Skip to main content
Erschienen in: Heart Failure Reviews 6/2019

14.05.2019 | Fibrinolytic Therapy

Research progress on the pathogenesis of CTEPH

verfasst von: Lu Yan, Xin Li, Zhihong Liu, Zhihui Zhao, Qin Luo, Qin Zhao, Qi Jin, Xue Yu, Yi Zhang

Erschienen in: Heart Failure Reviews | Ausgabe 6/2019

Einloggen, um Zugang zu erhalten

Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) is an established long-term complication of pulmonary thromboembolism (PTE). However, studies have shown that many patients with a definitive CTEPH diagnosis have no history of symptomatic PTE, suggesting that PTE is not the only cause of CTEPH. Despite extensive progress in research on pulmonary hypertension in recent years, due to a lack of relevant studies on the pathophysiology of CTEPH, implementing pulmonary endarterectomy (PEA) in patients has many challenges, and the prognosis of patients with CTEPH is still not optimistic. Therefore, revealing the pathogenesis of CTEPH would be of great significance for understanding the occurrence and development of CTEPH, developing relevant drug treatment studies and formulating intervention strategies, and may provide new preventive measures. This article summarizes the current research progress in CTEPH pathogenesis from the perspective of risk factors related to medical history, abnormal coagulation and fibrinolytic mechanisms, inflammatory mechanisms, genetic susceptibility factors, angiogenesis, in situ thrombosis, vascular remodeling, and other aspects.
Literatur
1.
Zurück zum Zitat Opitz C, Rosenkranz S, Ghofrani HA, Grünig E, Klose H, Olschewski H, Hoeper M (2016) ESC guidelines 2015 pulmonary hypertension: diagnosis and treatment. Dtsch Med Wochenschr 141(24):1764–1769PubMedCrossRef Opitz C, Rosenkranz S, Ghofrani HA, Grünig E, Klose H, Olschewski H, Hoeper M (2016) ESC guidelines 2015 pulmonary hypertension: diagnosis and treatment. Dtsch Med Wochenschr 141(24):1764–1769PubMedCrossRef
2.
Zurück zum Zitat Lang IM, Pesavento R, Bonderman D, Yuan JX (2013) Risk factors and basic mechanisms of chronic thromboembolic pulmonary hypertension: a current understanding. Eur Respir J 41(2):462–468PubMedCrossRef Lang IM, Pesavento R, Bonderman D, Yuan JX (2013) Risk factors and basic mechanisms of chronic thromboembolic pulmonary hypertension: a current understanding. Eur Respir J 41(2):462–468PubMedCrossRef
3.
Zurück zum Zitat Elwing JM, Vaidya A, Auger WR (2018) Chronic thromboembolic pulmonary hypertension: An Update. Clin Chest Med 39(3):605–620PubMedCrossRef Elwing JM, Vaidya A, Auger WR (2018) Chronic thromboembolic pulmonary hypertension: An Update. Clin Chest Med 39(3):605–620PubMedCrossRef
4.
Zurück zum Zitat Gall H, Hoeper MM, Richter MJ, Cacheris W, Hinzmann B, Mayer E (2017) An epidemiological analysis of the burden of chronic thromboembolic pulmonary hypertension in the USA, Europe and Japan. Eur Respir Rev 26(143):160121PubMedCrossRef Gall H, Hoeper MM, Richter MJ, Cacheris W, Hinzmann B, Mayer E (2017) An epidemiological analysis of the burden of chronic thromboembolic pulmonary hypertension in the USA, Europe and Japan. Eur Respir Rev 26(143):160121PubMedCrossRef
5.
Zurück zum Zitat Tapson VF, Platt DM, Xia F, Teal SA, de la Orden M, Divers CH, Satler CA, Joish VN, Channick RN (2016) Monitoring for pulmonary hypertension following pulmonary embolism: the INFORM study. Am J Med 129(9):978–985 e972 PubMedCrossRef Tapson VF, Platt DM, Xia F, Teal SA, de la Orden M, Divers CH, Satler CA, Joish VN, Channick RN (2016) Monitoring for pulmonary hypertension following pulmonary embolism: the INFORM study. Am J Med 129(9):978–985 e972 PubMedCrossRef
6.
Zurück zum Zitat Pengo V, Lensing AW, Prins MH, Marchiori A, Davidson BL, Tiozzo F, Albanese P, Biasiolo A, Pegoraro C, Iliceto S, Prandoni P, Thromboembolic Pulmonary Hypertension Study Group (2004) Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med 350(22):2257–2264PubMedCrossRef Pengo V, Lensing AW, Prins MH, Marchiori A, Davidson BL, Tiozzo F, Albanese P, Biasiolo A, Pegoraro C, Iliceto S, Prandoni P, Thromboembolic Pulmonary Hypertension Study Group (2004) Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med 350(22):2257–2264PubMedCrossRef
7.
Zurück zum Zitat Yang S, Yang Y, Zhai Z, Kuang T, Gong J, Zhang S, Zhu J, Liang L, Shen YH, Wang C (2015) Incidence and risk factors of chronic thromboembolic pulmonary hypertension in patients after acute pulmonary embolism. J Thorac Dis 7(11):1927–1938PubMedPubMedCentral Yang S, Yang Y, Zhai Z, Kuang T, Gong J, Zhang S, Zhu J, Liang L, Shen YH, Wang C (2015) Incidence and risk factors of chronic thromboembolic pulmonary hypertension in patients after acute pulmonary embolism. J Thorac Dis 7(11):1927–1938PubMedPubMedCentral
8.
Zurück zum Zitat Escribano-Subias P, Blanco I, Lopez-Meseguer M et al (2012) Survival in pulmonary hypertension in Spain: insights from the Spanish registry. Eur Respir J 40(3):596–603PubMedCrossRef Escribano-Subias P, Blanco I, Lopez-Meseguer M et al (2012) Survival in pulmonary hypertension in Spain: insights from the Spanish registry. Eur Respir J 40(3):596–603PubMedCrossRef
9.
Zurück zum Zitat Fernandes T, Auger W, Fedullo P (2018) Epidemiology and risk factors for chronic thromboembolic pulmonary hypertension. Thromb Res 164:145–149PubMedCrossRef Fernandes T, Auger W, Fedullo P (2018) Epidemiology and risk factors for chronic thromboembolic pulmonary hypertension. Thromb Res 164:145–149PubMedCrossRef
10.
