Chronic thromboembolic pulmonary hypertension: epidemiology, diagnosis, treatment — current state of the problem
- Authors: Chernyavskiy A.M.1, Edemskiy A.G.1, Vasiltseva O.Y.1, Kliver E.N.1, Grankin D.S.1, Sirota D.A.1, Romanov A.B.1
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Affiliations:
- E.N. Meshalkin National Medical Research Center
- Issue: Vol 78, No 4 (2023)
- Pages: 297-304
- Section: CARDIOLOGY AND CARDIOVASCULAR SURGERY: CURRENT ISSUES
- Published: 01.11.2023
- URL: https://vestnikramn.spr-journal.ru/jour/article/view/13995
- DOI: https://doi.org/10.15690/vramn13995
- ID: 13995
Cite item
Abstract
Chronic thromboembolic pulmonary hypertension is group IV of pulmonary hypertension, which develops with occlusive-stenotic lesions of the pulmonary artery after a pulmonary embolism. There are no clear data on the epidemiology of this disease. At the same time, it is obvious that it is much more widespread than is commonly believed. This is due to the nonspecific clinical picture and the lack of awareness of clinicians about this disease. On the one hand, the pathogenesis of CTEPH is well studied and in many respects similar to pulmonary arterial hypertension, on the other hand, it is not clear why blood clots do not dissolve in a certain percentage of patients. Diagnosis of chronic thromboembolic pulmonary hypertension is fairly well described and should be carried out according to a special algorithm. The treatment of choice is pulmonary endarterectomy. In inoperable patients and patients with residual pulmonary hypertension after surgery, it is possible to perform balloon angioplasty of the pulmonary artery and PAH-specific therapy. In our study, the safety and efficacy of a new method for the treatment of a residual form of chronic thromboembolic pulmonary hypertension, radiofrequency denervation of the pulmonary artery, has been proven. The pathogenetic basis of this technique is the desympathization of the pulmonary circulation by radiofrequency destruction of the autonomic ganglia of the bifurcation of the pulmonary artery and the interruption of the so-called pulmo-pulmonary reflex.
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About the authors
Alexander M. Chernyavskiy
E.N. Meshalkin National Medical Research Center
Email: amchern@mail.ru
ORCID iD: 0000-0003-4231-3059
SPIN-code: 5286-6950
MD, PhD, Professor, Corresponding Member of the RAS
Russian Federation, 15 Rechkunovskaya Str., Novosibirsk, 630055Alexander G. Edemskiy
E.N. Meshalkin National Medical Research Center
Author for correspondence.
Email: alexander.edemskiy@gmail.com
ORCID iD: 0000-0002-6661-7826
SPIN-code: 9363-0210
MD, PhD
Russian Federation, 15 Rechkunovskaya Str., Novosibirsk, 630055Oksana Y. Vasiltseva
E.N. Meshalkin National Medical Research Center
Email: vasiltsevaoy@gmail.com
ORCID iD: 0000-0002-2932-3159
MD, PhD, leading research associate
Russian Federation, 15 Rechkunovskaya Str., Novosibirsk, 630055Elena N. Kliver
E.N. Meshalkin National Medical Research Center
Email: e_kliver@meshalkin.ru
ORCID iD: 0000-0002-1119-4870
SPIN-code: 2990-4156
MD, PhD, leading research associate
Russian Federation, 15 Rechkunovskaya Str., Novosibirsk, 630055Denis S. Grankin
E.N. Meshalkin National Medical Research Center
Email: grankinds.denis@yandex.ru
ORCID iD: 0000-0002-0083-8888
MD, PhD
Russian Federation, 15 Rechkunovskaya Str., Novosibirsk, 630055Dmitriy A. Sirota
E.N. Meshalkin National Medical Research Center
Email: d_sirota@meshalkin.ru
ORCID iD: 0000-0002-9940-3541
SPIN-code: 4706-7549
MD, PhD
Russian Federation, 15 Rechkunovskaya Str., Novosibirsk, 630055Alexander B. Romanov
E.N. Meshalkin National Medical Research Center
Email: abromanov@rambler.ru
ORCID iD: 0000-0002-6958-6690
SPIN-code: 6044-4770
MD, PhD
Russian Federation, 15 Rechkunovskaya Str., Novosibirsk, 630055References
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