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3. Chronische trombo-embolische pulmonale hypertensie

Author

Surie, S., van Delden, O. M., Kloek, J. J., Bresser, P., Pulmonology, Amsterdam Cardiovascular Sciences, Amsterdam Gastroenterology Endocrinology Metabolism, Cancer Center Amsterdam, Radiology and Nuclear Medicine, Cardiothoracic Surgery, and Other departments

Abstract

Chronic thrombo-embolic pulmonary hypertension (CTEPH) was diagnosed in two patients, a man aged 55 years and a woman aged 54 years, who had both suffered an episode of pulmonary embolism. CTEPH is a rare but serious late complication of pulmonary embolism. If left untreated, it is a progressive disease with a poor prognosis. Pulmonary endarterectomy is the treatment of choice for CTEPH; both patients were treated successfully with this operation. In clinical practice patients are often initially misdiagnosed, due to unawareness of the condition, and are therefore subjected to a long delay before treatment. In the first patient the condition had not been recognised on CT scans. The second patient had initially been treated with psychotherapy for a suspected burn-out. All physicians involved in taking care of patients with pulmonary embolism, must be aware of this serious complication. Diagnosis and treatment of CTEPH require a high level of expertise

Published
2010

4. Bosentan in pulmonary arterial hypertension: a comparison between congenital heart disease and chronic pulmonary embolism.

Author

Duffels, M.G., Plas, M.N. van der, Surie, S., Winter, M.M., Bouma, B., Groenink, M., Dijk, A.P.J. van, Hoendermis, E.S., Berger, R.M., Bresser, P., Mulder, B.J., Duffels, M.G., Plas, M.N. van der, Surie, S., Winter, M.M., Bouma, B., Groenink, M., Dijk, A.P.J. van, Hoendermis, E.S., Berger, R.M., Bresser, P., and Mulder, B.J.

Abstract

Contains fulltext : 80796.pdf (publisher's version ) (Closed access), Background. In patients with pulmonary hypertension, it is unknown whether the treatment effect of bosentan is dependent on the duration of pulmonary vessel changes. Therefore, we studied the response to bosentan in patients with life-long pulmonary vessel changes (pulmonary arterial hypertension (PAH) due to congenital heart disease (CHD)) and in patients with subacutely induced pulmonary vessel changes (chronic thromboembolic pulmonary hypertension (CTEPH)).Methods. In this open-label study, 18 patients with PAH due to CHD and 16 patients with CTEPH were treated with bosentan for at least one year. All patients were evaluated at baseline and during follow-up by means of the six-minute walk distance (6-MWD) and laboratory tests.Results. Improvement of 6-MWD was comparable in patients with PAH due to CHD (444+/-112 m to 471+/-100 m, p=0.02), and in CTEPH (376+/-152 m to 423+/-141 m, p=0.03) after three months of treatment. After this improvement, 6-MWD stabilised in both groups.Conclusion. Although duration of pulmonary vessel changes is strikingly different in patients with PAH due to CHD and CTEPH, the effect of one year of bosentan treatment was comparable. The main treatment effect appears to be disease stabilisation and decreasing the rate of deterioration. (Neth Heart J 2009;17:334-8.).

Published
2009

5. Duration of right ventricular contraction predicts the efficacy of bosentan treatment in patients with pulmonary hypertension.

Author

Duffels, M.G., Hardziyenka, M., Surie, S., Bruin-Bon, R.H. de, Hoendermis, E.S., Dijk, A.P.J. van, Bouma, B.J., Tan, H.L., Berger, R.M., Bresser, P., Mulder, B.J., Duffels, M.G., Hardziyenka, M., Surie, S., Bruin-Bon, R.H. de, Hoendermis, E.S., Dijk, A.P.J. van, Bouma, B.J., Tan, H.L., Berger, R.M., Bresser, P., and Mulder, B.J.

Abstract

Contains fulltext : 80922.pdf (publisher's version ) (Closed access), AIMS: In patients with pulmonary hypertension (PH), elevated endothelin-1 levels are associated with prolonged duration of right ventricular (RV) contraction, which induces leftward ventricular septal bowing with impaired left diastolic filling. We hypothesized that baseline RV contraction duration predicts efficacy of endothelin receptor antagonist, bosentan. METHODS AND RESULTS: Eighteen PH patients (age 57, range 35-79 years, 33% male) received bosentan. Six minute walk distance (6-MWD) and echocardiography were performed at baseline and after 1 year follow-up. After 1 year of treatment, 6-MWD increased (mean 60 +/- 41 m) in 67% of patients (responders). Baseline RV contraction duration was longer in responders, compared with non-responders (612 +/- 66 vs. 514 +/- 23 ms; P < 0.01). A baseline RV contraction duration >550 ms was associated with improved 6-MWD (sensitivity 83%, specificity 83%; P < 0.01). CONCLUSION: An improvement of 6-MWD during bosentan treatment was associated with a decrease in RV contraction duration and could be predicted by a baseline RV contraction duration >550 ms.