Zurück zum Zitat Woo K, Tse L, Tse C, Metreweli C, Vallance-Owen J (1988) The prevalence and pattern of pulmonary thromboembolism in the Chinese in Hong Kong. Int J Cardiol 20(3):373–380PubMedCrossRef Woo K, Tse L, Tse C, Metreweli C, Vallance-Owen J (1988) The prevalence and pattern of pulmonary thromboembolism in the Chinese in Hong Kong. Int J Cardiol 20(3):373–380PubMedCrossRef
11.
Zurück zum Zitat Yang Y, Liang L, Zhai Z, He H, Xie W, Peng X, Wang C, on behalf of investigators for the National Cooperative Project for the Prevention and Treatment of PTE-DVT (2011) Pulmonary embolism incidence and fatality trends in Chinese hospitals from 1997 to 2008: a multicenter registration study. PLoS One 6(11):e26861PubMedPubMedCentralCrossRef Yang Y, Liang L, Zhai Z, He H, Xie W, Peng X, Wang C, on behalf of investigators for the National Cooperative Project for the Prevention and Treatment of PTE-DVT (2011) Pulmonary embolism incidence and fatality trends in Chinese hospitals from 1997 to 2008: a multicenter registration study. PLoS One 6(11):e26861PubMedPubMedCentralCrossRef
12.
Zurück zum Zitat Pepke-Zaba J, Delcroix M, Lang I, Mayer E, Jansa P, Ambroz D, Treacy C, D'Armini AM, Morsolini M, Snijder R, Bresser P, Torbicki A, Kristensen B, Lewczuk J, Simkova I, Barberà JA, de Perrot M, Hoeper MM, Gaine S, Speich R, Gomez-Sanchez MA, Kovacs G, Hamid AM, Jaïs X, Simonneau G (2011) Chronic thromboembolic pulmonary hypertension (CTEPH): results from an international prospective registry. Circulation 124(18):1973–1981PubMedCrossRef Pepke-Zaba J, Delcroix M, Lang I, Mayer E, Jansa P, Ambroz D, Treacy C, D'Armini AM, Morsolini M, Snijder R, Bresser P, Torbicki A, Kristensen B, Lewczuk J, Simkova I, Barberà JA, de Perrot M, Hoeper MM, Gaine S, Speich R, Gomez-Sanchez MA, Kovacs G, Hamid AM, Jaïs X, Simonneau G (2011) Chronic thromboembolic pulmonary hypertension (CTEPH): results from an international prospective registry. Circulation 124(18):1973–1981PubMedCrossRef
13.
Zurück zum Zitat Al-Naamani N, Espitia HG, Velazquez-Moreno H et al (2016) Chronic thromboembolic pulmonary hypertension: experience from a single center in Mexico. Lung 194(2):315–323PubMedPubMedCentralCrossRef Al-Naamani N, Espitia HG, Velazquez-Moreno H et al (2016) Chronic thromboembolic pulmonary hypertension: experience from a single center in Mexico. Lung 194(2):315–323PubMedPubMedCentralCrossRef
14.
Zurück zum Zitat Riedel M, Stanek V, Widimsky J, Prerovsky I (1982) Longterm follow-up of patients with pulmonary thromboembolism. Late prognosis and evolution of hemodynamic and respiratory data. Chest 81(2):151–158PubMedCrossRef Riedel M, Stanek V, Widimsky J, Prerovsky I (1982) Longterm follow-up of patients with pulmonary thromboembolism. Late prognosis and evolution of hemodynamic and respiratory data. Chest 81(2):151–158PubMedCrossRef
15.
Zurück zum Zitat Lewczuk J, Piszko P, Jagas J, Porada A, Sobkowicz B, Wrabec K, Wójciak S (2001) Prognostic factors in medically treated patients with chronic pulmonary embolism. Chest 119(3):818–823PubMedCrossRef Lewczuk J, Piszko P, Jagas J, Porada A, Sobkowicz B, Wrabec K, Wójciak S (2001) Prognostic factors in medically treated patients with chronic pulmonary embolism. Chest 119(3):818–823PubMedCrossRef
16.
Zurück zum Zitat Auger WR, Kim NH, Trow TK (2010) Chronic thromboembolic pulmonary hypertension. Clin Chest Med 31(4):741–758PubMedCrossRef Auger WR, Kim NH, Trow TK (2010) Chronic thromboembolic pulmonary hypertension. Clin Chest Med 31(4):741–758PubMedCrossRef
17.
Zurück zum Zitat Egermayer P, Peacock AJ (2000) Is pulmonary embolism a common cause of chronic pulmonary hypertension? Limitations of the embolic hypothesis. Eur Respir J 15(3):440–448PubMedCrossRef Egermayer P, Peacock AJ (2000) Is pulmonary embolism a common cause of chronic pulmonary hypertension? Limitations of the embolic hypothesis. Eur Respir J 15(3):440–448PubMedCrossRef
18.
Zurück zum Zitat Lang IM, Marsh JJ, Konopka RG, Olman MA, Binder BR, Moser KM, Schleef RR (1993) Factors contributing to increased vascular fibrinolytic activity in mongrel dogs. Circulation 87(6):1990–2000PubMedCrossRef Lang IM, Marsh JJ, Konopka RG, Olman MA, Binder BR, Moser KM, Schleef RR (1993) Factors contributing to increased vascular fibrinolytic activity in mongrel dogs. Circulation 87(6):1990–2000PubMedCrossRef
19.
Zurück zum Zitat Lang IM, Marsh J, Moser K, Schleef R (1992) Presence of active and latent type 1 plasminogen activator inhibitor associated with porcine platelets. Blood 80(9):2269–2274CrossRefPubMed Lang IM, Marsh J, Moser K, Schleef R (1992) Presence of active and latent type 1 plasminogen activator inhibitor associated with porcine platelets. Blood 80(9):2269–2274CrossRefPubMed
20.
Zurück zum Zitat Fedullo PF, Auger WR, Kerr KM, Rubin LJ (2001) Chronic thromboembolic pulmonary hypertension. N Engl J Med 345(20):1465–1472PubMedCrossRef Fedullo PF, Auger WR, Kerr KM, Rubin LJ (2001) Chronic thromboembolic pulmonary hypertension. N Engl J Med 345(20):1465–1472PubMedCrossRef
21.
Zurück zum Zitat Pesavento R, Filippi L, Palla A, Visonà A, Bova C, Marzolo M, Porro F, Villalta S, Ciammaichella M, Bucherini E, Nante G, Battistelli S, Muiesan ML, Beltramello G, Prisco D, Casazza F, Ageno W, Palareti G, Quintavalla R, Monti S, Mumoli N, Zanatta N, Cappelli R, Cattaneo M, Moretti V, Corà F, Bazzan M, Ghirarduzzi A, Frigo AC, Miniati M, Prandoni P, SCOPE Investigators (2017) Impact of residual pulmonary obstruction on the long-term outcome of patients with pulmonary embolism. Eur Respir J 49(5):1601980PubMedCrossRef Pesavento R, Filippi L, Palla A, Visonà A, Bova C, Marzolo M, Porro F, Villalta S, Ciammaichella M, Bucherini E, Nante G, Battistelli S, Muiesan ML, Beltramello G, Prisco D, Casazza F, Ageno W, Palareti G, Quintavalla R, Monti S, Mumoli N, Zanatta N, Cappelli R, Cattaneo M, Moretti V, Corà F, Bazzan M, Ghirarduzzi A, Frigo AC, Miniati M, Prandoni P, SCOPE Investigators (2017) Impact of residual pulmonary obstruction on the long-term outcome of patients with pulmonary embolism. Eur Respir J 49(5):1601980PubMedCrossRef
22.
Zurück zum Zitat Yamaki S, Ando M, Fukumoto Y, Higuchi Y, Kaneko K, Maeda K, Shimokawa H (2014) Histopathological examination by lung biopsy for the evaluation of operability and postoperative prognosis in patients with chronic thromboembolic pulmonary hypertension. Circ J 78(2):476–482PubMedCrossRef Yamaki S, Ando M, Fukumoto Y, Higuchi Y, Kaneko K, Maeda K, Shimokawa H (2014) Histopathological examination by lung biopsy for the evaluation of operability and postoperative prognosis in patients with chronic thromboembolic pulmonary hypertension. Circ J 78(2):476–482PubMedCrossRef
23.
Zurück zum Zitat Lang IM, Madani M (2014) Update on chronic thromboembolic pulmonary hypertension. Circulation 130(6):508–518PubMedCrossRef Lang IM, Madani M (2014) Update on chronic thromboembolic pulmonary hypertension. Circulation 130(6):508–518PubMedCrossRef
24.
Zurück zum Zitat Edward JA, Mandras S (2017) An update on the management of chronic thromboembolic pulmonary hypertension. Curr Probl Cardiol 42(1):7–38PubMedCrossRef Edward JA, Mandras S (2017) An update on the management of chronic thromboembolic pulmonary hypertension. Curr Probl Cardiol 42(1):7–38PubMedCrossRef
25.
Zurück zum Zitat Miniati M, Monti S, Bottai M, Scoscia E, Bauleo C, Tonelli L, Dainelli A, Giuntini C (2006) Survival and restoration of pulmonary perfusion in a long-term follow-up of patients after acute pulmonary embolism. Medicine (Baltimore) 85(5):253–262CrossRef Miniati M, Monti S, Bottai M, Scoscia E, Bauleo C, Tonelli L, Dainelli A, Giuntini C (2006) Survival and restoration of pulmonary perfusion in a long-term follow-up of patients after acute pulmonary embolism. Medicine (Baltimore) 85(5):253–262CrossRef
26.
Zurück zum Zitat Becattini C, Agnelli G, Pesavento R, Silingardi M, Poggio R, Taliani MR, Ageno W (2006) Incidence of chronic thromboembolic pulmonary hypertension after a first episode of pulmonary embolism. Chest 130(1):172–175PubMedCrossRef Becattini C, Agnelli G, Pesavento R, Silingardi M, Poggio R, Taliani MR, Ageno W (2006) Incidence of chronic thromboembolic pulmonary hypertension after a first episode of pulmonary embolism. Chest 130(1):172–175PubMedCrossRef
27.
Zurück zum Zitat Klok FA, van Kralingen KW, van Dijk AP, Heyning FH, Vliegen HW, Huisman MV (2010) Prospective cardiopulmonary screening program to detect chronic thromboembolic pulmonary hypertension in patients after acute pulmonary embolism. Haematologica 95(6):970–975PubMedPubMedCentralCrossRef Klok FA, van Kralingen KW, van Dijk AP, Heyning FH, Vliegen HW, Huisman MV (2010) Prospective cardiopulmonary screening program to detect chronic thromboembolic pulmonary hypertension in patients after acute pulmonary embolism. Haematologica 95(6):970–975PubMedPubMedCentralCrossRef
28.
Zurück zum Zitat Poli D, Grifoni E, Antonucci E, Arcangeli C, Prisco D, Abbate R, Miniati M (2010) Incidence of recurrent venous thromboembolism and of chronic thromboembolic pulmonary hypertension in patients after a first episode of pulmonary embolism. J Thromb Thrombolysis 30(3):294–299PubMedCrossRef Poli D, Grifoni E, Antonucci E, Arcangeli C, Prisco D, Abbate R, Miniati M (2010) Incidence of recurrent venous thromboembolism and of chronic thromboembolic pulmonary hypertension in patients after a first episode of pulmonary embolism. J Thromb Thrombolysis 30(3):294–299PubMedCrossRef
29.
Zurück zum Zitat Guerin L, Couturaud F, Parent F et al (2014) Prevalence of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism. Prevalence of CTEPH after pulmonary embolism. Thromb Haemost 112(3):598–605PubMedCrossRef Guerin L, Couturaud F, Parent F et al (2014) Prevalence of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism. Prevalence of CTEPH after pulmonary embolism. Thromb Haemost 112(3):598–605PubMedCrossRef
30.
Zurück zum Zitat Otero R, Oribe M, Ballaz A, Jimenez D, Uresandi F, Nauffal D, Conget F, Rodriguez C, Elias T, Jara L, Cayuela A, Blanco I, Barberá J (2011) Echocardiographic assessment of pulmonary arterial pressure in the follow-up of patients with pulmonary embolism. Thromb Res 127(4):303–308PubMedCrossRef Otero R, Oribe M, Ballaz A, Jimenez D, Uresandi F, Nauffal D, Conget F, Rodriguez C, Elias T, Jara L, Cayuela A, Blanco I, Barberá J (2011) Echocardiographic assessment of pulmonary arterial pressure in the follow-up of patients with pulmonary embolism. Thromb Res 127(4):303–308PubMedCrossRef
31.
Zurück zum Zitat Dentali F, Donadini M, Gianni M, Bertolini A, Squizzato A, Venco A, Ageno W (2009) Incidence of chronic pulmonary hypertension in patients with previous pulmonary embolism. Thromb Res 124(3):256–258PubMedCrossRef Dentali F, Donadini M, Gianni M, Bertolini A, Squizzato A, Venco A, Ageno W (2009) Incidence of chronic pulmonary hypertension in patients with previous pulmonary embolism. Thromb Res 124(3):256–258PubMedCrossRef
32.
Zurück zum Zitat Korkmaz A, Ozlu T, Ozsu S, Kazaz Z, Bulbul Y (2012) Long-term outcomes in acute pulmonary thromboembolism: the incidence of chronic thromboembolic pulmonary hypertension and associated risk factors. Clin Appl Thromb Hemost 18(3):281–288PubMedCrossRef Korkmaz A, Ozlu T, Ozsu S, Kazaz Z, Bulbul Y (2012) Long-term outcomes in acute pulmonary thromboembolism: the incidence of chronic thromboembolic pulmonary hypertension and associated risk factors. Clin Appl Thromb Hemost 18(3):281–288PubMedCrossRef
33.
Zurück zum Zitat Fedullo P, Kerr KM, Kim NH, Auger WR (2011) Chronic thromboembolic pulmonary hypertension. Am J Respir Crit Care Med 183(12):1605–1613PubMedCrossRef Fedullo P, Kerr KM, Kim NH, Auger WR (2011) Chronic thromboembolic pulmonary hypertension. Am J Respir Crit Care Med 183(12):1605–1613PubMedCrossRef
34.
Zurück zum Zitat Bonderman D, Wilkens H, Wakounig S, Schäfers HJ, Jansa P, Lindner J, Simkova I, Martischnig AM, Dudczak J, Sadushi R, Skoro-Sajer N, Klepetko W, Lang IM (2009) Risk factors for chronic thromboembolic pulmonary hypertension. Eur Respir J 33(2):325–331PubMedCrossRef Bonderman D, Wilkens H, Wakounig S, Schäfers HJ, Jansa P, Lindner J, Simkova I, Martischnig AM, Dudczak J, Sadushi R, Skoro-Sajer N, Klepetko W, Lang IM (2009) Risk factors for chronic thromboembolic pulmonary hypertension. Eur Respir J 33(2):325–331PubMedCrossRef
35.
Zurück zum Zitat Bonderman D, Jakowitsch J, Adlbrecht C, Schemper M, Kyrle P, Schönauer V, Exner M, Klepetko W, Kneussl M, Maurer G, Lang I (2005) Medical conditions increasing the risk of chronic thromboembolic pulmonary hypertension. Thromb Haemost 93(3):512–516PubMedCrossRef Bonderman D, Jakowitsch J, Adlbrecht C, Schemper M, Kyrle P, Schönauer V, Exner M, Klepetko W, Kneussl M, Maurer G, Lang I (2005) Medical conditions increasing the risk of chronic thromboembolic pulmonary hypertension. Thromb Haemost 93(3):512–516PubMedCrossRef
36.
Zurück zum Zitat Kim NH, Lang IM (2012) Risk factors for chronic thromboembolic pulmonary hypertension. Eur Respir Rev 21(123):27–31PubMedCrossRef Kim NH, Lang IM (2012) Risk factors for chronic thromboembolic pulmonary hypertension. Eur Respir Rev 21(123):27–31PubMedCrossRef
37.
Zurück zum Zitat Kyrle PA, Minar E, Hirschl M, Bialonczyk C, Stain M, Schneider B, Weltermann A, Speiser W, Lechner K, Eichinger S (2000) High plasma levels of factor VIII and the risk of recurrent venous thromboembolism. N Engl J Med 343(7):457–462PubMedCrossRef Kyrle PA, Minar E, Hirschl M, Bialonczyk C, Stain M, Schneider B, Weltermann A, Speiser W, Lechner K, Eichinger S (2000) High plasma levels of factor VIII and the risk of recurrent venous thromboembolism. N Engl J Med 343(7):457–462PubMedCrossRef
38.
Zurück zum Zitat Bonderman D, Turecek PL, Jakowitsch J, Weltermann A, Adlbrecht C, Schneider B, Kneussl M, Rubin L, Kyrle P, Klepetko W, Maurer G, Lang I (2003) High prevalence of elevated clotting factor VIII in chronic thromboembolic pulmonary hypertension. Thromb Haemost 90(3):372–376PubMedCrossRef Bonderman D, Turecek PL, Jakowitsch J, Weltermann A, Adlbrecht C, Schneider B, Kneussl M, Rubin L, Kyrle P, Klepetko W, Maurer G, Lang I (2003) High prevalence of elevated clotting factor VIII in chronic thromboembolic pulmonary hypertension. Thromb Haemost 90(3):372–376PubMedCrossRef
39.
Zurück zum Zitat Lisman T, de Groot PG, Meijers JC, Rosendaal FR (2005) Reduced plasma fibrinolytic potential is a risk factor for venous thrombosis. Blood 105(3):1102–1105PubMedCrossRef Lisman T, de Groot PG, Meijers JC, Rosendaal FR (2005) Reduced plasma fibrinolytic potential is a risk factor for venous thrombosis. Blood 105(3):1102–1105PubMedCrossRef
40.
Zurück zum Zitat Morris TA (2013) Why acute pulmonary embolism becomes chronic thromboembolic pulmonary hypertension: clinical and genetic insights. Curr Opin Pulm Med 19(5):422–429PubMed Morris TA (2013) Why acute pulmonary embolism becomes chronic thromboembolic pulmonary hypertension: clinical and genetic insights. Curr Opin Pulm Med 19(5):422–429PubMed
42.
Zurück zum Zitat Vuylsteke A, Sharples L, Charman G, Kneeshaw J, Tsui S, Dunning J, Wheaton E, Klein A, Arrowsmith J, Hall R, Jenkins D (2011) Circulatory arrest versus cerebral perfusion during pulmonary endarterectomy surgery (PEACOG): a randomised controlled trial. Lancet 378(9800):1379–1387PubMedCrossRef Vuylsteke A, Sharples L, Charman G, Kneeshaw J, Tsui S, Dunning J, Wheaton E, Klein A, Arrowsmith J, Hall R, Jenkins D (2011) Circulatory arrest versus cerebral perfusion during pulmonary endarterectomy surgery (PEACOG): a randomised controlled trial. Lancet 378(9800):1379–1387PubMedCrossRef
43.
Zurück zum Zitat Lang IM, Marsh JJ, Olman MA, Moser KM, Schleef RR (1994) Parallel analysis of tissue-type plasminogen activator and type 1 plasminogen activator inhibitor in plasma and endothelial cells derived from patients with chronic pulmonary thromboemboli. Circulation 90(2):706–712PubMedCrossRef Lang IM, Marsh JJ, Olman MA, Moser KM, Schleef RR (1994) Parallel analysis of tissue-type plasminogen activator and type 1 plasminogen activator inhibitor in plasma and endothelial cells derived from patients with chronic pulmonary thromboemboli. Circulation 90(2):706–712PubMedCrossRef
44.
Zurück zum Zitat Morris TA, Marsh JJ, Chiles PG, Auger WR, Fedullo PF, Woods VL Jr (2006) Fibrin derived from patients with chronic thromboembolic pulmonary hypertension is resistant to lysis. Am J Respir Crit Care Med 173(11):1270–1275PubMedPubMedCentralCrossRef Morris TA, Marsh JJ, Chiles PG, Auger WR, Fedullo PF, Woods VL Jr (2006) Fibrin derived from patients with chronic thromboembolic pulmonary hypertension is resistant to lysis. Am J Respir Crit Care Med 173(11):1270–1275PubMedPubMedCentralCrossRef
45.
Zurück zum Zitat Morris TA, Marsh JJ, Chiles PG, Magana MM, Liang NC, Soler X, DeSantis DJ, Ngo D, Woods VL (2009) High prevalence of dysfibrinogenemia among patients with chronic thromboembolic pulmonary hypertension. Blood 114(9):1929–1936PubMedPubMedCentralCrossRef Morris TA, Marsh JJ, Chiles PG, Magana MM, Liang NC, Soler X, DeSantis DJ, Ngo D, Woods VL (2009) High prevalence of dysfibrinogenemia among patients with chronic thromboembolic pulmonary hypertension. Blood 114(9):1929–1936PubMedPubMedCentralCrossRef
46.
Zurück zum Zitat Miniati M, Fiorillo C, Becatti M, Monti S, Bottai M, Marini C, Grifoni E, Formichi B, Bauleo C, Arcangeli C, Poli D, Nassi PA, Abbate R, Prisco D (2010) Fibrin resistance to lysis in patients with pulmonary hypertension other than thromboembolic. Am J Respir Crit Care Med 181(9):992–996PubMedCrossRef Miniati M, Fiorillo C, Becatti M, Monti S, Bottai M, Marini C, Grifoni E, Formichi B, Bauleo C, Arcangeli C, Poli D, Nassi PA, Abbate R, Prisco D (2010) Fibrin resistance to lysis in patients with pulmonary hypertension other than thromboembolic. Am J Respir Crit Care Med 181(9):992–996PubMedCrossRef
47.
Zurück zum Zitat Suntharalingam J, Goldsmith K, van Marion V, Long L, Treacy CM, Dudbridge F, Toshner MR, Pepke-Zaba J, Eikenboom JCJ, Morrell NW (2008) Fibrinogen Aalpha Thr312Ala polymorphism is associated with chronic thromboembolic pulmonary hypertension. Eur Respir J 31(4):736–741PubMedCrossRef Suntharalingam J, Goldsmith K, van Marion V, Long L, Treacy CM, Dudbridge F, Toshner MR, Pepke-Zaba J, Eikenboom JCJ, Morrell NW (2008) Fibrinogen Aalpha Thr312Ala polymorphism is associated with chronic thromboembolic pulmonary hypertension. Eur Respir J 31(4):736–741PubMedCrossRef
48.
Zurück zum Zitat Standeven KF, Grant PJ, Carter AM, Scheiner T, Weisel JW, Ariens RA (2003) Functional analysis of the fibrinogen Aalpha Thr312Ala polymorphism: effects on fibrin structure and function. Circulation 107(18):2326–2330PubMedCrossRef Standeven KF, Grant PJ, Carter AM, Scheiner T, Weisel JW, Ariens RA (2003) Functional analysis of the fibrinogen Aalpha Thr312Ala polymorphism: effects on fibrin structure and function. Circulation 107(18):2326–2330PubMedCrossRef
49.
Zurück zum Zitat Kellermair J, Redwan B, Alias S, Jabkowski J, Panzenboeck A, Kellermair L, Winter MP, Weltermann A, Lang IM (2013) Platelet endothelial cell adhesion molecule 1 deficiency misguides venous thrombus resolution. Blood 122(19):3376–3384PubMedCrossRef Kellermair J, Redwan B, Alias S, Jabkowski J, Panzenboeck A, Kellermair L, Winter MP, Weltermann A, Lang IM (2013) Platelet endothelial cell adhesion molecule 1 deficiency misguides venous thrombus resolution. Blood 122(19):3376–3384PubMedCrossRef
50.
Zurück zum Zitat Bonderman D, Jakowitsch J, Redwan B, Bergmeister H, Renner MK, Panzenböck H, Adlbrecht C, Georgopoulos A, Klepetko W, Kneussl M, Lang IM (2008) Role for staphylococci in misguided thrombus resolution of chronic thromboembolic pulmonary hypertension. Arterioscler Thromb Vasc Biol 28(4):678–684PubMedCrossRef Bonderman D, Jakowitsch J, Redwan B, Bergmeister H, Renner MK, Panzenböck H, Adlbrecht C, Georgopoulos A, Klepetko W, Kneussl M, Lang IM (2008) Role for staphylococci in misguided thrombus resolution of chronic thromboembolic pulmonary hypertension. Arterioscler Thromb Vasc Biol 28(4):678–684PubMedCrossRef
51.
