Gender Differences in Chronic Thromboembolic Pulmonary Hypertension in Japan

• Shigeta Ayako

  Department of Respirology, Graduate School of Medicine, Chiba University

• Tanabe Nobuhiro

  Department of Respirology, Graduate School of Medicine, Chiba University

• Shimizu Hidefumi

  Department of Respirology, Graduate School of Medicine, Chiba University

• Hoshino Susumu

  Department of Respirology, Graduate School of Medicine, Chiba University

• Maruoka Miki

  Department of Respirology, Graduate School of Medicine, Chiba University

• Sakao Seiichiro

  Department of Respirology, Graduate School of Medicine, Chiba University

• Tada Yuji

  Department of Respirology, Graduate School of Medicine, Chiba University

• Kasahara Yasunori

  Department of Respirology, Graduate School of Medicine, Chiba University

• Takiguchi Yuichi

  Department of Respirology, Graduate School of Medicine, Chiba University

• Tatsumi Koichiro

  Department of Respirology, Graduate School of Medicine, Chiba University

• Masuda Masahisa

  National Hospital Organization, Chiba Medical Center

• Kuriyama Takayuki

  Department of Respirology, Graduate School of Medicine, Chiba University

Abstract

Background The predominance of chronic thromboembolic pulmonary hypertension (CTEPH) in females and association of HLA-B*5201 with CTEPH have been reported in Japan. However, the clinical characteristics of female CTEPH remain uncertain. The purpose of the present study is to clarify the clinical phenotype of female CTEPH in Japan. Methods and Results The 150 consecutive patients (female 103, male 47; age 52.8±12.4 years SD) were admitted to Chiba University Hospital, and diagnosis was confirmed using right cardiac catheterization and pulmonary angiography. Among these patients, 78 underwent pulmonary endarterectomy. Clinical characteristics, pulmonary hemodynamics, extent of central disease and surgical outcome in females were compared with those in males. The female patients were elderly and had less deep vein thrombosis, less acute embolic episodes, better cardiac function, lower arterial oxygen tension and more peripheral thrombi, and showed less improvement through surgery than males. When the patients were identified using HLA-B*5201, HLA-B*5201-positive female patients had less embolic episodes and better cardiac function with lower operative mortality. In contrast, HLA-B*5201-negative female patients had less embolic episodes, and more peripheral thrombi, resulting in less improvement by surgery. Conclusion The clinical phenotype of female CTEPH differed from that of male CTEPH. Additionally, gender differences of HLA-B*5201-positive type were dissimilar to those of HLA-B*5201-negative type. (Circ J 2008; 72: 2069 - 2074)<br>

Journal

• Circulation Journal

  Circulation Journal 72 (12), 2069-2074, 2008

  The Japanese Circulation Society

Keywords

• Chronic thromboembolic pulmonary hypertension
• Gender difference
• HLA
• Pulmonary embolism

Details

• CRID: 1390001205105774720
• NII Article ID: 110006987366
• NII Book ID: AA11591968
• DOI: 10.1253/circj.cj-08-0377
• ISSN: 13474820
• ISSN: 13469843
• Web Site: http://www.jstage.jst.go.jp/article/circj/72/12/72_CJ-08-0377/_pdf
• Text Lang: en
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed