Abstract
BackgroundChronic thromboembolic pulmonary hypertension (CTEPH) is a type of pulmonary hypertension caused by persistent thromboembolism of the pulmonary arteries. In clinical practice, CTEPH patients often show obstructive ventilatory impairment, even in the absence of a smoking history. Recent reports imply a tendency for CTEPH patients to have a lower FEV1.0; however, the mechanism underlying obstructive impairment remains unknown.MethodsWe retrospectively analyzed CTEPH patients who underwent a pulmonary function test and respiratory impedance test to evaluate their exertional dyspnea during admission for right heart catheterization from January 2000 to December 2019. We excluded patients with a smoking history to rule out the effect of smoking on obstructive impairment.ResultsA total of 135 CTEPH patients were analyzed. The median FEV1.0/FVC was 76.0%, %FEV 1.0 had a negative correlation with the mean pulmonary artery pressure and pulmonary vascular resistance and the CT Angiogram (CTA) obstruction score. A multivariate regression analysis revealed that the CTA obstruction score was an independent factor of a lower %FEV1.0. In the 54 patients who underwent pulmonary endarterectomy, %FEV1.0 was improved in some cases and was not in some. Mean PAP largely decreased after PEA in the better %FEV1.0 improved cases, suggesting that vascular involvement in CTEPH could be associated with spirometry obstructive impairment.Conclusion%FEV1.0 had a significant correlation with the CTA obstruction score. Obstructive impairment might have an etiological relationship with vascular involvement. Further investigations could shed new light on the etiology of CTEPH.
Highlights
Chronic thromboembolic pulmonary hypertension (CTEPH) is a type of pulmonary hypertension caused by persistent thromboembolism of the pulmonary arteries
A recent report describing the pulmonary function test (PFT) findings of CTEPH patients showed that they tended to have a low FEV1.0 compared to healthy controls [9]
We evaluated the data of right heart catheterization (RHC), CT angiogram, respiratory function test of CTEPH patients
Summary
Chronic thromboembolic pulmonary hypertension (CTEPH) is a type of pulmonary hypertension caused by persistent thromboembolism of the pulmonary arteries. Recent reports imply a tendency for CTEPH patients to have a lower FEV1.0; the mechanism underlying obstructive impairment remains unknown. Chronic thromboembolic pulmonary hypertension (CTEPH) is a type of pulmonary hypertension caused by persistent thromboembolism of pulmonary arteries that fail to undergo complete thrombolysis after pulmonary. CTEPH patients often show obstructive ventilatory impairment, even in the absence of a smoking history. A case report found that a CTEPH patient was misdiagnosed with bronchial asthma because of exertional dyspnea and a low FEV1.0 [8]. A recent report describing the pulmonary function test (PFT) findings of CTEPH patients showed that they tended to have a low FEV1.0 compared to healthy controls [9]. The relationship between the lung mechanics and hemodynamics is unclear
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