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Tytuł pozycji:

How should a physician approach the pharmacological management of chronic thromboembolic pulmonary hypertension?

Tytuł:
How should a physician approach the pharmacological management of chronic thromboembolic pulmonary hypertension?
Autorzy:
Tian Z; Department of Cardiology, Key Laboratory of Pulmonary Vascular Medicine, Peking Union Medical College Hospital, Chinese Academy Medical Sciences, Beijing, China.
Jiang X; Department of Cardiology, Key Laboratory of Pulmonary Vascular Medicine, Peking Union Medical College Hospital, Chinese Academy Medical Sciences, Beijing, China.
Jing ZC; Head of Cardiology Department, Key Laboratory of Pulmonary Vascular Medicine, Peking Union Medical College Hospital, Chinese Academy Medical Sciences, Beijing, China.
Źródło:
Expert opinion on pharmacotherapy [Expert Opin Pharmacother] 2021 Apr; Vol. 22 (5), pp. 557-563. Date of Electronic Publication: 2020 Oct 05.
Typ publikacji:
Journal Article
Język:
English
Imprint Name(s):
Publication: London : Informa Healthcare
Original Publication: London : Ashley Publications, c1999-
MeSH Terms:
Hypertension, Pulmonary*/drug therapy
Hypertension, Pulmonary*/etiology
Physicians*
Pulmonary Embolism*/complications
Pulmonary Embolism*/drug therapy
Chronic Disease ; Endarterectomy ; Humans
Contributed Indexing:
Keywords: Anticoagulation; balloon pulmonary angioplasty; chronic thromboembolic pulmonary hypertension; medical therapy; pulmonary endarterectomy; riociguat
Entry Date(s):
Date Created: 20201005 Date Completed: 20210427 Latest Revision: 20220421
Update Code:
20240105
DOI:
10.1080/14656566.2020.1828349
PMID:
33016151
Czasopismo naukowe
Introduction: Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by the presence of organized thromboembolic material and proliferative fibrous intima occluding varying degrees of the pulmonary arteries, and is also accompanied by small vessel vasculopathy in occluded and non-occluded pulmonary vasculature. The similarity in hemodynamics and pathophysiology between CTEPH and group 1 pulmonary arterial hypertension provides the rationale for clinical use of pulmonary arterial hypertension (PAH)-specific therapy.
Areas Covered: The authors present the current knowledge concerning the updated therapeutic strategies in CTEPH, and try to illustrate the established and uncertain role of PAH-specific therapy and anticoagulation therapy. The real-world observational registries and landmark randomized controlled trials of PAH-specific drugs in CTEPH are emphasized in the manuscript.
Expert Opinion: Despite surgical and interventional therapies, which could provide effective and potential curable treatments, medical therapies are still the substantial and irreplaceable option for patients with CTEPH. More and more PAH-specific drugs have demonstrated favorable efficacy and safety profiles in patients with CTEPH. Additionally, anticoagulation therapy is also a substantial medical treatment in all CTEPH patients without contradiction. However, the benefit-to-risk balance in life-long anticoagulation and whether more individualized anticoagulation strategies are needed warrants further investigation.

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