文献类型：期刊文献

英文题名：Research advances in chronic thromboembolic pulmonary hypertension: from pathological mechanisms to multidisciplinary management

作者：Zhang, Juan-Juan[1];Huang, Yu-Qian[2];Liu, Xue-Kai[3];Sun, Xiao-Long[3];Zhong, Xiang[1];Zhou, Chuan[4];Wang, Chao[5];Xie, Ping[1,3,6,7,8]

第一作者：张锦锦;张静婧;张建军;张晶晶

通信作者：Xie, P[1];Xie, P[2];Xie, P[3];Xie, P[4];Xie, P[5]

机构：[1]Gansu Univ Chinese Med, Sch Tradit Chinese & Western Med, Lanzhou, Peoples R China;[2]Chengdu Second Peoples Hosp, Ctr Med Cosmetol, Chengdu, Peoples R China;[3]Gansu Univ Chinese Med, Clin Med Coll 1, Lanzhou, Peoples R China;[4]Univ Elect Sci & Technol China, Sichuan Prov Peoples Hosp, Dept Geriatr Gen Surg, Chengdu, Sichuan, Peoples R China;[5]Shaanxi Prov Peoples Hosp, Dept Urol, Xian, Peoples R China;[6]Gansu Prov Peoples Hosp, Dept Cardiovasc Med, Lanzhou, Peoples R China;[7]Lanzhou Univ, Sch Clin Med 1, Lanzhou, Peoples R China;[8]Natl Clin Res Ctr Cardiovasc Dis, Construct Unit, Branch Ctr, Lanzhou, Peoples R China

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Gansu Univ Chinese Med, Sch Tradit Chinese & Western Med, Lanzhou, Peoples R China;[2]corresponding author), Gansu Univ Chinese Med, Clin Med Coll 1, Lanzhou, Peoples R China;[3]corresponding author), Gansu Prov Peoples Hosp, Dept Cardiovasc Med, Lanzhou, Peoples R China;[4]corresponding author), Lanzhou Univ, Sch Clin Med 1, Lanzhou, Peoples R China;[5]corresponding author), Natl Clin Res Ctr Cardiovasc Dis, Construct Unit, Branch Ctr, Lanzhou, Peoples R China.|[10735]甘肃中医药大学;

年份：2026

卷号：13

外文期刊名：FRONTIERS IN CARDIOVASCULAR MEDICINE

收录：;Scopus(收录号：2-s2.0-105042273277);WOS:【SCI-EXPANDED(收录号:WOS:001786357300001)】；

基金：The author(s) declared that financial support was received for this work and/or its publication. Gansu Provincial Joint Research Fund (No. 24JRRA886). Graduate Innovation and Entrepreneurship Fund Project of Gansu University of Chinese Medicine (No. 2026CXCY-017).

语种：英文

外文关键词：chronic thromboembolic pulmonary hypertension; diagnostic imaging; multimodal therapy; pathophysiology; precision medicine

摘要：Chronic Thromboembolic Pulmonary Hypertension (CTEPH), classified as group 4 pulmonary hypertension (PH), is a progressive disease caused by unresolved pulmonary artery thrombi that undergo organization and fibrosis, leading to increased pulmonary vascular resistance, right heart failure, and death. Over the past decade, the understanding, diagnosis, and management of CTEPH have undergone profound transformation. This review aims to summarize and discuss recent advances in CTEPH, focusing on pathophysiological mechanisms, diagnostic innovations, therapeutic evolution, and future directions. Current evidence establishes CTEPH as a complex, multifactorial disease involving genetic susceptibility, endothelial dysfunction, inflammation, and aberrant vascular remodeling-far beyond simple mechanical obstruction. In diagnosis, novel imaging modalities including ultra-high-resolution CT, dual-energy CT, computational fluid dynamics, and artificial intelligence have significantly enhanced the sensitivity, objectivity, and functional assessment of pulmonary vascular lesions. Therapeutically, a "three-pillar" paradigm is now firmly established, with pulmonary endarterectomy (PEA) as the curative cornerstone, complemented by balloon pulmonary angioplasty (BPA) and targeted pharmacotherapy (e.g., riociguat). This paradigm is increasingly evolving toward multimodal combination strategies, including preoperative bridging therapy and management of residual PH after intervention. Despite these advances, critical challenges remain: precise identification of operable patients, optimization of surgical and interventional techniques, development of novel targeted therapies, and construction of individualized prognostic models integrating multiomics and artificial intelligence. By addressing these core issues, this review provides a comprehensive, clinically oriented perspective on the current state and future trajectory of CTEPH research and multidisciplinary management, while also discussing emerging precision medicine approaches (e.g., multi-omics and artificial intelligence) that remain investigational.