Longitudinal Study to Identify Predictive Factors of Post-thrombotic Pulmonary Hypertension
The current data on the incidence of pulmonary hypertension (PH) are very variable, depending on the different studies designs. There are no data on the prognostic of PH in patients with asymptomatic pulmonary thromboembolisms (PT), neither paucisymptomatic PH, in which without a prospective follow-up would be underdiagnosed. We thought that the prognosis of both clinical forms (PT with or without symptoms) would be similar.
The objective of this study is know the real incidence of pulmonary hypertension (PH) post symptomatic and asymptomatic pulmonary thromboembolic (PT).
연구 개요
상세 설명
Rationale
Pulmonary hypertension (PH) post pulmonary thromboembolisms is a serious and complex disease, is one major cause of pulmonary hypertension (1). It is the most feared late complication of pulmonary thromboembolism (PT) characterized by the organization of thrombotic material within the pulmonary arteries (2). Although a purely mechanical theory is too simplistic in view of the lack of correlation between the proportion of obliterated pulmonary arteries and the numbers of PH.
Acute, symptomatic, or asymptomatic PT may be the initial event, but disease progression would result from progressive vascular remodeling of small vessels. It is possible that unresolved pulmonary arterial thrombosis is a decisive factor for vascular endothelial cells to initiate their mesenchymal transition (3).
On the other hand, Pulmonary hypertension post pulmonary thromboembolisms is the only subclass of pulmonary hypertension that has a curative surgical treatment (4). The diagnosis of this situation should be detected as soon as possible to optimize the results of surgical and pharmacological treatment. Surgical indication should be established as early as possible to avoid progression (5).
Hypothesis
The current data on the incidence of PH are very variable, depending on the different studies designs. There are no data on the prognostic of PH in patients with asymptomatic PT, neither paucisymptomatic PH, in which without a prospective follow-up would be underdiagnosed. We thought that the prognosis of both clinical forms (PT with or without symptoms) would be similar. Also we thought and that there are forms of paucisymptomatic PH whose diagnosis and treatment would benefit from a prospective follow-up.
Objectives
Main objective
To know the incidence of pulmonary hypertension (PH) post symptomatic and asymptomatic pulmonary thromboembolic (PT).
The secondary objectives of the study are:
- To defined clinical subtypes of PT with a predictive value of diagnosis of PH in two years.
- To Measure biomarkers described that may be related to the diagnosis of PH or the disease progression.
- Use of genetic, proteomic, RNA transcription, cytometric and cellular and metabolic identification assays to aid in the search for new genetic factors and / or PH biomarkers.
연구 유형
등록 (실제)
연락처 및 위치
연구 장소
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Alava, 스페인
- Hospital de Araba
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Barcelona, 스페인
- Hospital del Mar
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Gerona, 스페인
- Hospital U. de Girona Doctor Josep Trueta
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Granada, 스페인
- Hospital U. Virgen de las Nieves
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Madrid, 스페인
- Hospital U. La Paz
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Madrid, 스페인
- Hospital U. Ramon y Cajal
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Sevilla, 스페인
- Hospital San Juan de Dios
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Valladolid, 스페인
- Hospital C. U. de Valladolid
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Zaragoza, 스페인
- Hospital C. U. Lozano Blesa
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Asturias
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Oviedo, Asturias, 스페인
- Hospital U. Central. de Asturias
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Barcelona
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Badalona, Barcelona, 스페인
- Hospital M. de Badalona
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Badalona, Barcelona, 스페인
- Hospital U. German Trias i Pujol
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Sant Cugat del Valles, Barcelona, 스페인
- Hospital G. de Cataluña
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Viladecans, Barcelona, 스페인
- Hospital de Viladecans
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Cantabria
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Santander, Cantabria, 스페인
- Hospital U. Marques de Valdecilla
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Torrelavega, Cantabria, 스페인
- Hospital Sierrallana
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Guipuzcua
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Bilbao, Guipuzcua, 스페인
- Hospital de Cruces
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La Rioja
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Logrono, La Rioja, 스페인
- Hospital San Pedro
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Madrid
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Alcorcón, Madrid, 스페인
- Hospital U. Fundación Alcorcón
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Getafe, Madrid, 스페인
- Hospital U. de Getafe
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Navarra
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Pamplona, Navarra, 스페인
- Hospital Virgen del Camino
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Sevilla
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Seville, Sevilla, 스페인, 41013
- Hospital Virgen del Rocío
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Vizcaya
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Galdacano, Vizcaya, 스페인
- Hospital Galdakao-Usansolo
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참여기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
샘플링 방법
연구 인구
설명
Inclusion Criteria:
- Patients 18 years or older and able to provide informed consent
- Diagnosis of pulmonary thromboembolisms confirmed by
- Computed Tomography Angiography (CTA) if there are a partial transluminal defect surrounded by contrast or a complete occlusion of pulmonary artery.
- Pulmonary ventilation/perfusion scan.- Patients with high risk based on PIOPED study criteria or in patients with deep venous thrombosis confirmed by echography and positron emission tomography (PET) scan not concluding.
Exclusion Criteria:
- Any contraindication to the performance of the pulmonary hypertension diagnostic tests
- Any circumstance, to investigator criteria, to impede the patient follow up
- Life expectancy lower than 6 months
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
연구는 무엇을 측정합니까?
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Pulmonary hypertension
기간: 2 years
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Diagnosis on pulmonary hypertension after pulmonary thromboembolism
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2 years
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공동 작업자 및 조사자
수사관
- 연구 의자: Remedios Otero Candelera, Hospital Universitario Virgen del Rocío IBIS
간행물 및 유용한 링크
일반 간행물
- Condliffe R, Kiely DG, Gibbs JS, Corris PA, Peacock AJ, Jenkins DP, Hodgkins D, Goldsmith K, Hughes RJ, Sheares K, Tsui SS, Armstrong IJ, Torpy C, Crackett R, Carlin CM, Das C, Coghlan JG, Pepke-Zaba J. Improved outcomes in medically and surgically treated chronic thromboembolic pulmonary hypertension. Am J Respir Crit Care Med. 2008 May 15;177(10):1122-7. doi: 10.1164/rccm.200712-1841OC. Epub 2008 Feb 21.
- Tueller C, Stricker H, Soccal P, Tamm M, Aubert JD, Maggiorini M, Zwahlen M, Nicod L; Swiss Society for Pulmonary Hypertension. Epidemiology of pulmonary hypertension: new data from the Swiss registry. Swiss Med Wkly. 2008 Jun 28;138(25-26):379-84. doi: 10.4414/smw.2008.11915.
- Lang IM. Chronic thromboembolic pulmonary hypertension--not so rare after all. N Engl J Med. 2004 May 27;350(22):2236-8. doi: 10.1056/NEJMp048088. No abstract available.
- Humbert M. Pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: pathophysiology. Eur Respir Rev. 2010 Mar;19(115):59-63. doi: 10.1183/09059180.00007309.
- Galie N, Kim NH. Pulmonary microvascular disease in chronic thromboembolic pulmonary hypertension. Proc Am Thorac Soc. 2006 Sep;3(7):571-6. doi: 10.1513/pats.200605-113LR.
연구 기록 날짜
연구 주요 날짜
연구 시작 (실제)
기본 완료 (실제)
연구 완료 (실제)
연구 등록 날짜
최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
추가 정보
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폐 고혈압에 대한 임상 시험
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