Published
2009

7. Poster session III * Friday 10 December 2010, 08:30-12:30

Author

Guldbrand, D., primary, Goetzsche, O., additional, Eika, B., additional, Watanabe, N., additional, Taniguchi, M., additional, Akagi, T., additional, Koide, N., additional, Sano, S., additional, Orbovic, B., additional, Obrenovic-Kircanski, B., additional, Ristic, S., additional, Soskic, L. J., additional, Alhabshan, F., additional, Jijeh, A., additional, Abo Remsh, H., additional, Alkhaldi, A., additional, Najm, H. K., additional, Gasior, Z., additional, Skowerski, M., additional, Kulach, A., additional, Szymanski, L., additional, Sosnowski, M., additional, Wang, M., additional, Siu, C. W., additional, Lee, K., additional, Yue, W. S., additional, Yan, G. H., additional, Lee, S., additional, Lau, C. P., additional, Tse, H. F., additional, O'connor, K., additional, Rosca, M., additional, Magne, J., additional, Romano, G., additional, Moonen, M., additional, Pierard, L. A., additional, Lancellotti, P., additional, Floria, M., additional, De Roy, L., additional, Blommaert, D., additional, Jamart, J., additional, Dormal, F., additional, Lacrosse, M., additional, Arsenescu Georgescu, C., additional, Mizariene, V., additional, Bucyte, S., additional, Bertasiute, A., additional, Pociute, E., additional, Zaliaduonyte-Peksiene, D., additional, Baronaite-Dudoniene, K., additional, Sileikiene, R., additional, Vaskelyte, J., additional, Jurkevicius, R., additional, Dencker, M., additional, Thorsson, O., additional, Karlsson, M. K., additional, Linden, C., additional, Wollmer, P., additional, Andersen, L. B., additional, Catalano, O., additional, Perotti, M. R., additional, Colombo, E., additional, De Giorgi, M., additional, Cattaneo, M., additional, Cobelli, F., additional, Priori, S. G., additional, Ober, C., additional, Iancu Adrian, I. A., additional, Andreea Parv, P. A., additional, Cadis Horatiu, C. H., additional, Ober Mihai, O. M., additional, Chmielecki, M., additional, Fijalkowski, M., additional, Galaska, R., additional, Dubaniewicz, W., additional, Lewicki, L., additional, Targonski, R., additional, Ciecwierz, D., additional, Puchalski, W., additional, Koprowski, A., additional, Rynkiewicz, A., additional, Hristova, K., additional, La Gerche, A., additional, Katova, T. Z., additional, Kostova, V., additional, Simova, Y., additional, Kempny, A., additional, Diller, G. P., additional, Orwat, S., additional, Kaleschke, G., additional, Kerckhoff, G., additional, Schmidt, R., additional, Radke, R. M., additional, Baumgartner, H., additional, Smarz, K., additional, Zaborska, B., additional, Jaxa-Chamiec, T., additional, Maciejewski, P., additional, Budaj, A., additional, Kiotsekoglou, A., additional, Govind, S. C., additional, Gadiyaram, V., additional, Moggridge, J. C., additional, Govindan, M., additional, Gopal, A. S., additional, Ramesh, S. S., additional, Brodin, L. A., additional, Saha, S. K., additional, Ramzy, I. S., additional, Lindqvist, P., additional, Lam, Y. Y., additional, Duncan, A. M., additional, Henein, M. Y., additional, Craciunescu, I. S., additional, Serban, M., additional, Iancu, M., additional, Revnic, C., additional, Popescu, B. A., additional, Alexandru, D., additional, Rogoz, D., additional, Uscatescu, V., additional, Ginghina, C., additional, Careri, G., additional, Di Monaco, A., additional, Nerla, R., additional, Tarzia, P., additional, Lamendola, P., additional, Sestito, A., additional, Lanza, G. A., additional, Crea, F., additional, Giannini, F., additional, Pinamonti, B., additional, Santangelo, S., additional, Perkan, A., additional, Vitrella, G., additional, Rakar, S., additional, Merlo, M., additional, Della Grazia, E., additional, Salvi, A., additional, Sinagra, G., additional, Scislo, P., additional, Kochanowski, J., additional, Piatkowski, R., additional, Roik, M., additional, Postula, M., additional, Opolski, G., additional, Castillo, J., additional, Herszkowicz, N., additional, Ferreira, C., additional, Lonnebakken, M. T., additional, Staal, E. M., additional, Nordrehaug, J. E., additional, Gerdts, E., additional, Przewlocka-Kosmala, M., additional, Orda, A., additional, Karolko, B., additional, Bajraktari, G., additional, Gustafsson, U., additional, Holmgren, A., additional, Frattini, S., additional, Faggiano, P., additional, Zilioli, V., additional, Locantore, E., additional, Longhi, S., additional, Bellandi, F., additional, Faden, G., additional, Triggiani, M., additional, Dei Cas, L., additional, Seo, S. M., additional, Jung, H. O., additional, An, S. H., additional, Jung, S. Y., additional, Park, C. S., additional, Jeon, H. K., additional, Youn, H. J., additional, Chung, W. B., additional, Kim, J. H., additional, Uhm, J. S., additional, Mampuya, W., additional, Brochu, M. C., additional, Do, D. H., additional, Essadiqi, B., additional, Farand, P., additional, Lepage, S., additional, Daly, M. J., additional, Monaghan, M., additional, Hamilton, A., additional, Lockhart, C., additional, Kodoth, V., additional, Maguire, C., additional, Morton, A., additional, Manoharan, G., additional, Spence, M. S., additional, Streb, W., additional, Mitrega, K., additional, Nowak, J., additional, Duszanska, A., additional, Szulik, M., additional, Kalinowski, M., additional, Kukulski, T., additional, Kalarus, Z., additional, Calvo Iglesias, F. E., additional, Solla-Ruiz, I., additional, Villanueva-Benito, I., additional, Paredes-Galan, E., additional, Bravo-Amaro, M., additional, Iniguez-Romo, A., additional, Yildirimturk, O., additional, Helvacioglu, F. F., additional, Tayyareci, Y., additional, Yurdakul, S., additional, Demiroglu, I. C., additional, Aytekin, S., additional, Enache, R., additional, Piazza, R., additional, Muraru, D., additional, Roman-Pognuz, A., additional, Calin, A., additional, Leiballi, E., additional, Antonini-Canterin, F., additional, Nicolosi, G. L., additional, Ridard, C., additional, Bellouin, A., additional, Thebault, C., additional, Laurent, M., additional, Donal, E., additional, Sutandar, A., additional, Siswanto, B. B., additional, Irmalita, I., additional, Harimurti, G., additional, Saxena, A., additional, Ramakrishnan, S., additional, Roy, A., additional, Krishnan, A., additional, Misra, P., additional, Bhargava, B., additional, Poole-Wilson, P. A., additional, Loegstrup, B. B., additional, Andersen, H. R., additional, Poulsen, S. H., additional, Klaaborg, K. E., additional, Egeblad, H. E., additional, Gu, X., additional, Gu, X. Y., additional, He, Y. H., additional, Li, Z. A., additional, Han, J. C., additional, Chen, J., additional, Mansencal, N., additional, Mitry, E., additional, Rougier, P., additional, Dubourg, O., additional, Villarraga, H., additional, Adjei-Twum, K., additional, Cudjoe, T. K. M., additional, Clavell, A., additional, Schears, R. M., additional, Cabrera