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  1. Article ; Online: Illuminating the many faces of pulmonary hypertension.

    Newman, Joseph / Pepke-Zaba, Joanna

    The Lancet. Respiratory medicine

    2023  Volume 11, Issue 9, Page(s) 760–762

    MeSH term(s) Humans ; Hypertension, Pulmonary
    Language English
    Publishing date 2023-08-14
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 2686754-0
    ISSN 2213-2619 ; 2213-2600
    ISSN (online) 2213-2619
    ISSN 2213-2600
    DOI 10.1016/S2213-2600(23)00291-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Chronic Thromboembolic Pulmonary Hypertension: A Review of the Multifaceted Pathobiology.

    Ghani, Hakim / Pepke-Zaba, Joanna

    Biomedicines

    2023  Volume 12, Issue 1

    Abstract: Chronic thromboembolic pulmonary disease results from the incomplete resolution of thrombi, leading to fibrotic obstructions. These vascular obstructions and additional microvasculopathy may lead to chronic thromboembolic pulmonary hypertension (CTEPH) ... ...

    Abstract Chronic thromboembolic pulmonary disease results from the incomplete resolution of thrombi, leading to fibrotic obstructions. These vascular obstructions and additional microvasculopathy may lead to chronic thromboembolic pulmonary hypertension (CTEPH) with increased pulmonary arterial pressure and pulmonary vascular resistance, which, if left untreated, can lead to right heart failure and death. The pathobiology of CTEPH has been challenging to unravel due to its rarity, possible interference of results with anticoagulation, difficulty in selecting the most relevant study time point in relation to presentation with acute pulmonary embolism (PE), and lack of animal models. In this article, we review the most relevant multifaceted cross-talking pathogenic mechanisms and advances in understanding the pathobiology in CTEPH, as well as its challenges and future direction. There appears to be a genetic background affecting the relevant pathological pathways. This includes genetic associations with dysfibrinogenemia resulting in fibrinolysis resistance, defective angiogenesis affecting thrombus resolution, and inflammatory mediators driving chronic inflammation in CTEPH. However, these are not necessarily specific to CTEPH and some of the pathways are also described in acute PE or deep vein thrombosis. In addition, there is a complex interplay between angiogenic and inflammatory mediators driving thrombus non-resolution, endothelial dysfunction, and vascular remodeling. Furthermore, there are data to suggest that infection, the microbiome, circulating microparticles, and the plasma metabolome are contributing to the pathobiology of CTEPH.
    Language English
    Publishing date 2023-12-24
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2720867-9
    ISSN 2227-9059
    ISSN 2227-9059
    DOI 10.3390/biomedicines12010046
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  3. Article ; Online: Pulmonary Embolism (PE) to Chronic Thromboembolic Pulmonary Disease (CTEPD): Findings from a Survey of UK Physicians.

    Pepke-Zaba, Joanna / Howard, Luke / Kiely, David G / Sweeney, Shruti / Johnson, Martin

    Advances in respiratory medicine

    2024  Volume 92, Issue 1, Page(s) 45–57

    Abstract: Chronic thromboembolic pulmonary disease (CTEPD) is a complication of pulmonary embolism (PE). We conducted an online survey of UK PE-treating physicians to understand practices in the follow-up of PE and awareness of CTEPD. The physicians surveyed ( ...

    Abstract Chronic thromboembolic pulmonary disease (CTEPD) is a complication of pulmonary embolism (PE). We conducted an online survey of UK PE-treating physicians to understand practices in the follow-up of PE and awareness of CTEPD. The physicians surveyed (
    MeSH term(s) Humans ; Pulmonary Embolism/complications ; Pulmonary Embolism/diagnosis ; Pulmonary Embolism/therapy ; Physicians ; Cardiology ; Internal Medicine ; United Kingdom
    Language English
    Publishing date 2024-01-09
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2893877-X
    ISSN 2543-6031 ; 2451-4934
    ISSN (online) 2543-6031
    ISSN 2451-4934
    DOI 10.3390/arm92010007
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  4. Article ; Online: Perioperative Management in Pulmonary Endarterectomy.

    Jenkins, David P / Martinez, Guillermo / Salaunkey, Kiran / Reddy, S Ashwin / Pepke-Zaba, Joanna

    Seminars in respiratory and critical care medicine

    2023  Volume 44, Issue 6, Page(s) 851–865

    Abstract: Pulmonary endarterectomy (PEA) is the treatment of choice for patients with chronic thromboembolic pulmonary hypertension (PH), provided lesions are proximal enough in the pulmonary vasculature to be surgically accessible and the patient is well enough ... ...

