Pulmonary Embolism Research

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Pulmonary".

Deadline for manuscript submissions: closed (15 March 2021) | Viewed by 13113

Special Issue Editor


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Guest Editor
Department of Medicine, Section of Pulmonary, Critical Care and Sleep Medicine, Texas A&M University, College Station, TX, USA
Interests: critical care; quality improvement; pulmonary hypertension; IPF; sleep medicine; sepsis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

A pulmonary embolism (PE) is the occlusion of a pulmonary blood vessel by a clot in one or more of the pulmonary arteries or its branches. Untreated pulmonary embolism carries a high mortality rate (100,000–300,000/year in the USA), especially when a right ventricular strain pattern is present. The incidence of pulmonary embolism is estimated to be 60–70 per 100,000 of the population, and for deep venous thrombosis, it is estimated to be 124 per 100,000. This is likely to be an underestimation, as in the autopsy setting, PE is clinically diagnosed in a higher number of cases (<50%). In addition, with acute pulmonary embolism, we have been challenged by chronic thromboembolic pulmonary hypertension (CTEPH). Diagnosis remains a challenge, and the patient can be asymptomatic to cardiogenic shock due to right-heart failure. Significant research has been done in the pathophysiology, diagnostic, and therapeutic modalities. Newer diagnostic and therapeutic modalities have emerged, but the complications of CTEPH remain. This Special Issue will try to address the research gaps in pulmonary embolisms, CTEPH, risk factors of PE in trauma, obesity, people with coagulation disorder, pregnant patients, COPD, and CHF patients. We will also focus on the pathology of protease activated receptors (PARs), the newer therapeutic technologies, and any advancement in the understanding of pathophysiology. Lastly, the microthrombus formation in the pulmonary artery among COVID-19 patients will also be addressed.

Dr. Salim Surani
Guest Editor

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Keywords

  • pulmonary embolism
  • DVT
  • PE
  • CTEPH: pulmonary hypertension
  • COVID-19
  • EIKOS
  • right ventricular failure
  • hypoxia
  • pregnancy
  • coagulopathy
  • PAR
  • protease activated receptor

Published Papers (4 papers)

