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In clinical practice, CTEPH patients often show obstructive ventilatory impairment, even in the absence of a smoking history. Recent reports imply a tendency for CTEPH patients to have a lower FEV\n                      <jats:sub>1.0<\/jats:sub>\n                      ; however, the mechanism underlying obstructive impairment remains unknown.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed CTEPH patients who underwent a pulmonary function test and respiratory impedance test to evaluate their exertional dyspnea during admission for right heart catheterization from January 2000 to December 2019. We excluded patients with a smoking history to rule out the effect of smoking on obstructive impairment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 135 CTEPH patients were analyzed. The median FEV\n                      <jats:sub>1.0<\/jats:sub>\n                      \/FVC was 76.0%, %FEV\n                      <jats:sub>1.0<\/jats:sub>\n                      had a negative correlation with the mean pulmonary artery pressure and pulmonary vascular resistance and the CT Angiogram (CTA) obstruction score. A multivariate regression analysis revealed that the CTA obstruction score was an independent factor of a lower %FEV\n                      <jats:sub>1.0<\/jats:sub>\n                      . In the 54 patients who underwent pulmonary endarterectomy, %FEV\n                      <jats:sub>1.0<\/jats:sub>\n                      was improved in some cases and was not in some. Mean PAP largely decreased after PEA in the better %FEV\n                      <jats:sub>1.0<\/jats:sub>\n                      improved cases, suggesting that vascular involvement in CTEPH could be associated with spirometry obstructive impairment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      %FEV\n                      <jats:sub>1.0<\/jats:sub>\n                      had a significant correlation with the CTA obstruction score. Obstructive impairment might have an etiological relationship with vascular involvement. Further investigations could shed new light on the etiology of CTEPH.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12890-021-01779-x","type":"journal-article","created":{"date-parts":[[2021,12,9]],"date-time":"2021-12-09T07:07:21Z","timestamp":1639033641000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Vascular involvement in chronic thromboembolic pulmonary hypertension is associated with spirometry obstructive impairment"],"prefix":"10.1186","volume":"21","author":[{"given":"Asako","family":"Yanagisawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Naito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Jujo-Sanada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiro","family":"Tanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiichi","family":"Ishida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Goro","family":"Matsumiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rika","family":"Suda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Kasai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayumi","family":"Sekine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiko","family":"Sugiura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayako","family":"Shigeta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiichiro","family":"Sakao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Tatsumi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuji","family":"Suzuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,9]]},"reference":[{"key":"1779_CR1","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1007\/s11886-015-0621-9","volume":"17","author":"AS Witkin","year":"2015","unstructured":"Witkin AS, Channick RN. 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