To verify whether the new hemodynamic definition of PH has any implication in treatment of CTEPD patients without PH, we retrospectively analysed the clinical and functional changes determined by pulmonary endarterectomy (PEA) in 63 CTEPD patients without PH who underwent surgery at our center, comparing those in whom the hemodynamic diagnosis of PH met recent guideline recommendations versus those in whom the diagnosis only met previous hemodynamic thresholds.

The results show that the vast majority of CTEPD patients without PH operated at our center would now be defined as CTEPH patients. PEA did not result in any improvement in exercise capacity nor in right ventricular function or lung function test in patients with mPAP ≤ 20 mmHg and PVR ≤ 2 WU; on the contrary, hemodynamic parameters, exercise capacity, right ventricular function and lung function significantly improved in patients with mPAP between 21 and 24 mmHg.

为了验证新的 PH 血流动力学定义对不伴有 PH 的 CTEPD 患者的治疗是否有任何影响，我们回顾性分析了在我中心接受手术的 63 例不伴有 PH 的 CTEPD 患者，通过肺动脉内膜切除术（PEA）确定的临床和功能变化，并比较其中 PH 的血流动力学诊断符合最近的指南建议，而诊断仅符合先前的血流动力学阈值的患者。

结果显示，在我们中心手术的绝大多数没有 PH 的 CTEPD 患者现在将被定义为 CTEPH 患者。对于 mPAP ≤ 20 mmHg 且 PVR ≤ 2 WU 的患者，PEA 没有导致运动能力、右心室功能或肺功能测试的任何改善；相反，mPAP 在 21 至 24 mmHg 之间的患者的血流动力学参数、运动能力、右心室功能和肺功能均显着改善。