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Circulation. 1984;70:580-587

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Circulation, Vol 70, 580-587, Copyright © 1984 by American Heart Association


ARTICLES

Primary pulmonary hypertension: natural history and the importance of thrombosis

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.


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CirculationHome page
H. Wilkens, A. Guth, J. Konig, N. Forestier, B. Cremers, B. Hennen, M. Bohm, and G. W. Sybrecht
Effect of Inhaled Iloprost Plus Oral Sildenafil in Patients With Primary Pulmonary Hypertension
Circulation, September 11, 2001; 104(11): 1218 - 1222.
[Abstract] [Full Text] [PDF]


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HeartHome page
British Cardiac Society Guidelines and Medical Pra
Recommendations on the management of pulmonary hypertension in clinical practice
Heart, September 1, 2001; 86(90001): i1 - 13.
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Br J AnaesthHome page
L. Monnery, J. Nanson, and G. Charlton
Primary pulmonary hypertension in pregnancy; a role for novel vasodilators
Br. J. Anaesth., August 1, 2001; 87(2): 295 - 298.
[Abstract] [Full Text] [PDF]


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Rheumatology (Oxford)Home page
A. J. MacGregor, R. Canavan, C. Knight, C. P. Denton, J. Davar, J. Coghlan, and C. M. Black
Pulmonary hypertension in systemic sclerosis: risk factors for progression and consequences for survival
Rheumatology, April 1, 2001; 40(4): 453 - 459.
[Abstract] [Full Text] [PDF]


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Eur Respir JHome page
N. Galie
Do we need controlled clinical trials in pulmonary arterial hypertension?
Eur. Respir. J., January 1, 2001; 17(1): 1 - 3.
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Eur Respir JHome page
T. Higenbottam and T. Siddons
Trials of inhaled Iloprost and other new vasodilating prostaglandins
Eur. Respir. J., January 1, 2001; 17(1): 6 - 7.
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ChestHome page
T. M. Hyers, G. Agnelli, R. D. Hull, T. A. Morris, M. Samama, V. Tapson, and J. G. Weg
Antithrombotic Therapy for Venous Thromboembolic Disease
Chest, January 1, 2001; 119 (2009): 176S - 193S.
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JAMAHome page
S. Gaine
Pulmonary Hypertension
JAMA, December 27, 2000; 284(24): 3160 - 3168.
[Abstract] [Full Text] [PDF]


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CirculationHome page
F. Sakamaki, S. Kyotani, N. Nagaya, N. Sato, H. Oya, T. Satoh, and N. Nakanishi
Increased Plasma P-Selectin and Decreased Thrombomodulin in Pulmonary Arterial Hypertension Were Improved by Continuous Prostacyclin Therapy
Circulation, November 28, 2000; 102(22): 2720 - 2725.
[Abstract] [Full Text] [PDF]


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CirculationHome page
D. J. Williamson, L. L. Wallman, R. Jones, A. M. Keogh, F. Scroope, BEd, R. Penny, C. Weber, and P. S. Macdonald
Hemodynamic Effects of Bosentan, an Endothelin Receptor Antagonist, in Patients With Pulmonary Hypertension
Circulation, July 25, 2000; 102(4): 411 - 418.
[Abstract] [Full Text] [PDF]


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ThoraxHome page
A J Peacock
Rare diseases bullet 5: Primary pulmonary hypertension
Thorax, December 1, 1999; 54(12): 1107 - 1118.
[Full Text]


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ChestHome page
R. J. Barst
Do No Harm
Chest, November 1, 1999; 116(5): 1147 - 1148.
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J Am Coll CardiolHome page
N. Nagaya, M. Uematsu, Y. Okano, T. Satoh, S. Kyotani, F. Sakamaki, N. Nakanishi, K. Miyatake, and T. Kunieda
Effect of orally active prostacyclin analogue on survival of outpatients with primary pulmonary hypertension
J. Am. Coll. Cardiol., October 1, 1999; 34(4): 1188 - 1192.
[Abstract] [Full Text] [PDF]


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ChestHome page
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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ChestHome page
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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Am. J. Pathol.Home page
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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ANN INTERN MEDHome page
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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CirculationHome page
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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CirculationHome page
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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ThoraxHome page
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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Arch. Dis. Child.Home page
S. G Haworth
Primary pulmonary hypertension in childhood
Arch. Dis. Child., November 1, 1998; 79(5): 452 - 455.
[Full Text]


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J Am Coll CardiolHome page
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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LupusHome page
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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HeartHome page
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]