[Pulmonary hemodynamics and long-term outcome in patients with chronic pulmonary thromboembolism and pulmonary hypertension].

We examined pulmonary hemodynamics and long-term outcome in 78 consecutive patients with chronic pulmonary thromboembolism and pulmonary hypertension. These patient's ages ranged from 19 to 75 years; the mean was 51.0 +/- 13.8 years and there was no difference in sex distribution. Mean pulmonary-artery pressure (PAm) was 44 +/- 14 mmHg and total pulmonary resistance (TPR) was 1138 +/- 634 dyne.sec.cm-5. Overall five-year survival was 58.4%, but in patients whose PAm was below 30 mmHg, the outcomes were better: all of these patients survived for at least 5 years. In patients whose PAm was above 30 mmHg, no correlation was found between the outcome and the magnitude of PAm. We divided the patients into four subgroups according to their TPR: 500 dyne.sec.cm-5 (TPR, 500 > or = TPR < 1000 dyne.sec.cm-5, 1000 < or = TPR < 1500 dyne.sec.cm-5, and 1500 dyne.sec.cm-5 < or = TPR. The five-year survivals in these groups were 100%, 88.9%, 52.4%, and 40.0%, respectively. Outcome correlated with the magnitude of TPR. TPR was useful for predicting the outcome of chronic pulmonary thromboembolism.

[1]  R. Tarazi,et al.  Experience and results with 150 pulmonary thromboendarterectomy operations over a 29-month period. , 1993, The Journal of thoracic and cardiovascular surgery.

[2]  W. Auger,et al.  Chronic thromboembolic pulmonary hypertension: clinical picture and surgical treatment. , 1992, The European respiratory journal.

[3]  K. Peterson,et al.  Chronic major-vessel thromboembolic pulmonary artery obstruction: appearance at angiography. , 1992, Radiology.

[4]  W. Auger,et al.  Chronic major-vessel thromboembolic pulmonary hypertension. , 1990, Circulation.

[5]  J. Constant,et al.  Present status of primary pulmonary hypertension. , 1989, The Tokai journal of experimental and clinical medicine.

[6]  K. Peterson,et al.  Pulmonary angiography in severe chronic pulmonary hypertension. , 1987, Annals of internal medicine.

[7]  K. Peterson,et al.  Modifications of techniques and early results of pulmonary thromboendarterectomy for chronic pulmonary embolism. , 1987, The Journal of thoracic and cardiovascular surgery.

[8]  W. M. Smith.  Epidemiology of congestive heart failure. , 1985, The American journal of cardiology.

[9]  J. Alpert,et al.  The natural history of pulmonary embolism. , 1984, Clinics in chest medicine.

[10]  J. Alpert,et al.  The clinical profile of unresolved pulmonary embolism. , 1983, Chest.

[11]  J. Widimský,et al.  Longterm follow-up of patients with pulmonary thromboembolism. Late prognosis and evolution of hemodynamic and respiratory data. , 1982, Chest.

[12]  J. S. Bower,et al.  Partial reversibility of chronic pulmonary hypertension caused by pulmonary thromboembolic disease. , 1981, The American review of respiratory disease.

[13]  R. Zelis,et al.  Vasodilators ineffective in secondary pulmonary hypertension. , 1980, The New England journal of medicine.

[14]  R. Hall,et al.  Clinical course and late prognosis of treated subacute massive, acute minor, and chronic pulmonary thromboembolism. , 1977, British heart journal.

[15]  K. Mcintyre,et al.  The hemodynamic response to pulmonary embolism in patients without prior cardiopulmonary disease. , 1971, The American journal of cardiology.

[16]  L. Dexter,et al.  Resolution rate of acute pulmonary embolism in man. , 1969, The New England journal of medicine.

[17]  H. Fred,et al.  Rapid resolution of pulmonary thromboemboli in man. An angiographic study. , 1966, JAMA.

[18]  P. Wood.  The Eisenmenger Syndrome , 1958 .