Aspectos epidemiológicos de la hipertensión pulmonar tromboembólica crónica

Quincoces, Aitor Ballaz; Ibáñez, Mikel Oribe

doi:10.1016/S0300-2896(09)73495-7

Archivos de Bronconeumología

ISSN: 0300-2896

Archivos de Bronconeumologia is an international journal that publishes original studies whose content is based upon results of research initiatives dealing with several aspects of respiratory medicine including epidemiology, respiratory physiology, pathophysiology of respiratory diseases, clinical management, thoracic surgery, pediatric lung diseases, respiratory critical care, respiratory allergy and translational research. Other types of articles such as editorials, reviews, and different types of letters are also published in the journal. Additionally, the journal expresses the voice of the following scientific societies: the Spanish Respiratory Society of Pneumology and Thoracic Surgery (SEPAR; https://www.separ.es/), the Latin American Thoracic Society (ALAT; https://alatorax.org/), and the Iberian American Association of Thoracic Surgery (AIACT; http://www.aiatorax.com/).

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La hipertensión pulmonar tromboembólica crónica (HPTEC), es una enfermedad grave, de muy mal pronóstico y con una supervivencia muy baja en pacientes no tratados o tratados únicamente con anticoagulación. Su verdadera incidencia y prevalencia se desconocen en la actualidad y se estima que probablemente sea una enfermedad infradiagnosticada. Los datos existentes hablan de cifras de incidencia que van desde el 0,1 al 3,8%. Las últimas investigaciones y trabajos publicados nos hacen reflexionar sobre la necesidad de conocer, no sólo la incidencia de la HPTEC en los pacientes sintomáticos sino también en los pacientes asintomáticos que posteriormente la desarrollan, así como en el resto de los casos en los que el episodio tromboembólico venoso se presenta de forma asintomática. Hay diferentes factores de riesgo asociados a una mayor predisposición para el desarrollo de HPTEC (edad avanzada, extensión en la localización de la obstrucción, presión pulmonar sistólica elevada, así como numerosas condiciones clínicas). Lo que sí parece claro, es que en estos últimos años, gracias a los avances experimentados en el manejo de la HPTEC, puede que el curso evolutivo y pronóstico de esta enfermedad esté sufriendo un cambio importante, convirtiéndose en una enfermedad crónica tratable.

Palabras clave:

Hipertensión pulmonar tromboembólica crónica

Embolismo pulmonar crónico

Incidencia

Prevalencia

Mortalidad

Epidemiología

Factores de riesgo

Tromboendarterectomía

Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) is a serious disease with a very poor prognosis and extremely low survival in untreated patients or in those treated with anticoagulation alone. The true incidence and prevalence of CTEPH is currently unknown and the disease is probably underdiagnosed. Current data indicate that the incidence ranges from 0.1% to 3.8%. The latest research and reported studies reveal the need to determine not only the incidence of CTEPH in symptomatic patients but also in asymptomatic patients who subsequently develop the disease, as well as in the remaining patients with an asymptomatic venous thromboembolic event. Several risk factors are associated with a greater predisposition to CTEPH (advanced age, extensive obstruction, elevated systolic pulmonary pressure, and numerous clinical conditions).

Due to advances made in the management of CTEPH in the last few years, the clinical course and prognosis and of this disease may be undergoing a major change and CTEPH may become a chronic, treatable disease.

Keywords:

Chronic thromboembolic pulmonary hypertension

Chronic pulmonary embolism

Incidence

Prevalence

Mortality

Epidemiology

Risk factors

Thromboendarterectomy

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Bibliografía

[1.]

J.A. Barberá, P. Escribano, P. Morales, M.A. Gómez, M. Oribe, A. Martínez, A. Román, J. Segovia, F. Santos, M.T. Subirana.

Estándares asistenciales en hipertensión pulmonar. Documento de consenso elaborado por la sociedad española de neumología y cirugía torácica (SEPAR) y la sociedad española de cardiología (SEC).