Zurück zum Zitat Zabini D, Heinemann A, Foris V, Nagaraj C, Nierlich P, Bálint Z, Kwapiszewska G, Lang IM, Klepetko W, Olschewski H, Olschewski A (2014) Comprehensive analysis of inflammatory markers in chronic thromboembolic pulmonary hypertension patients. Eur Respir J 44(4):951–962PubMedCrossRef Zabini D, Heinemann A, Foris V, Nagaraj C, Nierlich P, Bálint Z, Kwapiszewska G, Lang IM, Klepetko W, Olschewski H, Olschewski A (2014) Comprehensive analysis of inflammatory markers in chronic thromboembolic pulmonary hypertension patients. Eur Respir J 44(4):951–962PubMedCrossRef
52.
Zurück zum Zitat Quarck R, Nawrot T, Meyns B, Delcroix M (2009) C-reactive protein: a new predictor of adverse outcome in pulmonary arterial hypertension. J Am Coll Cardiol 53(14):1211–1218PubMedCrossRef Quarck R, Nawrot T, Meyns B, Delcroix M (2009) C-reactive protein: a new predictor of adverse outcome in pulmonary arterial hypertension. J Am Coll Cardiol 53(14):1211–1218PubMedCrossRef
53.
Zurück zum Zitat Cohn DM, Roshani S, Middeldorp S (2007) Thrombophilia and venous thromboembolism: implications for testing. Semin Thromb Hemost 33(6):573–581PubMedCrossRef Cohn DM, Roshani S, Middeldorp S (2007) Thrombophilia and venous thromboembolism: implications for testing. Semin Thromb Hemost 33(6):573–581PubMedCrossRef
54.
Zurück zum Zitat Wolf M, Boyer-Neumann C, Parent F, Eschwege V, Jaillet H, Meyer D, Simonneau G (2000) Thrombotic risk factors in pulmonary hypertension. Eur Respir J 15(2):395–399PubMedCrossRef Wolf M, Boyer-Neumann C, Parent F, Eschwege V, Jaillet H, Meyer D, Simonneau G (2000) Thrombotic risk factors in pulmonary hypertension. Eur Respir J 15(2):395–399PubMedCrossRef
55.
Zurück zum Zitat Wong CL, Szydlo R, Gibbs S, Laffan M (2010) Hereditary and acquired thrombotic risk factors for chronic thromboembolic pulmonary hypertension. Blood Coagul Fibrinolysis 21(3):201–206PubMedCrossRef Wong CL, Szydlo R, Gibbs S, Laffan M (2010) Hereditary and acquired thrombotic risk factors for chronic thromboembolic pulmonary hypertension. Blood Coagul Fibrinolysis 21(3):201–206PubMedCrossRef
56.
Zurück zum Zitat Lotta LA, Tuana G, Yu J, Martinelli I, Wang M, Yu F, Passamonti SM, Pappalardo E, Valsecchi C, Scherer SE, Hale W IV, Muzny DM, Randi G, Rosendaal FR, Gibbs RA, Peyvandi F (2013) Next-generation sequencing study finds an excess of rare, coding single-nucleotide variants of ADAMTS13 in patients with deep vein thrombosis. J Thromb Haemost 11(7):1228–1239PubMedCrossRef Lotta LA, Tuana G, Yu J, Martinelli I, Wang M, Yu F, Passamonti SM, Pappalardo E, Valsecchi C, Scherer SE, Hale W IV, Muzny DM, Randi G, Rosendaal FR, Gibbs RA, Peyvandi F (2013) Next-generation sequencing study finds an excess of rare, coding single-nucleotide variants of ADAMTS13 in patients with deep vein thrombosis. J Thromb Haemost 11(7):1228–1239PubMedCrossRef
57.
Zurück zum Zitat Orstavik KH, Magnus P, Reisner H, Berg K, Graham JB, Nance W (1985) Factor VIII and factor IX in a twin population. Evidence for a major effect of ABO locus on factor VIII level. Am J Hum Genet 37(1):89–101PubMedPubMedCentral Orstavik KH, Magnus P, Reisner H, Berg K, Graham JB, Nance W (1985) Factor VIII and factor IX in a twin population. Evidence for a major effect of ABO locus on factor VIII level. Am J Hum Genet 37(1):89–101PubMedPubMedCentral
58.
Zurück zum Zitat Ma Q, Jacobi PM, Emmer BT, Kretz CA, Ozel AB, McGee B, Kimchi-Sarfaty C, Ginsburg D, Li JZ, Desch KC (2017) Genetic variants in ADAMTS13 as well as smoking are major determinants of plasma ADAMTS13 levels. Blood Adv 1(15):1037–1046PubMedPubMedCentralCrossRef Ma Q, Jacobi PM, Emmer BT, Kretz CA, Ozel AB, McGee B, Kimchi-Sarfaty C, Ginsburg D, Li JZ, Desch KC (2017) Genetic variants in ADAMTS13 as well as smoking are major determinants of plasma ADAMTS13 levels. Blood Adv 1(15):1037–1046PubMedPubMedCentralCrossRef
59.
Zurück zum Zitat Chion CK, Doggen CJ, Crawley JT, Lane DA, Rosendaal FR (2007) ADAMTS13 and von Willebrand factor and the risk of myocardial infarction in men. Blood 109(5):1998–2000PubMedCrossRef Chion CK, Doggen CJ, Crawley JT, Lane DA, Rosendaal FR (2007) ADAMTS13 and von Willebrand factor and the risk of myocardial infarction in men. Blood 109(5):1998–2000PubMedCrossRef
60.