Bueno, F., additional, Molina Mora, M. J., additional, Fernandez Pastor, J., additional, Linde Estrella, A., additional, Pena Hernandez, J. L., additional, Isasti Aizpurua, G., additional, Carrasco Chinchilla, F., additional, Barrera Cordero, A., additional, Alzueta Rodriguez, F. J., additional, De Teresa Galvan, E., additional, Gaetano Contegiacomo, G. C., additional, Francesco Pollice, F. P., additional, Paolo Pollice, P. P., additional, Kontos, M. C., additional, Shin, D. H., additional, Yoo, S. Y., additional, Lee, C. K., additional, Jang, J. K., additional, Jung, S. I., additional, Song, S. I., additional, Seo, S. I., additional, Cheong, S. S., additional, Peteiro, J., additional, Perez-Perez, A., additional, Bouzas-Mosquera, A., additional, Pineiro, M., additional, Pazos, P., additional, Campo, R., additional, Castro-Beiras, A., additional, Gaibazzi, N., additional, Rigo, F., additional, Sartorio, D., additional, Reverberi, C., additional, Sitia, S., additional, Tomasoni, L., additional, Gianturco, L., additional, Ghio, L., additional, Stella, D., additional, Greco, P., additional, De Gennaro Colonna, V., additional, Turiel, M., additional, Cicala, S., additional, Magagnin, V., additional, Caiani, E., additional, Kyrzopoulos, S., additional, Tsiapras, D., additional, Domproglou, G., additional, Avramidou, E., additional, Voudris, V., additional, Wierzbowska-Drabik, K., additional, Lipiec, P., additional, Chrzanowski, L., additional, Roszczyk, N., additional, Kupczynska, K., additional, Kasprzak, J. D., additional, Sachpekidis, V., additional, Bhan, A., additional, Gianstefani, S., additional, Reiken, J., additional, Paul, M., additional, Pearson, P., additional, Harries, D., additional, Monaghan, M. J., additional, Dale, K., additional, Stoylen, A., additional, Kodali, V., additional, Toole, R., additional, Raju, P., additional, Mcintosh, R. A., additional, Silberbauer, J., additional, Baumann, O., additional, Patel, N. R., additional, Sulke, N., additional, Trivedi, U., additional, Hyde, J., additional, Venn, G., additional, Lloyd, G., additional, Wejner-Mik, P., additional, Wierzbowska, K., additional, Lowenstein, J. A., additional, Caniggia, C., additional, Garcia, A., additional, Amor, M., additional, Casso, N., additional, Lowenstein Haber, D., additional, Porley, C., additional, Zambrana, G., additional, Daru, V., additional, Deljanin Ilic, M., additional, Ilic, S., additional, Kalimanovska Ostric, D., additional, Stoickov, V., additional, Zdravkovic, M., additional, Paraskevaidis, I., additional, Ikonomidis, I., additional, Parissis, J., additional, Papadopoulos, C., additional, Stasinos, V., additional, Bistola, V., additional, Anastasiou-Nana, M., additional, Gudin Uriel, M., additional, Balaguer Malfagon, J. R., additional, Perez Bosca, J. L., additional, Ridocci Soriano, F., additional, Martinez Alzamora, N., additional, Paya Serrano, R., additional, Ciampi, Q., additional, Pratali, L., additional, Della Porta, M., additional, Petruzziello, B., additional, Villari, B., additional, Picano, E., additional, Sicari, R., additional, Rosner, A., additional, Avenarius, D., additional, Malm, S., additional, Iqbal, A., additional, Baltabaeva, A., additional, Sutherland, G. R., additional, Bijnens, B., additional, Myrmel, T., additional, Andersen, M., additional, Gustafsson, F., additional, Secher, N. H., additional, Brassard, P., additional, Jensen, A. S., additional, Hassager, C., additional, Madsen, P. L., additional, Moller, J. E., additional, Coutu, M., additional, Greentree, D., additional, Normandin, D., additional, Brun, H., additional, Dipchand, A., additional, Koopman, L., additional, Fackoury, C. T., additional, Truong, S., additional, Manlhiot, C., additional, Mertens, L., additional, Baroni, M., additional, Mariani, M., additional, Chabane, H. K., additional, Berti, S., additional, Ripoli, A., additional, Storti, S., additional, Glauber, M., additional, Scopelliti, P. A., additional, Antongiovanni, G. B., additional, Personeni, D., additional, Saino, A., additional, Tespili, M., additional, Jung, P., additional, Mueller, M., additional, Jander, F., additional, Sohn, H. Y., additional, Rieber, J., additional, Schneider, P., additional, Klauss, V., additional, Agricola, E., additional, Slavich, M., additional, Stella, S., additional, Ancona, M., additional, Oppizzi, M., additional, Bertoglio, L., additional, Melissano, G., additional, Margonato, A., additional, Chiesa, R., additional, Cejudo Diaz Del Campo, L., additional, Mesa Rubio, D., additional, Ruiz Ortiz, M., additional, Delgado Ortega, M., additional, Villanueva Fernandez, E., additional, Lopez Aguilera, J., additional, Toledano Delgado, F., additional, Pan Alvarez-Ossorio, M., additional, Suarez De Lezo Cruz Conde, J., additional, Lafuente, M., additional, Butz, T., additional, Meissner, A., additional, Lang, C. N., additional, Prull, M. W., additional, Plehn, G., additional, Trappe, H. J., additional, Nair, S. V., additional, Lee, L., additional, Mcleod, I., additional, Whyte, G., additional, Shrimpton, J., additional, Hildick Smith, D., additional, James, P. R., additional, Slikkerveer, J., additional, Appelman, Y. E. A., additional, Veen, G., additional, Porter, T. R., additional, Kamp, O., additional, Colonna, P., additional, Ten