Arch Bronconeumología, 44 (2008), pp. 87-89

[2.]

G. Simonneau, I.M. Robbins, M. Beghetti, R.N. Channick, M. Delcroix, C.P. Denton, et al.

Updated clinical classification of pulmonary hypertension.

J Am Coll Cardiol, 54 (2009), pp. S43-S54

http://dx.doi.org/10.1016/j.jacc.2009.04.012 | Medline

[3.]

J.E. Dalen, J.S. Banas Jr, H.L. Brooks, G.L. Evans, J.A. Paraskos, L. Dexter.

Resolution rate of acute pulmonary embolism in man.

N Engl J Med, 280 (1969), pp. 1194-1199

http://dx.doi.org/10.1056/NEJM196905292802202 | Medline

[4.]

A. Peacock, G. Simonneau, L. Rubin.

Controversies, uncertainties and future research on the treatment of chronic thromboembolic pulmonary hypertension.

Proc Am Thoracic Soc, 3 (2006), pp. 608-614

[5.]

S.W. Jamieson, D.P. Kapelanski.

Pulmonary endarterectomy.

Curr Probl Surg, 37 (2000), pp. 165-252

Medline

[6.]

P. Dartevelle, E. Fadel, S. Mussot, A. Chapelier, P. Hervé, M. De Perrot, J. Cerrina, F.L. Ladurie, D. Lehouerou, M. Humbert, O. Sitbon, G. Simonneau.

Chronic thromboembolic pulmonary hipertensión.

Eur Resp J, 23 (2004), pp. 637-648

[7.]

K.M. Moser, C.M. Bloor.

Pulmonary vascular lesions occurring in patients with chronic major vessel thromboembolic pulmonary hypertension.

Chest, 103 (1993), pp. 685-692

Medline

[8.]

A. Ribeiro, P. Lindmarker, H. Johnsson, A. Juhlin-Dannfelt, L. Jorfeldt.

Pulmonary embolism: one year follow up with echocardiography Doppler and five years survival analysis.

Circulation, 99 (1999), pp. 1325-1330

Medline

[9.]

V. Pengo, A.W. Lensing, M.H. Prins, A. Marchiori, B.L. Davidson, F. Tiozzo, P. Albanese, A. Brasilio, C. Pegoraro, S. Iliceto.

Incidence of chronic pulmonary hypertension after pulmonary embolism.

N Engl J Med, 350 (2004), pp. 2257-2264

http://dx.doi.org/10.1056/NEJMoa032274 | Medline

[10.]

C. Becatini, G. Agnelli, R. Pesavento, M. Silingardi, R. Poggio, M.R. Taliani, W. Ageno.

Incidence of chronic pulmonary hypertension after a first episode of pulmonary embolism.

Chest, 130 (2006), pp. 172-175

http://dx.doi.org/10.1378/chest.130.1.172 | Medline

[11.]

I. Lang, K. Kerr.

Risk factors for thromboembolic pulmonary hypertension.

Proc Am Thorac Soc, 3 (2006), pp. 568-570

http://dx.doi.org/10.1513/pats.200605-108LR | Medline

[12.]

F. Dentali, M. Donadini, M. Gianni, A. Bertolini, A. Squizzato, A. Venco, W. Ageno.

Incidence of chronic pulmonary hypertension in patients with previous pulmonary embolism.

Trombosis research, 124 (2009), pp. 256-258

[13.]

M.D. Fedullo, R. Wiliam, M.D. Auger, M. Kim, M.D. Kerr.

Chronic Pulmonary hyepertension.

N Engl, J Med, 345 (2001), pp. 1465-1472

[14.]

M. Lopez Meseguer, A. Roman Broto, I. Blanco, P. Escribano, F. García Hernández, J. Gaudó, E. Sala, P. Morales.

Registro Español de Hipertensión Arterial Pulmonar: características basales de los primeros 943 pacientes.