Zurück zum Zitat Newnham M, South K, Bleda M, Auger WR, Barberà JA, Bogaard H, Bunclark K, Cannon JE, Delcroix M, Hadinnapola C, Howard LS, Jenkins D, Mayer E, Ng C, Rhodes CJ, Screaton N, Sheares K, Simpson MA, Southwood M, Su L, Taboada D, Traylor M, Trembath RC, Villar SS, Wilkins MR, Wharton J, Gräf S, Pepke-Zaba J, Laffan M, Lane DA, Morrell NW, Toshner M (2019) The ADAMTS13–VWF axis is dysregulated in chronic thromboembolic pulmonary hypertension. Eur Respir J 53(3):1801805PubMedPubMedCentralCrossRef Newnham M, South K, Bleda M, Auger WR, Barberà JA, Bogaard H, Bunclark K, Cannon JE, Delcroix M, Hadinnapola C, Howard LS, Jenkins D, Mayer E, Ng C, Rhodes CJ, Screaton N, Sheares K, Simpson MA, Southwood M, Su L, Taboada D, Traylor M, Trembath RC, Villar SS, Wilkins MR, Wharton J, Gräf S, Pepke-Zaba J, Laffan M, Lane DA, Morrell NW, Toshner M (2019) The ADAMTS13–VWF axis is dysregulated in chronic thromboembolic pulmonary hypertension. Eur Respir J 53(3):1801805PubMedPubMedCentralCrossRef
61.
Zurück zum Zitat Feng YX, Liu D, Sun ML, Jiang X, Sun N, Mao YM, Jing ZC (2014) BMPR2 germline mutation in chronic thromboembolic pulmonary hypertension. Lung 192(4):625–627PubMedCrossRef Feng YX, Liu D, Sun ML, Jiang X, Sun N, Mao YM, Jing ZC (2014) BMPR2 germline mutation in chronic thromboembolic pulmonary hypertension. Lung 192(4):625–627PubMedCrossRef
62.
Zurück zum Zitat Ulrich S, Szamalek-Hoegel J, Hersberger M, Fischler M, Garcia JS, Huber LC, Grünig E, Janssen B, Speich R (2010) Sequence variants in BMPR2 and genes involved in the serotonin and nitric oxide pathways in idiopathic pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: relation to clinical parameters and comparison with left heart disease. Respiration 79(4):279–287PubMedCrossRef Ulrich S, Szamalek-Hoegel J, Hersberger M, Fischler M, Garcia JS, Huber LC, Grünig E, Janssen B, Speich R (2010) Sequence variants in BMPR2 and genes involved in the serotonin and nitric oxide pathways in idiopathic pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: relation to clinical parameters and comparison with left heart disease. Respiration 79(4):279–287PubMedCrossRef
63.
Zurück zum Zitat Distler JH, Hirth A, Kurowska-Stolarska M, Gay RE, Gay S, Distler O (2003) Angiogenic and angiostatic factors in the molecular control of angiogenesis. Q J Nucl Med 47(3):149–161PubMed Distler JH, Hirth A, Kurowska-Stolarska M, Gay RE, Gay S, Distler O (2003) Angiogenic and angiostatic factors in the molecular control of angiogenesis. Q J Nucl Med 47(3):149–161PubMed
64.
Zurück zum Zitat Waltham M, Burnand KG, Collins M, Smith A (2000) Vascular endothelial growth factor and basic fibroblast growth factor are found in resolving venous thrombi. J Vasc Surg 32(5):988–996PubMedCrossRef Waltham M, Burnand KG, Collins M, Smith A (2000) Vascular endothelial growth factor and basic fibroblast growth factor are found in resolving venous thrombi. J Vasc Surg 32(5):988–996PubMedCrossRef
65.
Zurück zum Zitat Henke PK, Wakefield TW, Kadell AM, Linn MJ, Varma MR, Sarkar M, Hawley A, Fowlkes JB, Strieter RM (2001) Interleukin-8 administration enhances venous thrombosis resolution in a rat model. J Surg Res 99(1):84–91PubMedCrossRef Henke PK, Wakefield TW, Kadell AM, Linn MJ, Varma MR, Sarkar M, Hawley A, Fowlkes JB, Strieter RM (2001) Interleukin-8 administration enhances venous thrombosis resolution in a rat model. J Surg Res 99(1):84–91PubMedCrossRef
66.
Zurück zum Zitat Yaoita N, Shirakawa R, Fukumoto Y, Sugimura K, Miyata S, Miura Y, Nochioka K, Miura M, Tatebe S, Aoki T, Yamamoto S, Satoh K, Kimura T, Shimokawa H, Horiuchi H (2014) Platelets are highly activated in patients of chronic thromboembolic pulmonary hypertension. Arterioscler Thromb Vasc Biol 34(11):2486–2494PubMedCrossRef Yaoita N, Shirakawa R, Fukumoto Y, Sugimura K, Miyata S, Miura Y, Nochioka K, Miura M, Tatebe S, Aoki T, Yamamoto S, Satoh K, Kimura T, Shimokawa H, Horiuchi H (2014) Platelets are highly activated in patients of chronic thromboembolic pulmonary hypertension. Arterioscler Thromb Vasc Biol 34(11):2486–2494PubMedCrossRef
67.
Zurück zum Zitat Moser KM, Bloor CM (1993) Pulmonary vascular lesions occurring in patients with chronic major vessel thromboembolic pulmonary hypertension. Chest 103(3):685–692PubMedCrossRef Moser KM, Bloor CM (1993) Pulmonary vascular lesions occurring in patients with chronic major vessel thromboembolic pulmonary hypertension. Chest 103(3):685–692PubMedCrossRef
68.
Zurück zum Zitat Lang IM, Marsh JJ, Olman MA, Moser KM, Loskutoff DJ, Schleef RR (1994) Expression of type 1 plasminogen activator inhibitor in chronic pulmonary thromboemboli. Circulation 89(6):2715–2721PubMedCrossRef Lang IM, Marsh JJ, Olman MA, Moser KM, Loskutoff DJ, Schleef RR (1994) Expression of type 1 plasminogen activator inhibitor in chronic pulmonary thromboemboli. Circulation 89(6):2715–2721PubMedCrossRef
69.
Zurück zum Zitat Sakao S, Tatsumi K (2013) Crosstalk between endothelial cell and thrombus in chronic thromboembolic pulmonary hypertension: perspective. Histol Histopathol 28(2):185–193PubMed Sakao S, Tatsumi K (2013) Crosstalk between endothelial cell and thrombus in chronic thromboembolic pulmonary hypertension: perspective. Histol Histopathol 28(2):185–193PubMed
70.