Cate, F. J., additional, Bokor, D., additional, Daponte, A., additional, Cocciolo, M., additional, Bona, M., additional, Sacchi, S., additional, Becher, H., additional, Chai, S. C., additional, Tan, P. J., additional, Goh, Y. S., additional, Ong, S. H., additional, Chow, J., additional, Lee, L. L., additional, Goh, P. P., additional, Tong, K. L., additional, Kakihara, R., additional, Naruse, C., additional, Hironaka, H., additional, Tsuzuku, T., additional, Ozawa, K., additional, Tomaszuk-Kazberuk, A., additional, Sobkowicz, B., additional, Malyszko, J., additional, Malyszko, J. S., additional, Sawicki, R., additional, Hirnle, T., additional, Dobrzycki, S., additional, Mysliwiec, M., additional, Musial, W. J., additional, Mathias, W., additional, Kowatsch, I., additional, Saroute, A. L. R., additional, Osorio, A. F. F., additional, Sbano, J. C. N., additional, Ramires, J. A. F., additional, Tsutsui, J. M., additional, Sakata, K., additional, Ito, H., additional, Ishii, K., additional, Sakuma, T., additional, Iwakura, K., additional, Yoshino, H., additional, Yoshikawa, J., additional, Shahgaldi, K., additional, Lopez, A., additional, Fernstrom, B., additional, Sahlen, A., additional, Winter, R., additional, Kovalova, S., additional, Necas, J., additional, Amundsen, B. H., additional, Jasaityte, R., additional, Kiss, G., additional, Barbosa, D., additional, D'hooge, J., additional, Torp, H., additional, Szmigielski, C. A., additional, Newton, J. D., additional, Rajpoot, K., additional, Noble, J. A., additional, Kerber, R., additional, Koopman, L. P., additional, Slorach, C., additional, Chahal, N., additional, Hui, W., additional, Sarkola, T., additional, Bradley, T. J., additional, Jaeggi, E. T., additional, Mccrindle, B. W., additional, Staron, A., additional, Jasinski, M., additional, Wos, S., additional, Sengupta, P., additional, Hayat, D., additional, Kloeckner, M., additional, Nahum, J., additional, Dussault, C., additional, Dubois Rande, J. L., additional, Gueret, P., additional, Lim, P., additional, King, G. J., additional, Brown, A., additional, Ho, E., additional, Amuntaser, I., additional, Bennet, K., additional, Mc Elhome, N., additional, Murphy, R. T., additional, Cooper, R. M., additional, Somauroo, J. D., additional, Shave, R. E., additional, Williams, K. L., additional, Forster, J., additional, George, C., additional, Bett, T., additional, George, K. P., additional, D'andrea, A., additional, Riegler, L., additional, Cocchia, R., additional, Golia, E., additional, Gravino, R., additional, Salerno, G., additional, Citro, R., additional, Caso, P. I. O., additional, Bossone, E., additional, Calabro', R., additional, Crispi, F., additional, Figueras, F., additional, Bartrons, J., additional, Eixarch, E., additional, Le Noble, F., additional, Ahmed, A., additional, Gratacos, E., additional, Shang, Q., additional, Yip, W. K., additional, Tam, L. S., additional, Zhang, Q., additional, Li, C. M., additional, Wang, T., additional, Ma, C. Y., additional, Li, K. M., additional, Yu, C. M., additional, Dahlslett, T., additional, Helland, I., additional, Edvardsen, T., additional, Skulstad, H., additional, Magda, L. S., additional, Florescu, M., additional, Ciobanu, A., additional, Dulgheru, R., additional, Mincu, R., additional, Vinereanu, D., additional, Luckie, M., additional, Chacko, S., additional, Nair, S., additional, Mamas, M., additional, Khattar, R. S., additional, El-Omar, M., additional, Kuch-Wocial, A., additional, Pruszczyk, P., additional, Szulc, M., additional, Styczynski, G., additional, Sinski, M., additional, Kaczynska, A., additional, Vela, Z., additional, Haliti, E., additional, Hyseni, V., additional, Olloni, R., additional, Rexhepaj, N., additional, Elezi, S., additional, Onaindia, J. J., additional, Quintana, O., additional, Cacicedo, A., additional, Velasco, S., additional, Alarcon, J. J., additional, Morillas, M., additional, Rumoroso, J. R., additional, Zumalde, J., additional, Lekuona, I., additional, Laraudogoitia Zaldumbide, E., additional, Poniku, A., additional, Ahmeti, A., additional, Duncan, R. F., additional, Mccomb, J. M., additional, Pemberton, J., additional, Lord, S. W., additional, Leong, D., additional, Plummer, C., additional, Macgowan, G., additional, Grubb, N., additional, Leung, M., additional, Kenny, A., additional, Prinz, C., additional, Voigt, J. U., additional, Zaidi, A., additional, Heatley, M., additional, Abildstrom, S. Z., additional, Hvelplund, A., additional, Berning, J., additional, Govind, S., additional, Brodin, L., additional, Gopal, A., additional, Castaldi, B., additional, Di Salvo, G., additional, Santoro, G., additional, Gaio, G., additional, Palladino, M. T., additional, Iacono, C., additional, Pacileo, G., additional, Russo, M. G., additional, Calabro, R., additional, Wang, Y. S., additional, Dong, L. L., additional, Shu, X. H., additional, Pan, C. Z., additional, Zhou, D. X., additional, Sen, T., additional, Tufekcioglu, O., additional, Ozdemir, M., additional, Tuncez, A., additional, Uygur, B., additional, Golbasi, Z., additional, Kisacik, H., additional, Delfino, L., additional, De Leo, F. D., additional, Chiappa, L. C., additional, Abdel Ghani, B., additional, Schiavina, R., additional, Salvade, P., additional, Morganti, A., additional, Bedogni, F., additional, Mahia, P., additional, Gutierrez, L., additional, Pineda, V., additional, Garcia, B., additional, Otaegui, I., additional, Rodriguez, J. F., additional, Gonzalez, M. T., additional, Descalzo, M., additional, Evangelista, A., additional, Garcia-Dorado, D., additional, Bruin De- Bon, H. A. C. M., additional, Van Den Brink, R. B. A., additional, Surie, S., additional, Bresser, P., additional, Vleugels, J., additional, Eckmann, H. M., additional, Samson, D. A., additional, Bouma, B. J., additional, Dedobbeleer, C., additional, Antoine, M., additional, Remmelink, M., additional, Unger, P., additional, Roosens, B., additional, Hmila, I., additional, Hernot, S., additional, Droogmans, S., additional, Van Camp, G., additional, Lahoutte, T., additional, Muyldermans, S., additional, Cosyns, B., additional, Feltes, G., additional, Serra, V., additional, Azevedo, O., additional, Barbado, J., additional, Herrera, J., additional, Rivera, A., additional, Paniagua, J., additional, Valverde, V., additional, Torras, J., additional, Arriba, G., additional, Christodoulides, T., additional, Ioannides, M., additional, Simamonian, K., additional, Yiangou, K., additional, Myrianthefs, M., additional, Nicolaides, E., additional, Pandolfo, M., additional, Kleijn, S. A., additional, Aly, M. F. A. A., additional, Terwee, C. B., additional, Van Rossum, A. C., additional, Delgado, V., additional, Shanks, M., additional, Siebelink, H. M., additional, Sieders, A., additional, Lamb, H., additional, Ajmone Marsan, N., additional, Westenberg, J., additional, De Roos, A., additional, Schuijf, J. D., additional, Bax, J. J., additional, Anwar, A. M., additional, Nosir, Y., additional, Chamsi-Pasha, H., additional, Tschernich, H. D., additional, Seeburger, J., additional, Borger, M., additional, Mukherjee, C., additional, Mohr, F. W., additional, Ender, J., additional, Obase, K., additional, Okura, H., additional, Yamada, R., additional, Miyamoto, Y., additional, Saito, K., additional, Imai, K., additional, Hayashida, A., additional, and Yoshida, K., additional

