{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:25:40Z","timestamp":1791822340586,"version":"4.3.4"},"reference-count":44,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T00:00:00Z","timestamp":1666828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Chronic thromboembolic pulmonary hypertension (CTEPH) is a chronic progressive disease, resulting from persistent arterial obstruction combined with small-vessel remodeling. Central and peripheral CTEPH are distinguished, according to the dominant lesion\u2019s location. This is important for surgical or percutaneous interventional assessment or for medical treatment. Material and Methods: Eighty-one patients (51 male\/30 female) with confirmed CTEPH were analyzed, while the CENTRAL type included 51 patients (63%) and the PERIPHERAL type 30 patients (37%). Results: A significant difference in CENTRAL type vs. PERIPHERAL type was determined in gender (male 72.5% vs. 46.7%; p = 0.0198). No difference was found in age, functional status, or echocardiographic parameters. Invasive hemodynamic parameters showed a significant difference in mean pulmonary arterial pressure (46 vs. 58 mmHg; p = 0.0002), transpulmonary gradient (34 vs. 47 mmHg; p = 0.0005), and cardiac index (2.04 vs. 2.5 L.min.m2; p = 0.02) but not in pulmonary vascular resistance. Risk factors showed a significant difference only in acute pulmonary embolism (93.8% vs. 60%; p = 0.0002) and malignancy (2% vs. 13.3%; p = 0.0426). Conclusions: Our study showed hemodynamic differences between CENTRAL type vs. PERIPHERAL type CTEPH with a worse hemodynamic picture in CENTRAL form. This may indicate a different pathophysiological response and\/or possible additional influences contributing especially to the peripheral pulmonary bed affection.<\/jats:p>","DOI":"10.3390\/medicina58111538","type":"journal-article","created":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T22:36:17Z","timestamp":1666910177000},"page":"1538","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Central versus Peripheral CTEPH\u2014Clinical and Hemodynamic Specifications"],"prefix":"10.3390","volume":"58","author":[{"given":"Monika","family":"Kaldararova","sequence":"first","affiliation":[{"name":"Department of Cardiology and Angiology, CTEPH Expert Centre, Medical Faculty, The National Institute of Cardiovascular Diseases, Slovak Medical University, Pod Krasnou horkou 1, 833 48 Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iveta","family":"Simkova","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, CTEPH Expert Centre, Medical Faculty, The National Institute of Cardiovascular Diseases, Slovak Medical University, Pod Krasnou horkou 1, 833 48 Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela","family":"Bohacekova","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, CTEPH Expert Centre, Medical Faculty, The National Institute of Cardiovascular Diseases, Slovak Medical University, Pod Krasnou horkou 1, 833 48 Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Reptova","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, CTEPH Expert Centre, Medical Faculty, The National Institute of Cardiovascular Diseases, Slovak Medical University, Pod Krasnou horkou 1, 833 48 Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tereza","family":"Hlavata","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, CTEPH Expert Centre, Medical Faculty, The National Institute of Cardiovascular Diseases, Slovak Medical University, Pod Krasnou horkou 1, 833 48 Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jozef","family":"Pacak","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, CTEPH Expert Centre, Medical Faculty, The National Institute of Cardiovascular Diseases, Slovak Medical University, Pod Krasnou horkou 1, 833 48 Bratislava, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaroslav","family":"Lindner","sequence":"additional","affiliation":[{"name":"2nd Department of Surgery\u2014Department of Cardiovascular Surgery, 1st Faculty of Medicine, General University Hospital, Charles University, U nemocnice 2, 128 02 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pavel","family":"Jansa","sequence":"additional","affiliation":[{"name":"Center for Pulmonary Hypertension, 1st Faculty of Medicine, General University Hospital, Charles University, U nemocnice 2, 128 02 Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1093\/eurheartj\/ehv317","article-title":"Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT)","volume":"37","author":"Humbert","year":"2016","journal-title":"Eur. 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