    Abstract Pulmonary endarterectomy (PEA) is the treatment of choice for patients with chronic thromboembolic pulmonary hypertension (PH), provided lesions are proximal enough in the pulmonary vasculature to be surgically accessible and the patient is well enough to benefit from the operation in the longer term. It is a major cardiothoracic operation, requiring specialized techniques and instruments developed over several decades to access and dissect out the intra-arterial fibrotic material. While in-hospital operative mortality is low (<5%), particularly in high-volume centers, careful perioperative management in the operating theater and intensive care is mandatory to balance ventricular performance, fluid balance, ventilation, and coagulation to avoid or treat complications. Reperfusion pulmonary edema, airway hemorrhage, and right ventricular failure are the most problematic complications, often requiring the use of extracorporeal membrane oxygenation to bridge to recovery. Successful PEA has been shown to improve both morbidity and mortality in large registries, with survival >70% at 10 years. For patients not suitable for PEA or with residual PH after PEA, balloon pulmonary angioplasty and/or PH medical therapy may prove beneficial. Here, we describe the indications for PEA, specific surgical and perioperative strategies, postoperative monitoring and management, and approaches for managing residual PH in the long term.
    MeSH term(s) Humans ; Pulmonary Embolism/surgery ; Pulmonary Embolism/complications ; Treatment Outcome ; Lung ; Endarterectomy/adverse effects ; Endarterectomy/methods ; Hypertension, Pulmonary/etiology ; Chronic Disease ; Pulmonary Artery
    Language English
    Publishing date 2023-07-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1183617-9
    ISSN 1098-9048 ; 1069-3424
    ISSN (online) 1098-9048
    ISSN 1069-3424
    DOI 10.1055/s-0043-1770123
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    Zs.A 1555: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  5. Article ; Online: The Digital 1-Minute Walk Test: A New Patient-centered Cardiorespiratory Endpoint.

    Robertson, Lucy / Newman, Joseph / Clayton, Shaun / Ferguson, Mary / Pepke-Zaba, Joanna / Cannon, John / Sheares, Karen / Taboada, Dolores / Bunclark, Katherine / Armstrong, Iain / Ferrer Mallol, Elisa / Davies, Elin Haf / Toshner, Mark

    American journal of respiratory and critical care medicine

    2024  Volume 209, Issue 6, Page(s) 753–756

    MeSH term(s) Humans ; Walk Test ; Exercise Test ; Walking ; Patient-Centered Care ; Cardiorespiratory Fitness
    Language English
    Publishing date 2024-01-11
    Publishing country United States
    Document type Letter
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.202310-1855LE
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Lifting the fog in intermediate-risk (submassive) PE: full dose, low dose, or no thrombolysis?

    Bhamani, Amyn / Pepke-Zaba, Joanna / Sheares, Karen

    F1000Research

    2019  Volume 8

    Abstract: Acute pulmonary embolism (PE) is a disease frequently encountered in clinical practice. While the management of haemodynamically stable, low risk patients with acute PE is well established, managing intermediate disease often presents a therapeutic ... ...

    Abstract Acute pulmonary embolism (PE) is a disease frequently encountered in clinical practice. While the management of haemodynamically stable, low risk patients with acute PE is well established, managing intermediate disease often presents a therapeutic dilemma. In this review, we discuss the various therapeutic options available in this patient group. This includes thrombolysis, surgical embolectomy and catheter directed techniques. We have also explored the role of specialist PE response teams in the management of such patients. ​.
    MeSH term(s) Acute Disease ; Embolectomy ; Humans ; Pulmonary Embolism/therapy ; Risk ; Thrombolytic Therapy
    Language English
    Publishing date 2019-03-25
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2699932-8
    ISSN 2046-1402 ; 2046-1402
    ISSN (online) 2046-1402
    ISSN 2046-1402
    DOI 10.12688/f1000research.17861.1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Perioperative Management in Pulmonary Endarterectomy

    Jenkins, David P. / Martinez, Guillermo / Salaunkey, Kiran / Reddy, S. Ashwin / Pepke-Zaba, Joanna

    Seminars in Respiratory and Critical Care Medicine

    (Pulmonary Hypertension)

    2023  Volume 44, Issue 06, Page(s) 851–865

    Abstract: Pulmonary endarterectomy (PEA) is the treatment of choice for patients with chronic thromboembolic pulmonary hypertension (PH), provided lesions are proximal enough in the pulmonary vasculature to be surgically accessible and the patient is well enough ... ...

    Series title Pulmonary Hypertension
    Abstract Pulmonary endarterectomy (PEA) is the treatment of choice for patients with chronic thromboembolic pulmonary hypertension (PH), provided lesions are proximal enough in the pulmonary vasculature to be surgically accessible and the patient is well enough to benefit from the operation in the longer term. It is a major cardiothoracic operation, requiring specialized techniques and instruments developed over several decades to access and dissect out the intra-arterial fibrotic material. While in-hospital operative mortality is low (<5%), particularly in high-volume centers, careful perioperative management in the operating theater and intensive care is mandatory to balance ventricular performance, fluid balance, ventilation, and coagulation to avoid or treat complications. Reperfusion pulmonary edema, airway hemorrhage, and right ventricular failure are the most problematic complications, often requiring the use of extracorporeal membrane oxygenation to bridge to recovery. Successful PEA has been shown to improve both morbidity and mortality in large registries, with survival >70% at 10 years. For patients not suitable for PEA or with residual PH after PEA, balloon pulmonary angioplasty and/or PH medical therapy may prove beneficial. Here, we describe the indications for PEA, specific surgical and perioperative strategies, postoperative monitoring and management, and approaches for managing residual PH in the long term.
    Keywords chronic thromboembolic pulmonary hypertension ; pulmonary hypertension ; pulmonary embolism ; pulmonary endarterectomy ; pulmonary thromboendarterectomy
    Language English
    Publishing date 2023-07-24
    Publisher Thieme Medical Publishers, Inc.
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 1183617-9
    ISSN 1098-9048 ; 1069-3424
    ISSN (online) 1098-9048
    ISSN 1069-3424
    DOI 10.1055/s-0043-1770123
    Database Thieme publisher's database