Zurück zum Zitat Sakao S, Hao H, Tanabe N, Kasahara Y, Kurosu K, Tatsumi K (2011) Endothelial-like cells in chronic thromboembolic pulmonary hypertension: crosstalk with myofibroblast-like cells. Respir Res 12:109PubMedPubMedCentralCrossRef Sakao S, Hao H, Tanabe N, Kasahara Y, Kurosu K, Tatsumi K (2011) Endothelial-like cells in chronic thromboembolic pulmonary hypertension: crosstalk with myofibroblast-like cells. Respir Res 12:109PubMedPubMedCentralCrossRef
71.
Zurück zum Zitat Firth AL, Yao W, Ogawa A, Madani MM, Lin GY, Yuan JX (2010) Multipotent mesenchymal progenitor cells are present in endarterectomized tissues from patients with chronic thromboembolic pulmonary hypertension. Am J Physiol Cell Physiol 298(5):C1217–C1225PubMedPubMedCentralCrossRef Firth AL, Yao W, Ogawa A, Madani MM, Lin GY, Yuan JX (2010) Multipotent mesenchymal progenitor cells are present in endarterectomized tissues from patients with chronic thromboembolic pulmonary hypertension. Am J Physiol Cell Physiol 298(5):C1217–C1225PubMedPubMedCentralCrossRef
72.
Zurück zum Zitat Zabini D, Nagaraj C, Stacher E, Lang IM, Nierlich P, Klepetko W, Heinemann A, Olschewski H, Bálint Z, Olschewski A (2012) Angiostatic factors in the pulmonary endarterectomy material from chronic thromboembolic pulmonary hypertension patients cause endothelial dysfunction. PLoS One 7(8):e43793PubMedPubMedCentralCrossRef Zabini D, Nagaraj C, Stacher E, Lang IM, Nierlich P, Klepetko W, Heinemann A, Olschewski H, Bálint Z, Olschewski A (2012) Angiostatic factors in the pulmonary endarterectomy material from chronic thromboembolic pulmonary hypertension patients cause endothelial dysfunction. PLoS One 7(8):e43793PubMedPubMedCentralCrossRef
73.
Zurück zum Zitat Firth AL, Yau J, White A, Chiles PG, Marsh JJ, Morris TA, Yuan JXJ (2009) Chronic exposure to fibrin and fibrinogen differentially regulates intracellular Ca2+ in human pulmonary arterial smooth muscle and endothelial cells. Am J Physiol Lung Cell Mol Physiol 296(6):L979–L986PubMedPubMedCentralCrossRef Firth AL, Yau J, White A, Chiles PG, Marsh JJ, Morris TA, Yuan JXJ (2009) Chronic exposure to fibrin and fibrinogen differentially regulates intracellular Ca2+ in human pulmonary arterial smooth muscle and endothelial cells. Am J Physiol Lung Cell Mol Physiol 296(6):L979–L986PubMedPubMedCentralCrossRef
74.
Zurück zum Zitat Rhodes CJ, Im H, Cao A, Hennigs JK, Wang L, Sa S, Chen PI, Nickel NP, Miyagawa K, Hopper RK, Tojais NF, Li CG, Gu M, Spiekerkoetter E, Xian Z, Chen R, Zhao M, Kaschwich M, del Rosario PA, Bernstein D, Zamanian RT, Wu JC, Snyder MP, Rabinovitch M (2015) RNA sequencing analysis detection of a novel pathway of endothelial dysfunction in pulmonary arterial hypertension. Am J Respir Crit Care Med 192(3):356–366PubMedPubMedCentralCrossRef Rhodes CJ, Im H, Cao A, Hennigs JK, Wang L, Sa S, Chen PI, Nickel NP, Miyagawa K, Hopper RK, Tojais NF, Li CG, Gu M, Spiekerkoetter E, Xian Z, Chen R, Zhao M, Kaschwich M, del Rosario PA, Bernstein D, Zamanian RT, Wu JC, Snyder MP, Rabinovitch M (2015) RNA sequencing analysis detection of a novel pathway of endothelial dysfunction in pulmonary arterial hypertension. Am J Respir Crit Care Med 192(3):356–366PubMedPubMedCentralCrossRef
75.
Zurück zum Zitat Abdul-Salam VB, Wharton J, Cupitt J, Berryman M, Edwards RJ, Wilkins MR (2010) Proteomic analysis of lung tissues from patients with pulmonary arterial hypertension. Circulation 122(20):2058–2067PubMedCrossRef Abdul-Salam VB, Wharton J, Cupitt J, Berryman M, Edwards RJ, Wilkins MR (2010) Proteomic analysis of lung tissues from patients with pulmonary arterial hypertension. Circulation 122(20):2058–2067PubMedCrossRef
76.
Zurück zum Zitat Hemnes AR, Trammell AW, Archer SL, Rich S, Yu C, Nian H, Penner N, Funke M, Wheeler L, Robbins IM, Austin ED, Newman JH, West J (2015) Peripheral blood signature of vasodilator-responsive pulmonary arterial hypertension. Circulation. 131(4):401–409 discussion 409 PubMedCrossRef Hemnes AR, Trammell AW, Archer SL, Rich S, Yu C, Nian H, Penner N, Funke M, Wheeler L, Robbins IM, Austin ED, Newman JH, West J (2015) Peripheral blood signature of vasodilator-responsive pulmonary arterial hypertension. Circulation. 131(4):401–409 discussion 409 PubMedCrossRef
Metadaten
Titel
Research progress on the pathogenesis of CTEPH
verfasst von
Lu Yan
Xin Li
Zhihong Liu
Zhihui Zhao
Qin Luo
Qin Zhao
Qi Jin
Xue Yu
Yi Zhang
Publikationsdatum
14.05.2019
Verlag
Springer US
Erschienen in
Heart Failure Reviews / Ausgabe 6/2019
Print ISSN: 1382-4147
Elektronische ISSN: 1573-7322
DOI
https://doi.org/10.1007/s10741-019-09802-4

Weitere Artikel der Ausgabe 6/2019

Heart Failure Reviews 6/2019 Zur Ausgabe

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Adipositas-Medikament auch gegen Schlafapnoe wirksam

24.04.2024 Adipositas Nachrichten

Der als Antidiabetikum sowie zum Gewichtsmanagement zugelassene Wirkstoff Tirzepatid hat in Studien bei adipösen Patienten auch schlafbezogene Atmungsstörungen deutlich reduziert, informiert der Hersteller in einer Vorab-Meldung zum Studienausgang.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.