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Review

12 pages, 1326 KiB  
Review
Revisiting a Distinct Entity in Pulmonary Vascular Disease: Chronic Thromboembolic Pulmonary Hypertension (CTEPH)
by Munish Sharma and Deborah Jo Levine
Medicina 2021, 57(4), 355; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57040355 - 07 Apr 2021
Cited by 7 | Viewed by 2532
Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH) is a specific type of pulmonary hypertension (PH) and the major component of Group 4 pulmonary hypertension (PH). It is caused by pulmonary vasculature obstruction that leads to a progressive increase in pulmonary vascular resistance and, ultimately, to [...] Read more.
Chronic thromboembolic pulmonary hypertension (CTEPH) is a specific type of pulmonary hypertension (PH) and the major component of Group 4 pulmonary hypertension (PH). It is caused by pulmonary vasculature obstruction that leads to a progressive increase in pulmonary vascular resistance and, ultimately, to failure of the right ventricle. Pulmonary thromboendarterectomy (PEA) is the only definitive therapy, so a timely diagnosis and early referral to a specialized PEA center to determine candidacy is prudent for a favorable outcome. Percutaneous balloon pulmonary angioplasty (BPA) has a potential role in patients unsuitable for PEA. Medical therapy with riociguat is the only PH-specific medical therapy currently approved for the treatment of inoperable or persistent CTEPH. This review article aims to revisit CTEPH succinctly with a review of prevailing literature. Full article
(This article belongs to the Special Issue Pulmonary Embolism Research)
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13 pages, 1099 KiB  
Review
Pulmonary Hypertension in Pregnancy: A Review
by Humayun Anjum and Salim Surani
Medicina 2021, 57(3), 259; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57030259 - 11 Mar 2021
Cited by 7 | Viewed by 3326
Abstract
Pulmonary hypertension (PH) is a disease, which targets the pulmonary vasculature affecting the heart and the lungs, and is characterized by a vast array of signs and symptoms. These manifestations of PH in pregnancy are highly variable and non-specific hence, it is prudent [...] Read more.
Pulmonary hypertension (PH) is a disease, which targets the pulmonary vasculature affecting the heart and the lungs, and is characterized by a vast array of signs and symptoms. These manifestations of PH in pregnancy are highly variable and non-specific hence, it is prudent to have a very keen and high index of suspicion while evaluating these patients. This rare disease can be extremely debilitating and can be associated with a poor overall prognosis. Pregnancy in women with PH puts them at an elevated risk because the physiological changes associated with pregnancy are not well endured leading to even higher morbidity and mortality in these patients. Although there are various modalities for evaluation and workup of PH, right heart catheterization (RHC) remains the gold standard. A mean pulmonary artery pressure (PAP) of more than 20 mm of Hg is considered diagnostic. It is indeed heartening to see that in the past decade many novel therapeutic modalities have emerged and along with a better understanding of the disease process have proved to be promising in terms of reducing the adverse outcomes and preventing death in this population of patients. Full article
(This article belongs to the Special Issue Pulmonary Embolism Research)
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20 pages, 431 KiB  
Review
Review of Medical Therapies for the Management of Pulmonary Embolism
by Ladan Panahi, George Udeani, Michael Horseman, Jaye Weston, Nephy Samuel, Merlyn Joseph, Andrea Mora and Daniela Bazan
Medicina 2021, 57(2), 110; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina57020110 - 26 Jan 2021
Cited by 8 | Viewed by 3908
Abstract
Traditionally, the management of patients with pulmonary embolism has been accomplished with anticoagulant treatment with parenteral heparins and oral vitamin K antagonists. Although the administration of heparins and oral vitamin K antagonists still plays a role in pulmonary embolism management, the use of [...] Read more.
Traditionally, the management of patients with pulmonary embolism has been accomplished with anticoagulant treatment with parenteral heparins and oral vitamin K antagonists. Although the administration of heparins and oral vitamin K antagonists still plays a role in pulmonary embolism management, the use of these therapies are limited due to other options now available. This is due to their toxicity profile, clearance limitations, and many interactions with other medications and nutrients. The emergence of direct oral anticoagulation therapies has led to more options now being available to manage pulmonary embolism in inpatient and outpatient settings conveniently. These oral therapeutic options have opened up opportunities for safe and effective pulmonary embolism management, as more evidence and research is now available about reversal agents and monitoring parameters. The evolution of the pharmacological management of pulmonary embolism has provided us with better understanding regarding the selection of anticoagulants. There is also a better understanding and employment of anticoagulants in pulmonary embolism in special populations, such as patients with liver failure, renal failure, malignancy, and COVID-19. Full article
(This article belongs to the Special Issue Pulmonary Embolism Research)
10 pages, 601 KiB  
Review
Revisiting One of the Dreaded Outcomes of the Current Pandemic: Pulmonary Embolism in COVID-19
by Munish Sharma and Salim Surani
Medicina 2020, 56(12), 670; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina56120670 - 03 Dec 2020
Cited by 3 | Viewed by 2679
Abstract
Pulmonary embolism (PE) is a commonly encountered clinical entity in patients with coronavirus disease 2019 (COVID-19). Up to 1/3 of patients have been found to have PE in the setting of COVID-19. Given the novelty of the virus causing this pandemic, it has [...] Read more.
Pulmonary embolism (PE) is a commonly encountered clinical entity in patients with coronavirus disease 2019 (COVID-19). Up to 1/3 of patients have been found to have PE in the setting of COVID-19. Given the novelty of the virus causing this pandemic, it has not been easy to address diagnostic and management issues in PE. Ongoing research and publications of the scientific literature have helped in dealing with COVID-19 lately and this applies to PE as well. In this article, we attempt to succinctly yet comprehensively discuss PE in patients with COVID-19 with a review of the prevailing literature. Full article
(This article belongs to the Special Issue Pulmonary Embolism Research)
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