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    Zs.A 1555: Show issues Location:
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  8. Article ; Online: The prognostic ability of cardiac output determined by inert gas rebreathing technique in pulmonary hypertension.

    Robertson, Lucy / Bunclark, Katherine / Ross, Robert Mackenzie / Cannon, John / Sheares, Karen / Taboada, Dolores / Pepke-Zaba, Joanna / Toshner, Mark

    Chronic respiratory disease

    2022  Volume 19, Page(s) 14799731221078473

    Abstract: This investigation validated the inert gas rebreathing (IGR) technique and determined IGR prognostic ability compared to invasive cardiac output measurements in patients with pulmonary hypertension. IGR compared with thermodilution cardiac output ... ...

    Abstract This investigation validated the inert gas rebreathing (IGR) technique and determined IGR prognostic ability compared to invasive cardiac output measurements in patients with pulmonary hypertension. IGR compared with thermodilution cardiac output demonstrated a moderate bias. IGR technique demonstrated long-term prognostic value comparable to invasive cardiac output in pulmonary hypertension patients.
    MeSH term(s) Cardiac Output ; Humans ; Hypertension, Pulmonary/diagnosis ; Prognosis
    Language English
    Publishing date 2022-02-10
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2211488-9
    ISSN 1479-9731 ; 1479-9723
    ISSN (online) 1479-9731
    ISSN 1479-9723
    DOI 10.1177/14799731221078473
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    Zs.A 6215: Show issues Location:
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  9. Article ; Online: Prevalence and clinical significance of conduction disease in patients with idiopathic pulmonary arterial hypertension.

    Reddy, Sathineni Ashwin / Nethercott, Sarah L / Teh, Wen / De Bie, Eckart Mdd / Pepke-Zaba, Joanna / Toshner, Mark R / Martin, Claire A

    The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation

    2022  Volume 41, Issue 7, Page(s) 861–865

    Abstract: Anatomical and physiological changes in the right heart as a direct consequence of the upstream pressure overload characteristic of idiopathic pulmonary hypertension (IPAH) are likely to lead to conduction disease in these patients. However, the ... ...

    Abstract Anatomical and physiological changes in the right heart as a direct consequence of the upstream pressure overload characteristic of idiopathic pulmonary hypertension (IPAH) are likely to lead to conduction disease in these patients. However, the prevalence and clinical implications of atrioventricular conduction disease in IPAH patients are not well-characterized. In this observational cohort study, we show that conduction disease is far more prevalent in a cohort of 175 IPAH patients than a group of matched comparators (37.1% vs 10.8%), and is associated with older age, male sex and more severe right heart dilatation. However, conduction disease is independently associated with worse functionality and higher mortality in this patient group. Prospective study is required to substantiate this, and whether intervention such as prophylactic pacing could restore prognosis.
    MeSH term(s) Familial Primary Pulmonary Hypertension/diagnosis ; Familial Primary Pulmonary Hypertension/epidemiology ; Heart ; Humans ; Male ; Prevalence ; Prognosis ; Prospective Studies ; Pulmonary Arterial Hypertension
    Language English
    Publishing date 2022-04-07
    Publishing country United States
    Document type Journal Article ; Observational Study
    ZDB-ID 1062522-7
    ISSN 1557-3117 ; 1053-2498
    ISSN (online) 1557-3117
    ISSN 1053-2498
    DOI 10.1016/j.healun.2022.03.024
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    Zs.A 2056: Show issues Location:
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  10. Article ; Online: Cardiac MRI in the assessment of chronic thromboembolic pulmonary hypertension and response to treatment.

    Bartnik, Aleksandra / Pepke-Zaba, Joanna / Bunclark, Katherine / Ruggiero, Alessandro / Jenkins, D / Taghavi, J / Tsui, Steven / Screaton, Nicholas / D'Errico, L / Weir-McCall, Jonathan

    Thorax

    2023  Volume 79, Issue 1, Page(s) 90–97

    MeSH term(s) Humans ; Hypertension, Pulmonary/diagnostic imaging ; Magnetic Resonance Imaging ; Pulmonary Circulation ; Radiography ; Pulmonary Embolism/complications ; Pulmonary Embolism/diagnostic imaging ; Chronic Disease ; Pulmonary Artery/diagnostic imaging
    Language English
    Publishing date 2023-12-15
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 204353-1
    ISSN 1468-3296 ; 0040-6376
    ISSN (online) 1468-3296
    ISSN 0040-6376
    DOI 10.1136/thorax-2022-219716
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