PMID- 37276770
OWN - NLM
STAT- MEDLINE
DCOM- 20231216
LR  - 20231216
IS  - 2590-0412 (Electronic)
IS  - 2590-0412 (Linking)
VI  - 84
DP  - 2023 Nov
TI  - Changes in the management of chronic thromboembolic pulmonary hypertension over a 
      10-year period, in a French expert regional competence centre.
PG  - 101021
LID - S2590-0412(23)00033-8 [pii]
LID - 10.1016/j.resmer.2023.101021 [doi]
AB  - Over the last few years, the advent of balloon pulmonary angioplasty (BPA) had 
      led to changes in the management of chronic thromboembolic pulmonary hypertension 
      (CTEPH). We reviewed data from 98 CTEPH patients diagnosed during the last decade 
      in a pulmonary hypertension (PH) expert centre. The management modalities of 2 
      periods (Period A: 2011-15 and Period B: 2016-20) were compared. Age (period A: 
      72 [58-80] years; period B: 69 [62-79] years), clinical (New York Heart 
      Association (NYHA) functional class III-IV: 25/41, 61% vs 39/57, 68%), and 
      hemodynamic assessments (pulmonary vascular resistance: 7.5 [6.2-8.7] WU vs 8.0 
      [6.0-10.2] WU) at baseline were not significantly different. Pulmonary 
      endarterectomy was performed in less than one third of patients (12, 29.3% vs 15, 
      26.3%). For patients not eligible for surgery, medical therapy was mostly 
      prescribed alone during period A (medical therapy alone, patients diagnosed in 
      period A: 61% vs in period B: 17.5%) while it was associated with BPA during 
      period B (medical therapy + BPA, 12% vs 61.4%). The 5-year survival rate was 
      excellent for patients who underwent surgery (96.3%) or BPA (95.2%), but was only 
      42.1% for patients under oral medication only (p < 0.0001). Patients diagnosed 
      with CTEPH who cannot be operated should undergo BPA. The survival rate after BPA 
      is as good as after surgery and significantly better than that of oral medication 
      only.
CI  - Copyright (c) 2023 SPLF and Elsevier Masson SAS. All rights reserved.
FAU - Provost, Mathilde
AU  - Provost M
AD  - Centre de competences de l'hypertension pulmonaire (Pulmo Tension), service de 
      pneumologie, Hospices Civils de Lyon, Hopital Louis Pradel, Lyon, France.
FAU - Mornex, Jean-Francois
AU  - Mornex JF
AD  - Centre de competences de l'hypertension pulmonaire (Pulmo Tension), service de 
      pneumologie, Hospices Civils de Lyon, Hopital Louis Pradel, Lyon, France; Centre 
      de reference coordonnateur des maladies pulmonaires rares (RespiFil), service de 
      pneumologie, Hospices Civils de Lyon, Hopital Louis Pradel, Lyon, France; 
      Universite de Lyon, universite Lyon 1, INRAE, EPHE, UMR754, IVPC, F-69007 , Lyon, 
      France.
FAU - Nasser, Mouhamad
AU  - Nasser M
AD  - Centre de competences de l'hypertension pulmonaire (Pulmo Tension), service de 
      pneumologie, Hospices Civils de Lyon, Hopital Louis Pradel, Lyon, France; Centre 
      de reference coordonnateur des maladies pulmonaires rares (RespiFil), service de 
      pneumologie, Hospices Civils de Lyon, Hopital Louis Pradel, Lyon, France.
FAU - Zeghmar, Sabrina
AU  - Zeghmar S
AD  - Centre de competences de l'hypertension pulmonaire (Pulmo Tension), service de 
      pneumologie, Hospices Civils de Lyon, Hopital Louis Pradel, Lyon, France.
FAU - Traclet, Julie
AU  - Traclet J
AD  - Centre de competences de l'hypertension pulmonaire (Pulmo Tension), service de 
      pneumologie, Hospices Civils de Lyon, Hopital Louis Pradel, Lyon, France; Centre 
      de reference coordonnateur des maladies pulmonaires rares (RespiFil), service de 
      pneumologie, Hospices Civils de Lyon, Hopital Louis Pradel, Lyon, France.
