Androulakis Emmanuel, Lioudaki Eirini, Christophides Theodoros, Ahmad Mahmood, Fayed Hossam, Laskar Nabila, Schreiber Benjamin
Department of Cardiology, Royal Free Hospital, Royal Free London NHS Foundation Trust, Pond Street, London, NW3 2QG, London, UK.
Expert Rev Respir Med. 2015 Jun;9(3):351-9. doi: 10.1586/17476348.2015.1046843. Epub 2015 May 14.
Chronic thromboembolic pulmonary hypertension is defined as pulmonary hypertension (PH) caused by single or recurrent pulmonary emboli and is characterized by chronic obstruction of the pulmonary arteries leading to increased vascular resistance and PH. Also, progressive remodeling may occur in occluded and nonoccluded territories. Better understanding of the underlying mechanisms and risk factors could improve diagnosis and allow appropriate interventions. Pulmonary endarterectomy is an established approach and is considered the definitive treatment for chronic PH, resulting from thromboembolic disease. Furthermore, percutaneous transluminal pulmonary angioplasty is technically feasible, especially for those with peripheral-type of the disease. In addition, several agents, including prostanoids, endothelin receptor antagonists and phosphodiesterase type-5 inhibitors, have been tested in selected patients yielding promising results. Several novel agents are under investigation, and extensive research is currently in progress aiming to resolve uncertainties in the understanding and treatment of the disease.
慢性血栓栓塞性肺动脉高压被定义为由单次或反复肺栓塞引起的肺动脉高压（PH），其特征是肺动脉慢性阻塞导致血管阻力增加和PH。此外，在闭塞和未闭塞区域可能会发生进行性重塑。更好地了解潜在机制和危险因素可以改善诊断并允许进行适当干预。肺动脉内膜剥脱术是一种既定的方法，被认为是治疗由血栓栓塞性疾病引起的慢性PH的确定性治疗方法。此外，经皮腔内肺动脉成形术在技术上是可行的，特别是对于患有外周型疾病的患者。此外，包括前列环素、内皮素受体拮抗剂和5型磷酸二酯酶抑制剂在内的几种药物已在选定患者中进行了测试，取得了有希望的结果。几种新型药物正在研究中，目前正在进行广泛的研究，旨在解决对该疾病理解和治疗方面的不确定性。