Published
2010
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12. Pulmonary endarterectomy normalizes interventricular dyssynchrony and right ventricular systolic wall stress

Author

Mauritz Gert-Jan, Vonk-Noordegraaf Anton, Kind Taco, Surie Sulaiman, Kloek Jaap J, Bresser Paul, Saouti Nabil, Bosboom Joachim, Westerhof Nico, and Marcus J Tim

Subjects
Chronic Thrombo-Embolic Pulmonary Hypertension, Pulmonary Endarterectomy, interventricular mechanical asynchrony, myocardial strain, wall stress, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Background Interventricular mechanical dyssynchrony is a characteristic of pulmonary hypertension. We studied the role of right ventricular (RV) wall stress in the recovery of interventricular dyssynchrony, after pulmonary endarterectomy (PEA) in chronic thromboembolic pulmonary hypertension (CTEPH). Methods In 13 consecutive patients with CTEPH, before and 6 months after pulmonary endarterectomy, cardiovascular magnetic resonance myocardial tagging was applied. For the left ventricular (LV) and RV free walls, the time to peak (Tpeak) of circumferential shortening (strain) was calculated. Pulmonary Artery Pressure (PAP) was measured by right heart catheterization within 48 hours of PEA. Then the RV free wall systolic wall stress was calculated by the Laplace law. Results After PEA, the left to right free wall delay (L-R delay) in Tpeak strain decreased from 97 ± 49 ms to -4 ± 51 ms (P < 0.001), which was not different from normal reference values of -35 ± 10 ms (P = 0.18). The RV wall stress decreased significantly from 15.2 ± 6.4 kPa to 5.7 ± 3.4 kPa (P < 0.001), which was not different from normal reference values of 5.3 ± 1.39 kPa (P = 0.78). The reduction of L-R delay in Tpeak was more strongly associated with the reduction in RV wall stress (r = 0.69,P = 0.007) than with the reduction in systolic PAP (r = 0.53, P = 0.07). The reduction of L-R delay in Tpeak was not associated with estimates of the reduction in RV radius (r = 0.37,P = 0.21) or increase in RV systolic wall thickness (r = 0.19,P = 0.53). Conclusion After PEA for CTEPH, the RV and LV peak strains are resynchronized. The reduction in systolic RV wall stress plays a key role in this resynchronization.

Published
2012
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15. Higher plasma interleukin - 6 levels are associated with lung cavitation in drug-resistant tuberculosis.

Author

Maseko TG, Ngubane S, Letsoalo M, Rambaran S, Archary D, Samsunder N, Perumal R, Chinappa S, Padayatchi N, Naidoo K, and Sivro A

Subjects
Humans, Adult, Male, Female, Lung pathology, HIV Infections pathology, Coinfection pathology, Tuberculosis, Multidrug-Resistant immunology, Tuberculosis, Multidrug-Resistant pathology, Interleukin-6 blood, Interleukin-6 immunology
Abstract

Background: Lung cavitation is associated with heightened TB transmission and poor treatment outcomes. This study aimed to determine the relationship between systemic inflammation and lung cavitation in drug-resistant TB patients with and without HIV co-infection., Methods: Plasma samples were obtained from 128 participants from the CAPRISA 020 Individualized M(X)drug-resistant TB Treatment Strategy Study (InDEX) prior to treatment initiation. Lung cavitation was present in 61 of the 128 drug-resistant TB patients with 93 being co-infected with HIV. The plasma cytokine and chemokine levels were measured using the 27-Plex Human Cytokine immunoassay. Modified Poisson regression models were used to determine the association between plasma cytokine/chemokine expression and lung cavitation in individuals with drug-resistant TB., Results: Higher Interleukin-6 plasma levels (adjusted risk ratio [aRR] 1.405, 95% confidence interval [CI] 1.079-1.829, p = 0.011) were associated with a higher risk of lung cavitation in the multivariable model adjusting for age, sex, body mass index, HIV status, smoking and previous history of TB. Smoking was associated with an increased risk of lung cavitation (aRR 1.784, 95% CI 1.167-2.729, p = 0.008). An HIV positive status and a higher body mass index, were associated with reduced risk of lung cavitation (aRR 0.537, 95% CI 0.371-0.775, p = 0.001 and aRR 0.927, 95% CI 0.874-0.983, p = 0.012 respectively)., Conclusion: High plasma interleukin-6 levels are associated with an increased risk of cavitary TB highlighting the role of interleukin-6 in the immunopathology of drug-resistant TB., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Published
2023
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16. Ethical and policy considerations for COVID-19 vaccination modalities: delayed second dose, fractional dose, mixed vaccines.

Author

Wolff J, Atuire C, Bhan A, Emanuel E, Faden R, Ghimire P, Greco D, Ho CWL, Kochhar S, Moon S, Schaefer OG, Shamsi-Gooshki E, Singh JA, Smith MJ, Thomé B, Touré A, and Upshar R

Subjects
Humans, Immunization Schedule, Time Factors, COVID-19 Vaccines administration & dosage, Health Policy, Vaccination ethics, Vaccination methods
Abstract

Competing Interests: Competing interests: None declared.

Published
2021
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17. Effect of pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension on stroke volume response to exercise.

Author

Surie S, van der Plas MN, Marcus JT, Kind T, Kloek JJ, Vonk-Noordegraaf A, and Bresser P

Subjects
Angiography, Cardiac Catheterization, Case-Control Studies, Chronic Disease, Exercise Test, Female, Heart Rate physiology, Humans, Hydrogen-Ion Concentration, Magnetic Resonance Imaging, Male, Middle Aged, Oxygen Consumption physiology, Treatment Outcome, Vascular Resistance physiology, Endarterectomy methods, Exercise Tolerance physiology, Hypertension, Pulmonary physiopathology, Hypertension, Pulmonary surgery, Pulmonary Embolism physiopathology, Pulmonary Embolism surgery
Abstract

