title: Reversal of diffuse patchy pattern in lung perfusion scan in a case of severe pulmonary arterial hypertension.
abstract: A diffuse patchy pattern in the perfusion scan of the lung is a hallmark of severe pulmonary arterial hypertension (PAH). However, the mechanisms of this unique pattern remain uncertain. We here present the case of a 19-year-old woman with severe PAH who demonstrated reversal of the diffuse patchy pattern with improvement of pulmonary blood flow within a month after upfront triple combination therapy. Our case is a first report showing reversibility of diffuse patchy pattern by a short-term treatment in severe PAH. These findings suggest the possibility that the mechanisms underlying the diffuse patchy pattern may involve reversible vasoconstriction in addition to remodeling of small pulmonary arteries.
authors.affiliation: Department of Cardiovascular Medicine, Kyushu University Graduate School of Medicine, Fukuoka, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Kodama
authors.affiliation: Department of Advanced Cardiovascular Regulation and Therapeutics, Kyushu University Graduate School of Medicine, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. Electronic address: koabe@cardiol.med.kyushu-u.ac.jp.
authors.forename: Kohtaro
authors.initials: K
authors.lastname: Abe
authors.affiliation: Department of Cardiovascular Medicine, Kyushu University Graduate School of Medicine, Fukuoka, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Hosokawa
authors.affiliation: Department of Cardiovascular Medicine, Kyushu University Graduate School of Medicine, Fukuoka, Japan.
authors.forename: Kisho
authors.initials: K
authors.lastname: Ohtani
authors.affiliation: Department of Molecular Imaging and Diagnosis, Kyushu University Graduate School of Medicine, Fukuoka, Japan.
authors.forename: Michinobu
authors.initials: M
authors.lastname: Nagao
authors.affiliation: Department of Advanced Cardiovascular Regulation and Therapeutics, Kyushu University Graduate School of Medicine, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Hirooka
authors.affiliation: Department of Cardiovascular Medicine, Kyushu University Graduate School of Medicine, Fukuoka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Sunagawa
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D000077300:Bosentan; D004359:Drug Therapy, Combination; D011464:Epoprostenol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000503:physiopathology; D008168:Lung / Q000000981:diagnostic imaging*; D011652:Pulmonary Circulation; D011859:Radiography; D011877:Radionuclide Imaging; D013449:Sulfonamides / Q000627:therapeutic use; D000068581:Tadalafil / Q000627:therapeutic use
chemical_list: D000959:Antihypertensive Agents; D013449:Sulfonamides; D000068581:Tadalafil; D011464:Epoprostenol; D000077300:Bosentan
keywords: Diffuse patchy pattern; Pulmonary arterial hypertension; Upfront combination therapy