger, Frank; Sablotzki, Armin; Staehler, G.; Stark, W; Wirtz, Hubert; Witt, Christian; Behr, J.

doi:10.1055/s-0030-1255970

Cited by 6 publications

(2 citation statements)

References 17 publications

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“…However, our understanding of the pathophysiology of CTEPH is limited and an obstacle in the development of new treatment strategies. 4 The pathogenesis of CTEPH is still under debate. According to the local thrombosis hypothesis, CTEPH originates from primary distal pulmonary arteropathy accompanied by secondary in situ thrombosis.…”

Section: Hronic Thromboembolic Pulmonary Hypertension (Cteph)mentioning

confidence: 99%

Development and Characterization of an Inducible Rat Model of Chronic Thromboembolic Pulmonary Hypertension

Arias-Loza¹,

Jung²,

Abeßer³

et al. 2016

Hypertension

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C hronic thromboembolic pulmonary hypertension (CTEPH)is an important but yet under-researched entity of PH. CTEPH is characterized by nonresolving thrombi that obstruct pulmonary arteries and promote progressive pulmonary vascular remodeling. The chronic increase in pulmonary vascular resistance translates into elevated pulmonary artery pressure and results in right ventricular (RV) hypertrophy, which ultimately causes RV dilatation and failure.2 The treatment of choice is pulmonary endarterectomy that consist in the surgical removal of organized thrombi to an extent that improves pulmonary hemodynamics. However, a relevant number of patients present persistent small-vessel vasculopathy post pulmonary endarterectomy , 3 and many affected individuals are poor candidates for pulmonary endarterectomy because of a predominantly distal surgically inaccessible embolism pattern, high age, or severe comorbidities. Therefore to improve quality of life and eventually survival, numerous CTEPH patients require additional or alternative nonsurgical treatment. However, our understanding of the pathophysiology of CTEPH is limited and an obstacle in the development of new treatment strategies. 4 The pathogenesis of CTEPH is still under debate. According to the local thrombosis hypothesis, CTEPH originates from primary distal pulmonary arteropathy accompanied by secondary in situ thrombosis. However, this hypothesis does not provide a mechanism to explain proximal pulmonary artery thrombosis.5 Thus, the majority of experts in the field favor the embolism hypothesis that attributes CTEPH pathogenesis to a single or recurrent pulmonary embolisms (PE). The latter hypothesis is supported by a history of PE in ≤75% of all CTEPH patients and by the beneficial effects of timely performed pulmonary endarterectomy. 2,6 Finally, several risk factors for CTEPH including specific procoagulation factors such as phospholipid antibodies, protein S and protein C, factor V mutations, malignancy, inflammatory bowel disease, and previous deep vein thrombosis are also risk factors for recurrent PE.6,7 It is not yet understood how PE progresses to CTEPH, and the mechanisms behind thrombi escape to thrombolysis and subsequent fibrotic transformation are still unknown. Consequently, there is a need for simple and reproducible CTEPH animal models that not only permit the analysis of molecular signals involved in the pathology of this disease but also enable the evaluation of new therapeutic strategies to improve the fate of individuals diagnosed with CTEPH.Abstract-Chronic thromboembolic pulmonary hypertension (CTEPH) is an entity of PH that not only limits patients quality of life but also causes significant morbidity and mortality. The treatment of choice is pulmonary endarterectomy. However numerous patients do not qualify for pulmonary endarterectomy or present with residual vasculopathy post pulmonary endarterectomy and require specific vasodilator treatment. Currently, there is no available specific small animal model of CTEPH that could serve a...

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Section: Hronic Thromboembolic Pulmonary Hypertension (Cteph)mentioning

confidence: 99%

Development and Characterization of an Inducible Rat Model of Chronic Thromboembolic Pulmonary Hypertension

Arias-Loza¹,

Jung²,

Abeßer³

et al. 2016

Hypertension

View full text Add to dashboard Cite

show abstract

“…Einige Studien[ 1 , 7 ] deuten darauf hin, dass sie auch im Vergleich mit anderen chronisch erkrankten Patienten stärker beeinträchtigt zu sein scheinen. Dies macht PH-Patienten zu einer wichtigen unterstützungsbedürftigen Zielgruppe, nicht nur aufgrund der hohen Behandlungsbereitschaft, sondern vor allem auch, weil depressive Symptome eine Lebensqualitätsminderung bedeuten, die möglicherweise mit verminderter Adherence und negativem Krankheitsverlauf in Zusammenhang stehen könnte[ 29 ] . Um die Schwelle für die Inanspruchnahme eines psychosomatischen Gesprächsangebotes zu senken, sollten entsprechende Angebote in den Räumen der Ambulanzen für PH vorgehalten werden.…”

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