In pulmonary hypertension, exercise is limited by an impaired right ventricular (RV) stroke volume response. We hypothesized that improvement in exercise capacity after pulmonary endarterectomy (PEA) for chronic thromboembolic pulmonary hypertension (CTEPH) is paralleled by an improved RV stroke volume response. We studied the extent of PEA-induced restoration of RV stroke volume index (SVI) response to exercise using cardiac magnetic resonance imaging (cMRI). Patients with CTEPH (n = 18) and 7 healthy volunteers were included. Cardiopulmonary exercise testing and cMRI were performed before and 1 year after PEA. For cMRI studies, pre- and post-operatively, all patients exercised at 40% of their preoperative cardiopulmonary exercise testing-assessed maximal workload. Post-PEA patients (n = 13) also exercised at 40% of their postoperative maximal workload. Control subjects exercised at 40% of their predicted maximal workload. Preoperatively, SVI (n = 18) decreased during exercise from 35.9 ± 7.4 to 33.0 ± 9.0 ml·m(2) (p = 0.023); in the control subjects, SVI increased (46.6 ± 7.6 vs 57.9 ± 11.8 ml·m(-2), p = 0.001). After PEA, the SVI response (ΔSVI) improved from -2.8 ± 4.6 to 4.0 ± 4.6 ml·m(2) (p <0.001; n = 17). On exercise at 40% of the postoperative maximal workload, SVI did not increase further and was still significantly lower compared with controls. Moreover, 4 patients retained a negative SVI response, despite (near) normalization of their pulmonary hemodynamics. The improvement in SVI response was accompanied by an increased exercise tolerance and restoration of RV remodeling. In conclusion, in CTEPH, exercise is limited by an impaired stroke volume response. PEA induces a restoration of SVI response to exercise that appears, however, incomplete and not evident in all patients., (Copyright © 2014 Elsevier Inc. All rights reserved.)

Published
2014
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18. Bosentan treatment is associated with improvement of right ventricular function and remodeling in chronic thromboembolic pulmonary hypertension.

Author

Surie S, Reesink HJ, Marcus JT, van der Plas MN, Kloek JJ, Vonk-Noordegraaf A, and Bresser P

Subjects
Aged, Bosentan, Endarterectomy, Exercise Test, Exercise Tolerance drug effects, Female, Humans, Hypertension, Pulmonary diagnosis, Hypertension, Pulmonary etiology, Hypertension, Pulmonary physiopathology, Hypertrophy, Right Ventricular diagnosis, Hypertrophy, Right Ventricular etiology, Hypertrophy, Right Ventricular physiopathology, Magnetic Resonance Imaging, Male, Middle Aged, Netherlands, Pilot Projects, Pulmonary Embolism complications, Pulmonary Embolism diagnosis, Pulmonary Embolism physiopathology, Recovery of Function, Single-Blind Method, Time Factors, Treatment Outcome, Ventricular Dysfunction, Right diagnosis, Ventricular Dysfunction, Right etiology, Ventricular Dysfunction, Right physiopathology, Ventricular Function, Left drug effects, Waiting Lists, Antihypertensive Agents therapeutic use, Hypertension, Pulmonary drug therapy, Hypertrophy, Right Ventricular drug therapy, Pulmonary Embolism drug therapy, Sulfonamides therapeutic use, Ventricular Dysfunction, Right drug therapy, Ventricular Function, Right drug effects, Ventricular Remodeling drug effects
Abstract

Background: Medical pretreatment before pulmonary endarterectomy (PEA) can optimize right ventricular (RV) function and may improve postoperative outcome in high-risk patients. Using cardiac magnetic resonance imaging (cMRI), we determined whether the dual endothelin-1 antagonist bosentan improves RV function and remodeling in patients with chronic thromboembolic pulmonary hypertension (CTEPH) who waited for PEA., Hypothesis: We hypothesized that medical therapy prior to PEA will be associated with improvements in RV remodeling and function., Methods: In this pilot study, 15 operable CTEPH patients were randomly assigned to either bosentan (n = 8) or no bosentan (n = 7, control) for 16 weeks, next to "best standard of care." Both before and after treatment, RV stroke volume index (RVSVI), RV ejection fraction (RVEF), RV mass, RV isovolumic relaxation time (rIVRT), leftward ventricular septal bowing (LVSB), and left ventricular ejection fraction (LVEF) were determined using cMRI., Results: After 16 weeks, the change (Δ) from baseline (median [range]) in the studied cMRI parameters differed significantly between the bosentan group and the controls: Δ RVSVI: 6 [-4-11] vs 1 [-6-3] mL/m(-2) ; Δ RVEF: 8 [-10-15] vs -4 [-7-5]%; Δ RV mass: -3 [-6--2] vs 2 [-1-3] g/m(-2) ; Δ rIVRT: -30 [-130-20] vs 10 [-30-30] msec; Δ LVSB: 0.03 [-0.03-0.13] vs -0.03[-0.08-0.04] cm(-1) ; and Δ LVEF: 8 [-5-17] vs -2 [-14-2]% (all P < 0.05). The change from baseline in mean pulmonary artery pressure (-11 [-17-11] vs 5 [-6-21] mm Hg, P < 0.05) and 6-minute walk distance (20 [3-88] vs -4 [-40-40] m, P < 0.05) also differed significantly., Conclusions: In CTEPH, compared with control, treatment with bosentan for 16 weeks was associated with a significant improvement in cMRI parameters of RV function and remodelling., (© 2013 Wiley Periodicals, Inc.)

Published
2013
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19. Right ventricular pacing improves haemodynamics in right ventricular failure from pressure overload: an open observational proof-of-principle study in patients with chronic thromboembolic pulmonary hypertension.

Author

Hardziyenka M, Surie S, de Groot JR, de Bruin-Bon HA, Knops RE, Remmelink M, Yong ZY, Baan J Jr, Bouma BJ, Bresser P, and Tan HL

Subjects
Adult, Aged, Aged, 80 and over, Cardiac Output physiology, Chronic Disease, Diastole physiology, Electrocardiography, Female, Humans, Male, Middle Aged, Stroke Volume physiology, Ventricular Dysfunction, Right etiology, Cardiac Pacing, Artificial methods, Heart Ventricles physiopathology, Hemodynamics physiology, Hypertension, Pulmonary complications, Thromboembolism complications, Ventricular Dysfunction, Right physiopathology, Ventricular Dysfunction, Right therapy
Abstract

