title: Journey of a patient with chronic thromboembolic pulmonary hypertension.
abstract: Right ventricle (RV) dysfunction is a key outcome determinant and a leading cause of death for patients with chronic thromboembolic pulmonary hypertension (CTEPH). In this report, we followed the 5-year clinical journey of a patient with CTEPH. The tricuspid pressure gradient was significantly increased in the early phase of CTEPH and "normalized" at the late phase of this patient's clinical journey, but this "normalized" gradient is not a positive treatment response but rather an ominous sign of advancing right heart failure owing to an exhaustion of RV contractile function. Thus, appropriate interpretation of the tricuspid pressure gradient change is of importance for assessing RV dysfunction and treatment outcome during follow-up in patients with CTEPH. Besides systolic pulmonary artery pressure (SPAP), other RV functional parameters such as tricuspid annular plane systolic excursion, RV fractional area change, and RV longitudinal strain, together with clinical markers, may provide additional guidance regarding functional improvement or progression in patients with CTEPH.
authors.affiliation: Department of Internal Medicine I - Cardiology, University of Würzburg, Würzburg, Germany. E_Liu_D@ukw.de.|Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany. E_Liu_D@ukw.de.
authors.forename: Dan
authors.initials: D
authors.lastname: Liu
authors.affiliation: Department of Internal Medicine I - Cardiology, University of Würzburg, Würzburg, Germany. Hu_K@ukw.de.|Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany. Hu_K@ukw.de.
authors.forename: Kai
authors.initials: K
authors.lastname: Hu
authors.affiliation: Department of Internal Medicine I - Cardiology, University of Würzburg, Würzburg, Germany. Pelzer_T@ukw.de.|Department of Internal Medicine I - Pneumology, University of Würzburg, Würzburg, Germany. Pelzer_T@ukw.de.
authors.forename: Heinz-Theo
authors.initials: HT
authors.lastname: Pelzer
authors.affiliation: Department of Internal Medicine I - Cardiology, University of Würzburg, Würzburg, Germany. Stoerk_S@ukw.de.|Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany. Stoerk_S@ukw.de.
authors.forename: Stefan
authors.initials: S
authors.lastname: Störk
authors.affiliation: Department of Internal Medicine I - Cardiology, University of Würzburg, Würzburg, Germany. f.weidemann@katharinen-hospital.de.|Comprehensive Heart Failure Center, University of Würzburg, Würzburg, Germany. f.weidemann@katharinen-hospital.de.|Medical Clinic II, Katharinen-Hospital Unna, Obere Husemannstraße 2, 59423, Unna, Germany. f.weidemann@katharinen-hospital.de.
authors.forename: Frank
authors.initials: F
authors.lastname: Weidemann
mesh_terms: D000368:Aged; D002908:Chronic Disease; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis*; D011655:Pulmonary Embolism / Q000175:diagnosis*