FAU - Ahmad, Kais
AU  - Ahmad K
AD  - Centre de competences de l'hypertension pulmonaire (Pulmo Tension), service de 
      pneumologie, Hospices Civils de Lyon, Hopital Louis Pradel, Lyon, France; Centre 
      de reference coordonnateur des maladies pulmonaires rares (RespiFil), service de 
      pneumologie, Hospices Civils de Lyon, Hopital Louis Pradel, Lyon, France.
FAU - Lestelle, Francois
AU  - Lestelle F
AD  - Centre de competences de l'hypertension pulmonaire (Pulmo Tension), service de 
      pneumologie, Hospices Civils de Lyon, Hopital Louis Pradel, Lyon, France; Centre 
      de reference coordonnateur des maladies pulmonaires rares (RespiFil), service de 
      pneumologie, Hospices Civils de Lyon, Hopital Louis Pradel, Lyon, France.
FAU - Chour, Ali
AU  - Chour A
AD  - Centre de competences de l'hypertension pulmonaire (Pulmo Tension), service de 
      pneumologie, Hospices Civils de Lyon, Hopital Louis Pradel, Lyon, France.
FAU - Diesler, Remi
AU  - Diesler R
AD  - Centre de competences de l'hypertension pulmonaire (Pulmo Tension), service de 
      pneumologie, Hospices Civils de Lyon, Hopital Louis Pradel, Lyon, France.
FAU - Cottin, Vincent
AU  - Cottin V
AD  - Centre de competences de l'hypertension pulmonaire (Pulmo Tension), service de 
      pneumologie, Hospices Civils de Lyon, Hopital Louis Pradel, Lyon, France; Centre 
      de reference coordonnateur des maladies pulmonaires rares (RespiFil), service de 
      pneumologie, Hospices Civils de Lyon, Hopital Louis Pradel, Lyon, France; 
      Universite de Lyon, universite Lyon 1, INRAE, EPHE, UMR754, IVPC, F-69007 , Lyon, 
      France.
FAU - Turquier, Segolene
AU  - Turquier S
AD  - Centre de competences de l'hypertension pulmonaire (Pulmo Tension), service de 
      pneumologie, Hospices Civils de Lyon, Hopital Louis Pradel, Lyon, France. 
      Electronic address: segolene.turquier@chu-lyon.fr.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230603
PL  - France
TA  - Respir Med Res
JT  - Respiratory medicine and research
JID - 101746324
SB  - IM
MH  - Humans
MH  - Middle Aged
MH  - Aged
MH  - Aged, 80 and over
MH  - *Pulmonary Embolism/complications/epidemiology/surgery
MH  - *Hypertension, Pulmonary/diagnosis/epidemiology/etiology
MH  - Chronic Disease
MH  - Hemodynamics
MH  - Vascular Resistance
OTO - NOTNLM
OT  - Angioplasty
OT  - Pulmonary endarterectomy
OT  - Pulmonary hypertension
OT  - Survival
OT  - Thrombosis
COIS- Declaration of Competing Interest None.
EDAT- 2023/06/05 19:10
MHDA- 2023/12/17 09:43
CRDT- 2023/06/05 18:05
PHST- 2022/08/24 00:00 [received]
PHST- 2023/04/06 00:00 [revised]
PHST- 2023/04/15 00:00 [accepted]
PHST- 2023/12/17 09:43 [medline]
PHST- 2023/06/05 19:10 [pubmed]
PHST- 2023/06/05 18:05 [entrez]
AID - S2590-0412(23)00033-8 [pii]
AID - 10.1016/j.resmer.2023.101021 [doi]
PST - ppublish
SO  - Respir Med Res. 2023 Nov;84:101021. doi: 10.1016/j.resmer.2023.101021. Epub 2023 
      Jun 3.