Aims: Right ventricular (RV) failure in patients with chronic thromboembolic pulmonary hypertension (CTEPH), and other types of pulmonary arterial hypertension is associated with right-to-left ventricle (LV) delay in peak myocardial shortening and, consequently, the onset of diastolic relaxation. We aimed to establish whether RV pacing may resynchronize the onsets of RV and LV diastolic relaxation, and improve haemodynamics., Methods and Results: Fourteen CTEPH patients (mean age 63.7 ± 12.0 years, 10 women) with large (≥60 ms) RV-to-LV delay in the onset of diastolic relaxation (DIVD, diastolic interventricular delay) were studied. Temporary RV pacing was performed by atrioventricular (A-V) sequential pacing with incremental shortening of A-V delay to advance RV activation. Effects were assessed using tissue Doppler echocardiography and LV pressure-conductance catheter measurements in a subset of patients. Compared with right atrial pacing, RV pacing at optimal A-V delay (average 140 ± 22 ms, range 120-180 ms) resulted in significant DIVD reduction (59 ± 19 to 3 ± 22 ms, P < 0.001), and increase in LV stroke volume as measured by LV outflow tract velocity-time integral (14.9 ± 2.8 to 16.9 ± 3.0 cm, P < 0.001), along with enhanced global RV contractility and LV diastolic filling., Conclusion: Right-to-left ventricle resynchronization of the onset of diastolic relaxation results in stroke volume increase in CTEPH patients. Whether RV pacing may be a novel therapeutic target in RV failure following chronic pressure overload remains to be investigated.

Published
2011
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20. Time course of restoration of systolic and diastolic right ventricular function after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension.

Author

Surie S, Bouma BJ, Bruin-Bon RA, Hardziyenka M, Kloek JJ, Van der Plas MN, Reesink HJ, and Bresser P

Subjects
Adult, Aged, Chronic Disease, Female, Hemodynamics, Humans, Hypertension, Pulmonary etiology, Male, Middle Aged, Pulmonary Embolism complications, Recovery of Function, Time Factors, Endarterectomy, Hypertension, Pulmonary physiopathology, Hypertension, Pulmonary surgery, Pulmonary Artery surgery, Ventricular Function, Right
Abstract

Background: In chronic thromboembolic pulmonary hypertension, right ventricular (RV) pressure overload causes RV remodeling and dysfunction. Successful pulmonary endarterectomy (PEA) initiates restoration of RV remodeling and global function. Little is known on the restoration of systolic and diastolic RV function. Using transthoracic echocardiography, we studied the time course and extent of postoperative restoration of systolic and diastolic RV function., Methods: In chronic thromboembolic pulmonary hypertension (n = 55, 36 women, age 52 ± 14 years), transthoracic echocardiography was performed before PEA (pre-PEA) and 2 weeks, 3 months, and 1 year postoperatively., Results: Two weeks postoperatively, RV afterload and dimension had decreased significantly, without further improvement during follow-up. Global RV function, expressed by the myocardial performance index, showed a gradual improvement (from pre-PEA 0.58 ± 0.29 to 0.45 ± 0.38, 0.39 ± 0.19, and 0.37 ± 0.18). In contrast, 2 weeks after PEA systolic RV function, as assessed by tricuspid annular plane systolic velocity excursion and peak tricuspid annular systolic velocity of the RV, had worsened, with a subsequent incomplete restoration during follow-up: tricuspid annular plane systolic velocity excursion from 19.3 ± 5.0 to 12.4 ± 2.5, 15.3 ± 3.0, and 16.8 ± 2.9 mm and systolic velocity of the right ventricle from 11.4 ± 3.0 to 9.6 ± 2.0, 10.0 ± 1.8, and 10.3 ± 1.7 cm/s. Postoperative diastolic RV function also showed a biphasic response: tricuspid inflow-to-annulus ratio from 6.1 ± 3.0 to 9.5 ± 3.5, 6.8 ± 2.4, and 6.3 ± 2.2 cm/s. Dynamics and ultimate level of restoration of systolic and diastolic RV function were similar in patients with and without residual pulmonary hypertension., Conclusions: Postoperative reduction in RV afterload caused an immediate improvement in RV dimension and global function. In contrast, systolic and diastolic RV function deteriorated after PEA with subsequently a gradual yet incomplete restoration during 1-year follow-up., (Copyright © 2011 Mosby, Inc. All rights reserved.)

Published
2011
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21. Longitudinal follow-up of six-minute walk distance after pulmonary endarterectomy.

Author

van der Plas MN, Surie S, Reesink HJ, van Steenwijk RP, Kloek JJ, and Bresser P

Subjects
Female, Follow-Up Studies, Humans, Hypertension, Pulmonary etiology, Longitudinal Studies, Male, Middle Aged, Pulmonary Embolism complications, Time Factors, Endarterectomy, Exercise Test methods, Hypertension, Pulmonary surgery, Pulmonary Embolism surgery, Walking
Abstract

Background: The 6-minute walk test is a useful tool to assess functional outcome after pulmonary endarterectomy (PEA) in chronic thromboembolic pulmonary hypertension. However, little is known about the longitudinal dynamics in functional improvement. We performed a longitudinal follow-up of 6-minute walk distance, New York Heart Association functional class, and echocardiography after PEA., Methods: We studied 71 patients with chronic thromboembolic pulmonary hypertension who underwent PEA. A 6-minute walk test and echocardiography were performed before PEA, at 3 months after, and at annual follow-up. At the time of this report, 52 patients had returned for 2-year follow-up, 32 for 3-year follow-up, 23 for 4-year follow-up, and 11 for 5-year follow-up., Results: Preoperatively, the 6-minute walk distance (6-MWD) correlated with hemodynamic severity of disease (mean pulmonary artery pressure: r = -0.55, p < 0.001); total pulmonary resistance: r = -0.59, p < 0.001) After PEA, 6-MWD increased from 440 ± 109 to 524 ± 83 meters at 1 year (n = 71, p < 0.001). Further improvement was observed from 523 ± 87 meters at 1 year to 536 ± 91 meters at 2 years (n = 52, p < 0.012). After 2 years, no further improvement was observed. At 1 year, the change in 6-MWD from baseline correlated significantly with the change observed in pulmonary hemodynamics. Changes in 6-MWD and hemodynamics were more pronounced in patients with residual pulmonary hypertension after PEA, despite the worse absolute outcome., Conclusions: In patients with chronic thromboembolic pulmonary hypertension, 6-MWD showed a gradual improvement up to 2 years after PEA. Patients with residual pulmonary hypertension benefited most from treatment, despite the worse absolute outcome., (Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Published
2011
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22. Chorea in adults following pulmonary endarterectomy.

Author

Surie S, Tijssen MA, Biervliet JD, de Beaumont EM, Kloek JJ, Rutten PM, Smeding HM, Bresser P, and de Bie RM

Subjects
Adult, Circulatory Arrest, Deep Hypothermia Induced adverse effects, Female, Humans, Male, Middle Aged, Pulmonary Embolism surgery, Chorea etiology, Endarterectomy adverse effects, Lung surgery, Postoperative Complications physiopathology
Published
2010
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23. Active search for chronic thromboembolic pulmonary hypertension does not appear indicated after acute pulmonary embolism.

