Valieva Z S, Martynyuk T V
Chazov National Medical Research Center of Cardiology.
Pirogov Russian National Research Medical University.
Ter Arkh. 2022 Aug 12;94(7):791-796. doi: 10.26442/00403660.2022.07.201741.
Presents data on the pathogenesis of chronic thromboembolic pulmonary hypertension (CTEPH), which serve as a rationale for approaches to the choice of treatment. CTEPH usually begins with persistent obstruction of the large and/or medium pulmonary arteries by organized thrombi. Impaired lysis of thrombi may be associated with abnormal fibrinolysis, hematological or autoimmune diseases. The molecular processes underlying the lesions of small vessels are not fully understand. The degree of small-vessel disease has a significant impact on the severity of CTEPH and postoperative outcomes. The CTEPH treatment has evolved with the development of three directions pulmonary endarterectomy, balloon angioplasty of pulmonary arteries and the use of specific therapy used for pulmonary arterial hypertension. The paper demonstrates the possibilities of a multimodal approach in the treatment of this category of patients.
本文展示了关于慢性血栓栓塞性肺动脉高压（CTEPH）发病机制的数据，这些数据为治疗方法的选择提供了理论依据。CTEPH通常始于机化血栓对大或中等肺动脉的持续阻塞。血栓溶解受损可能与异常纤维蛋白溶解、血液学或自身免疫性疾病有关。小血管病变的分子机制尚未完全明确。小血管疾病的程度对CTEPH的严重程度和术后结果有重大影响。随着肺血栓内膜剥脱术、肺动脉球囊血管成形术以及用于肺动脉高压的特异性治疗这三个方向的发展，CTEPH的治疗也在不断演进。本文展示了多模式方法治疗此类患者的可能性。