Archivos de Bronconeumología, 45 (2009), pp. 1-273

http://dx.doi.org/10.1016/S0300-2896(09)73494-5Article | Medline

[15.]

C. Tueller, H. Stricker, P. Soccal, M. Tamm, J.D. Aubert, M. Maggiorini, et al.

Epidemiology of pulmonary hypertension: new data from Swiss registry.

Swiss Med WKLY, 138 (2008), pp. 379-384

http://dx.doi.org/2008/25/smw-11915 | Medline

[16.]

V.F. Tapson, M. Humbert.

Incidente and prevalence of chronic thromboembolic pulmonary hypertension: from acute to chronic pulmonary embolism.

Proc Am Thorac Soc, 3 (2006), pp. 546-567

[17.]

N. Tanabe, A. Kimura, S. Amano, O. Okada, Y. Kasahara, K. Tatsumi, et al.

Association of clinical features with HLA in chronic pulmonary embolism.

Eur Respir J, 25 (2005), pp. 131-138

http://dx.doi.org/10.1183/09031936.04.00042304 | Medline

[18.]

D. Bonderman, P.L. Turecek, J. Jakowitsch, A. Waltermann, C. Adbrecht, B. Schneider, M. Kneussl, L.J. Rubin, P.A. Kyrle, W. Klepetko, G. Maurer, I.M. Lang.

High prevalence of elevated clotting factor VII in chronic thromboembolic pulmonary hypertension.

Proc Am Thorac Soc, 3 (2006), pp. 568-570

http://dx.doi.org/10.1513/pats.200605-108LR | Medline

[19.]

M. Wolf, C. Boyer-Neumann, F. Parent, V. Eschwege, H. Jaillet, D. Meyer, G. Simonneau.

Thrombotic risk factors in pulmonary hypertension.

Eur Resp J, 15 (2000), pp. 395-399

[20.]

M.D. Fedullo, R. Wiliam, M.D. Auger, M. Kim, M.D. Kerr.

Chronic Pulmonary hyepertension.

N Engl J Med, 345 (2001), pp. 1465-1472

http://dx.doi.org/10.1056/NEJMra010902 | Medline

[21.]

D. Bonderman, J. Jakowitsch, C. Adbrecht, M. Shemper, P.A. Kyrle, V. Schönauer, M. Exner, W. Klepatko, M.P. Kneussl, G. Maurer, I. Lang.

Medical conditions increasing the risk of chronic thromboembolic pulmonary hypertension.

Thromb Haemost, 93 (2005), pp. 512-516

http://dx.doi.org/10.1160/TH04-10-0657 | Medline

[22.]

M.D. Silverstein, J.A. Heit, D.N. Mohr, et al.

Trends in incidensce of deep vein thrombosis and pulmonary embolism: a 25-year population-based, cohort study.

Arch Intern Med, 158 (1998), pp. 585-593

Medline

[23.]

Estudio sobre la enfermedad tromboembólica venosa en España. Disponible en: http://www.Fasemi.org/grupos/e_tromboembólica/publicaciones/estudio_etv.pdf

[24.]

ACCF/AHA 2009 Expert Consensus Document on Pulmonary Hipertensión. J Am Coll Cardiol. Publised online Mar 30, 2009.

[25.]

M. Riedel, V. Stanek, J. Widimsky, I. Perovsky.

Longterm follow-up of patients with pulmonary thromboembolism: late prognosis on haemodynamic and respiratory data.

Chest, 81 (1982), pp. 151-158

Medline

[26.]

J. Lewezuk, P. Piszko, J. Jagas, A. Porada.

Prognostic factors in medically treated patients with chronic pulmonary embolism.

Chest, 119 (2001), pp. 818-823

Medline

[27.]

T. Kunieda, N. Nakanishi, T. Satoh, S. Kyotani, Y. Okano, N. Nagayaga.

Prognoses of primary pulmonary hypertension and chronic major vessel thromboembolic pulmonary hypertension determined from cumulative survival curves.

Intern Med, 38 (1999), pp. 543-546

Medline

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