Author

Surie S, Gibson NS, Gerdes VE, Bouma BJ, van Eck-Smit BL, Buller HR, and Bresser P

Subjects
Causality, Comorbidity, Female, Humans, Male, Middle Aged, Netherlands epidemiology, Prevalence, Risk Assessment methods, Risk Factors, Hypertension, Pulmonary diagnosis, Hypertension, Pulmonary epidemiology, Pulmonary Embolism diagnosis, Pulmonary Embolism epidemiology
Abstract

Introduction: Chronic thromboembolic pulmonary hypertension (CTEPH) is a life threatening but often, by pulmonary endarterectomy, curable disease. The incidence of CTEPH after an acute pulmonary embolism (PE) appears to be much higher than previously thought. Systematic follow-up of patients after PE might increase the number of diagnosed CTEPH patients., Aim: To study whether, compared to current clinical practice, a systematic search for CTEPH in patients after acute PE would increase the number of patients diagnosed with symptomatic, potentially treatable CTEPH., Methods: Consecutive patients with a prior diagnosis of acute PE were presented with a questionnaire, designed to establish the presence of either new or worsened dyspnea after the acute PE episode. If so, patients were evaluated for the presence of CTEPH., Results: PE patients (n=110; 56+/-18 years) were included after a median follow-up of three years. Overall mortality was 34% (37 patients); 1 patient had died due to CTEPH. In total 62 out of 69 questionnaires were returned; 23 patients reported new or worsened dyspnea related to the PE episode, and qualified for additional testing. In 2 patients, CTEPH was already diagnosed prior to this study. None of the remaining patients met the criteria for the diagnosis of CTEPH. The overall incidence of 2.7% (3/110; 95%CI 0.6-7.8%) is in agreement with earlier reported incidences., Conclusion: Our findings do not point to a role for a systematic search and pro-active approach towards patients with a recent history of pulmonary embolism to increase the number of patients diagnosed with potentially treatable CTEPH., (Copyright (c) 2009 Elsevier Ltd. All rights reserved.)

Published
2010
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24. [Chronic thrombo-embolic pulmonary hypertension].

Author

Surie S, van Delden OM, Kloek JJ, and Bresser P

Subjects
Endarterectomy, Female, Humans, Hypertension, Pulmonary etiology, Hypertension, Pulmonary surgery, Male, Middle Aged, Prognosis, Pulmonary Embolism complications, Pulmonary Embolism surgery, Treatment Outcome, Hypertension, Pulmonary diagnosis, Pulmonary Embolism diagnosis
Abstract

Chronic thrombo-embolic pulmonary hypertension (CTEPH) was diagnosed in two patients, a man aged 55 years and a woman aged 54 years, who had both suffered an episode of pulmonary embolism. CTEPH is a rare but serious late complication of pulmonary embolism. If left untreated, it is a progressive disease with a poor prognosis. Pulmonary endarterectomy is the treatment of choice for CTEPH; both patients were treated successfully with this operation. In clinical practice patients are often initially misdiagnosed, due to unawareness of the condition, and are therefore subjected to a long delay before treatment. In the first patient the condition had not been recognised on CT scans. The second patient had initially been treated with psychotherapy for a suspected burn-out. All physicians involved in taking care of patients with pulmonary embolism, must be aware of this serious complication. Diagnosis and treatment of CTEPH require a high level of expertise.

Published
2010

25. Bosentan as a bridge to pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension.

Author

Reesink HJ, Surie S, Kloek JJ, Tan HL, Tepaske R, Fedullo PF, and Bresser P

Subjects
Aged, Bosentan, Female, Humans, Male, Middle Aged, Antihypertensive Agents therapeutic use, Endarterectomy, Hypertension, Pulmonary therapy, Sulfonamides therapeutic use, Thromboembolism therapy
Abstract

Objectives: In proximal chronic thromboembolic pulmonary hypertension, pulmonary endarterectomy is the treatment of first choice. In general, medical treatment before pulmonary endarterectomy is not indicated. However, selected "high-risk" patients might benefit by optimization of pulmonary hemodynamics. Moreover, in patients whose surgery is delayed owing to limited medical resources, pretreatment may prevent clinical deterioration. The primary objective of this study was to determine whether the dual endothelin-1 antagonist bosentan improves pulmonary hemodynamics and functional capacity in patients with proximal chronic thromboembolic pulmonary hypertension waiting for pulmonary endarterectomy., Methods: We used an investigator-initiated, randomized, controlled single-blind study. Patients were randomized to receive bosentan (n = 13) or no bosentan (n = 12) for 16 weeks, next to "best standard of care." The primary end point was change in total pulmonary resistance. Secondary end points included changes in 6-minute walk distance, mean pulmonary artery pressure, and cardiac index., Results: After 16 weeks, the mean differences in change from baseline between the groups were as follows: total pulmonary resistance 299 dynes x s x cm(-5) (P = .004), 6-minute walk distance 33 m (P = .014), mean pulmonary artery pressure 11 mm Hg (P = .005), and cardiac index 0.3 L x min(-1) x m(-2) (P = .08). Treatment with bosentan was safe. After pulmonary endarterectomy, 4 patients died (no-bosentan group: n = 3); the short-term in-hospital postoperative clinical course was similar in both groups of patients., Conclusions: Patients with proximal chronic thromboembolic pulmonary hypertension may benefit hemodynamically and clinically from treatment with bosentan before pulmonary endarterectomy. Individual factors predictive of a beneficial response and whether this influences either morbidity or mortality associated with pulmonary endarterectomy remain to be established., (Copyright 2010 The American Association for Thoracic Surgery. All rights reserved.)

Published
2010
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26. Chorea in adults after pulmonary endarterectomy with deep hypothermia and circulatory arrest.

Author

de Bie RM, Surie S, Kloek JJ, Biervliet JD, de Beaumont EM, Rutten PM, Smeding HM, Bresser P, and Tijssen MA

Subjects
Adult, Female, Heart Arrest, Humans, Hypertension, Pulmonary surgery, Lung blood supply, Male, Middle Aged, Thromboembolism complications, Chorea etiology, Circulatory Arrest, Deep Hypothermia Induced adverse effects, Endarterectomy adverse effects, Hypertension, Pulmonary complications, Lung surgery, Thromboembolism surgery
Published
2008
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