The Role of Matrix Metalloproteinase 2 and 9 Enzymes in Developing Chronic Thromboembolic Pulmonary Hypertension

Chronic thromboembolic pulmonary hypertension is an occlusive disease in pulmonary artery. Only 4% of patients with acute pulmonary embolism develop chronic thromboembolic pulmonary hypertension and acute pulmonary embolism or deep vein thrombosis is reported in the anamnesis of 75% of those with chronic thromboembolic disease. Therefore, the etiology of the disease is not clear. Altought many studies are done, especially the role of inflamation is emhasised underlie the disease.

Matrix metalloproteinase enzymes play a substantial role of extracellular matrix remodeling. The clot formed in chronic thromboembolic pulmonary hypertension does not melt and turns into a fibrous state, it occludes the pulmonary artery.In this study, investigators aimed to investigate the role of matrix metalloproteinase enzymes in pulmonary arterial wall remodeling in patients with chronic thromboembolic pulmonary hypertension.

Matrix metalloprotinase enzymes are known to play a role in atherosclerosis. This research will investigate whether there is atherosclerosis together with inflamattion in the background of chronic thromboembolic hypertension.

Inclusion criteria

• Despite 3 months of anticoagulation therapy
• mean pulmonary arterial pressure > 20 mmHg
• pulmonary vasculary resistance > 3 wood
• pulmonary capillary wedge pressure < 15 mmHg
• perfusion defect in ventilation perfusion scintigraphy
• pulmonary angiography or computed tomography angiography showing pulmonary artery occlusive lesions

Exclusion criteria

• Patients undergoing pulmonary thromboendarterectomy concomitant coronary bypass, carotid endarterectomy, aortic valve, ascending aorta, mitral valve, tricuspid valve, pulmonary valve surgery
• Patients who have undergone surgical or percutaneous procedures due to atherosclerotic disease