Circulation, Vol 70, 580-587, Copyright © 1984 by American Heart Association
V Fuster, PM Steele, WD Edwards, BJ Gersh, MD McGoon and RL Frye
A long-term retrospective follow-up study was made of 120 patients (33
male, 87 female patients) with primary pulmonary hypertension-- diagnosed
by strict clinical and hemodynamic criteria--to obtain a better
understanding of the natural history and possible pathogenetic mechanisms
of the disease. The mean age at diagnosis was 34 (3 to 64) years, but only
24 patients (21%) remained alive 5 years later. Lung tissue obtained at
autopsy from 56 patients revealed two major pathologic types:
thromboembolic pulmonary hypertension in 32 patients (57%) and plexogenic
pulmonary arteriopathy in 18 (32%). Thus, in more than half the patients
undergoing autopsy the major histologic feature was thrombi without any
evidence of plexiform lesions. The two groups were similar with respect to
their clinical and hemodynamic features and short survival. Of the
variables tested for prognostic importance by stepwise multivariate
analysis, only two were significant: pulmonary arterial oxygen saturation
(p less than .00001) and anticoagulant therapy (p = .01). Anticoagulant
therapy is recommended for patients with primary pulmonary hypertension.
ARTICLES
Primary pulmonary hypertension: natural history and the importance of thrombosis
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D. Wax, R. Garofano, and R. J. Barst Effects of Long-term Infusion of Prostacyclin on Exercise Performance in Patients With Primary Pulmonary Hypertension Chest, October 1, 1999; 116(4): 914 - 920. [Abstract] [Full Text] [PDF] |
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S. Kesten, J. Dainauskas, V. McLaughlin, and S. Rich Development of Nonspecific Interstitial Pneumonitis Associated With Long-term Treatment of Primary Pulmonary Hypertension With Prostacyclin Chest, August 1, 1999; 116(2): 566 - 569. [Abstract] [Full Text] [PDF] |
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C. D. Cool, J. S. Stewart, P. Werahera, G. J. Miller, R. L. Williams, N. F. Voelkel, and R. M. Tuder Three-Dimensional Reconstruction of Pulmonary Arteries in Plexiform Pulmonary Hypertension Using Cell-Specific Markers : Evidence for a Dynamic and Heterogeneous Process of PulmonaryEndothelial Cell Growth Am. J. Pathol., August 1, 1999; 155(2): 411 - 419. [Abstract] [Full Text] [PDF] |
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V. V. McLaughlin, D. E. Genthner, M. M. Panella, D. M. Hess, and S. Rich Compassionate Use of Continuous Prostacyclin in the Management of Secondary Pulmonary Hypertension: A Case Series Ann Intern Med, May 4, 1999; 130(9): 740 - 743. [Abstract] [Full Text] [PDF] |
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E. B. Rosenzweig, D. Kerstein, and R. J Barst Long-Term Prostacyclin for Pulmonary Hypertension With Associated Congenital Heart Defects Circulation, April 13, 1999; 99(14): 1858 - 1865. [Abstract] [Full Text] [PDF] |
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R. J. Barst, G. Maislin, and A. P. Fishman Vasodilator Therapy for Primary Pulmonary Hypertension in Children Circulation, March 9, 1999; 99(9): 1197 - 1208. [Abstract] [Full Text] [PDF] |
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O. Sanchez, M. Humbert, O. Sitbon, and G. Simonneau Treatment of pulmonary hypertension secondary to connective tissue diseases Thorax, March 1, 1999; 54(3): 273 - 277. [Full Text] |
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S. G Haworth Primary pulmonary hypertension in childhood Arch. Dis. Child., November 1, 1998; 79(5): 452 - 455. [Full Text] |
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M. J. Ricciardi, B. P. Knight, F. J. Martinez, and M. Rubenfire Inhaled nitric oxide in primary pulmonary hypertension: A safe and effective agent for predicting response to nifedipine J. Am. Coll. Cardiol., October 1, 1998; 32(4): 1068 - 1073. [Abstract] [Full Text] [PDF] |
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L-S Tam and E K Li Successful treatment with immunosuppression, anticoagulation and vasodilator therapy of pulmonary hypertension in SLE associated with secondary antiphospholipid syndrome Lupus, September 1, 1998; 7(7): 495 - 497. [Abstract] [PDF] |
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T Higenbottam, A Y Butt, A McMahon, R Westerbeck, and L Sharples Long term intravenous prostaglandin (epoprostenol or iloprost) for treatment of severe pulmonary hypertension Heart, August 1, 1998; 80(2): 151 - 155. [Abstract] [Full Text] |
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