Reverse remodelling in chronic thromboembolic pulmonary hypertension: the right ventricular enigma continues

Abstract

Extract Chronic thromboembolic pulmonary hypertension (CTEPH) is characterised by persistent organised thromboembolic obstructions and associated vascular remodelling, leading to increased pulmonary arterial pressure and resistance [1, 2]. The resulting chronic afterload drives right ventricle (RV) remodelling, which may progress to maladaptation and ultimately right heart failure if untreated. CTEPH management is multimodal, including pulmonary endarterectomy (PEA), balloon pulmonary angioplasty (BPA), and pharmacological therapies including riociguat or off-label pulmonary hypertension (PH) medications. Management decisions are guided by chronic clot distribution, severity of pulmonary haemodynamics, comorbidities, patient preference and institutional expertise. Shareable abstract This editorial provides important insights into RV adaptation and reverse remodelling in CTEPH patients treated with pulmonary endarterectomy or with balloon pulmonary angioplasty https://bit.ly/4nEceOj