Chronic thromboembolic pulmonary hypertension (CTEPH) is a subset of pulmonary hypertension (PH) characterized by the obstruction of pulmonary arteries with fibrotic material and vascular remodeling that leads to increased pulmonary arterial pressure and right ventricular failure.~A United States CTEPH Registry has been established under the guidance of a Steering Committee consisting of recognized physicians and scientists with expertise in CTEPH and related diseases. The mission of the Registry will be to promote a greater understanding of the prevalence, pathophysiology, evaluation, and treatment of patients with CTEPH through shared information, education, and collaborative investigation among PH centers of excellence throughout the U.S. The development of a national CTEPH registry will be an important element in the advancement of the understanding of CTEPH and improvement in the care of patients who suffer from this debilitating disease.~All consecutive consenting patients recently diagnosed (< 6 months) with CTEPH at participating study sites will be enrolled. At the time of study entry, data on prior history and evaluation will be obtained from patient interview and review of medical records. Patients will be followed biannually after enrollment until the conclusion of the study (minimum of 1 year follow-up for final patients enrolled).~Much of the data gathered by the Registry will be presented as descriptive statistics. The Registry will seek the assistance of a biostatistician to develop a statistical plan for within patient and between patient cohort analyses.~Approximately 750 patients with newly diagnosed (< 6 months) CTEPH will be enrolled.~TIME FRAME:~Participants will be followed from the time of their enrollment until 1 year after the final patient is enrolled. Short term outcome measures and medical history will be collected during the initial visit, and clinical data will be collected from the initial clinic visits, hospital says, or procedures (if applicable). Patients will then be followed every 6 months after their enrollment for long term outcome measures on quality of life, functional status, and medical treatments.~DATA ANALYSES:~Demographics and Clinical Course:~Demographics, risk factors, time to appropriate testing and diagnosis, PAH targeted medication use, functional status, and hemodynamics at the time of enrollment will be provided annually as aggregate data to all investigators.~Evaluating Outcomes of PTE Surgery:~Descriptive statistics of the peri-operative data collected will be provided as aggregate data to all investigators annually. Immediate post-operative and longitudinal follow-up of all patients undergoing PTE surgery will also be provided as aggregate data annually to all sites. Comparisons of hemodynamics, functional status, medication and supplemental oxygen use and healthcare utilization will be made between the pre-operative data and longitudinal post-operative data.~Evaluating Predictors of Successful PTE:~Using longitudinal data collected on post-operative PTE patients, a definition of successful PTE will be established based upon hemodynamics, functional status and QoL. Retrospective analysis of pre-, peri-, and post-operative data can then be analyzed to identify factors that predict a successful or unsuccessful PTE surgery.~Evaluating Outcomes of Nonsurgical Therapy of CTEPH:~Predominantly descriptive statistics will be used to describe why patients are not operative candidates and the nonsurgical therapies (medication, balloon pulmonary angioplasty) used for treatment. Changes in hemodynamics, functional status, QoL and healthcare utilization on therapy will be provided as aggregate data annually.~Evolving Research Needs:~To adapt to the evolving science and research needs of the CTEPH community, separate analysis plans will be developed for new objectives identified and minor changes in the eCRF may occur in response to new diagnostics and treatments, if approved by the Steering Committee. Ongoing assessment of enrollment and data captured will also be performed by the Steering Committee to be certain the goals of the Registry are being met.~COMMITTEES:~A Steering Committee, chaired by Dr. Kim Kerr, is comprised of thought leaders in the areas of cardiology, pulmonology, and cardiothoracic surgery with expertise in CTEPH. The committee will have the following responsibilities:~Provide advice and guidance on the U.S. CTEPH Registry study design and protocol~Provide advice and guidance on the variables to be captured by the eCRF~Provide guidance on study sites selection~Review data results and provide insights into interpretation of the data annually~Provide input on the planning and organization of abstracts and manuscripts~Review abstracts and papers for submission to scientific journals or conferences~Present data at conferences~An Adjudication Committee, consisting of physicians with expertise in the diagnosis of CTEPH, will review all patients felt by Investigators to be eligible for the Registry. The adjudication committee members must confirm the diagnosis of CTEPH before the subject can be enrolled in the Registry.
The U.S. CTEPH Registry is a multicenter, observational, U.S.-based study of the clinical course and treatment of patients diagnosed with chronic thromboembolic pulmonary hypertension (CTEPH), WHO Group IV Classification for Pulmonary Hypertension. The mission of the Registry will be to promote a greater understanding of the prevalence, pathophysiology, evaluation, and treatment of patients with CTEPH through shared information, education, and collaborative investigation among pulmonary hypertension (PH) centers of excellence throughout the U.S.