@article{LiuHuPelzeretal.2015,
  author    = {Liu, Dan and Hu, Kai and Pelzer, Heinz-Theo and St{\"o}rk, Stefan and Weidemann, Frank},
  title     = {Journey of a patient with chronic thromboembolic pulmonary hypertension},
  series = {European Journal of Medical Research},
  volume    = {20},
  journal   = {European Journal of Medical Research},
  number    = {20},
  doi       = {10.1186/s40001-015-0112-x},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-125009},
  year      = {2015},
  abstract  = {Right ventricle (RV) dysfunction is a key outcome determinant and a leading cause of death for patients with chronic thromboembolic pulmonary hypertension (CTEPH). In this report, we followed the 5-year clinical journey of a patient with CTEPH. The tricuspid pressure gradient was significantly increased in the early phase of CTEPH and "normalized" at the late phase of this patient's clinical journey, but this "normalized" gradient is not a positive treatment response but rather an ominous sign of advancing right heart failure owing to an exhaustion of RV contractile function. Thus, appropriate interpretation of the tricuspid pressure gradient change is of importance for assessing RV dysfunction and treatment outcome during follow-up in patients with CTEPH. Besides systolic pulmonary artery pressure (SPAP), other RV functional parameters such as tricuspid annular plane systolic excursion, RV fractional area change, and RV longitudinal strain, together with clinical markers, may provide additional guidance regarding functional improvement or progression in patients with CTEPH.},
  language  = {en}
}
@article{HeldHesseGoettetal.2014,
  author    = {Held, Matthias and Hesse, Alexander and G{\"o}tt, Franziska and Holl, Regina and H{\"u}bner, Gudrun and Kolb, Philipp and Langen, Heinz Jakob and Romen, Tobias and Walter, Franziska and Sch{\"a}fers, Hans Joachim and Wilkens, Heinrike and Jany, Berthold},
  title     = {A symptom-related monitoring program following pulmonary embolism for the early detection of CTEPH: a prospective observational registry study},
  series = {BMC Pulmonary Medicine},
  volume    = {14},
  journal   = {BMC Pulmonary Medicine},
  doi       = {10.1186/1471-2466-14-141},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-119281},
  pages     = {141},
  year      = {2014},
  abstract  = {Background Chronic thromboembolic pulmonary hypertension (CTEPH) is a long-term complication following an acute pulmonary embolism (PE). It is frequently diagnosed at advanced stages which is concerning as delayed treatment has important implications for favourable clinical outcome. Performing a follow-up examination of patients diagnosed with acute PE regardless of persisting symptoms and using all available technical procedures would be both cost-intensive and possibly ineffective. Focusing diagnostic procedures therefore on only symptomatic patients may be a practical approach for detecting relevant CTEPH. This study aimed to evaluate if a follow-up program for patients with acute PE based on telephone monitoring of symptoms and further examination of only symptomatic patients could detect CTEPH. In addition, we investigated the role of cardiopulmonary exercise testing (CPET) as a diagnostic tool. Methods In a prospective cohort study all consecutive patients with newly diagnosed PE (n=170, 76 males, 94 females within 26 months) were recruited according to the inclusion and exclusion criteria. Patients were contacted via telephone and asked to answer standardized questions relating to symptoms. At the time of the final analysis 130 patients had been contacted. Symptomatic patients underwent a structured evaluation with echocardiography, CPET and complete work-up for CTEPH. Results 37.7\%, 25.5\% and 29.3\% of the patients reported symptoms after three, six, and twelve months respectively. Subsequent clinical evaluation of these symptomatic patients saw 20.4\%, 11.5\% and 18.8\% of patients at the respective three, six and twelve months time points having an echocardiography suggesting pulmonary hypertension (PH). CTEPH with pathological imaging and a mean pulmonary artery pressure (mPAP) ≥ 25 mm Hg at rest was confirmed in eight subjects. Three subjects with mismatch perfusion defects showed an exercise induced increase of PAP without increasing pulmonary artery occlusion pressure (PAOP). Two subjects with pulmonary hypertension at rest and one with an exercise induced increase of mPAP with normal PAOP showed perfusion defects without echocardiographic signs of PH but a suspicious CPET. Conclusion A follow-up program based on telephone monitoring of symptoms and further structured evaluation of symptomatic subjects can detect patients with CTEPH. CPET may serve as a complementary diagnostic tool.},
  language  = {en}
}