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Jiménez" "autores" => array:8 [ 0 => array:4 [ "nombre" => "Andrés" "apellidos" => "Tenes" "email" => array:1 [ 0 => "joseandrestenes@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Aldara" "apellidos" => "García-Sánchez" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Beatriz" "apellidos" => "Pintado-Cort" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Sara" "apellidos" => "González-Castro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Winnifer" "apellidos" => "Briceño" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Diego" "apellidos" => "Durán" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 6 => array:3 [ "nombre" => "Raquel" "apellidos" => "Morillo" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 7 => array:3 [ "nombre" => "David" "apellidos" => "Jiménez" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Respiratory Department, Hospital Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria IRYCIS, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Medicine Department, Universidad de Alcalá, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento de la hipertensión pulmonar tromboembólica crónica y sexo: revisión sistemática y metaanálisis" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 764 "Ancho" => 3576 "Tamanyo" => 190435 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">6MWD response to treatment according to sex.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Pulmonary hypertension (PH) is characterized by remodeling of pulmonary vasculature and rise of pulmonary resistance that leads to remodeling and hypertrophy of right ventricle.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">1</span></a> Chronic thromboembolic pulmonary hypertension (CTEPH) is a life-threatening disease of obstructive pulmonary artery remodeling resulting from chronic thromboembolic material in pulmonary arteries and vasculopathy in the distal vessels, which causes elevated pulmonary vascular resistance, progressive pulmonary hypertension, and right ventricular dysfunction.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">2</span></a> The recent published clinical guidelines endorsed by <span class="elsevierStyleItalic">ESC/ERS</span>, place CTEPH is in the group 4 of PH, labeled as <span class="elsevierStyleItalic">PH associated with pulmonary artery obstructions</span>.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">3</span></a> CTEPH has been reported with a cumulative incidence between 0.1% and 9.1% within the first 2 years after a symptomatic pulmonary embolism (PE) event<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">4</span></a> but still, a significant number of cases may originate from asymptomatic venous thromboembolic event (VTE).<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">5</span></a> It has been described an equally prevalence between women and men.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Therapeutic anticoagulation is recommended for patients with CTEPH for lifelong, as recurrent pulmonary thrombo-embolism accompanied by insufficient clot resolution are key pathophysiological features of this disease.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">3</span></a> Surgical pulmonary endarterectomy (PEA) is the treatment of choice, and it should be offered to all eligible patients with CTEPH.<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">7–9</span></a> PEA can normalize pulmonary hemodynamics and increase functional capacity.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">10</span></a> The surgical technique consists of a complete bilateral endarterectomy of the pulmonary arteries (PAs) down to segmental and subsegmental levels. In centers with experience the peri-operative mortality rates <2.5%<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">11</span></a> and post-operative PH is observed in approximately 25%, with excellent survive in long-term (averaging 90% in 3 years).<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">12</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">CTEPH has a microvascular component that explains the persistent PH after PEA, and it has emerged two approved therapies. Riociguat, a soluble guanylate cyclase stimulator, has demonstrated in inoperable CTEPH or those with persistent/recurrent PH after PEA improved in 6 minutes walking distance (6MWD) and reduced pulmonary vascular resistance (PVR) by 31% compared to placebo.<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">13</span></a> Treprostinil sub-cutaneous (s.c.), an analog of prostacyclin, similarly demonstrated improvement in 6MWD.<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">14</span></a> Other therapies have been used off-label but has no evidence in randomize clinical trials (RCTs).</p><p id="par0020" class="elsevierStylePara elsevierViewall">Balloon pulmonary angioplasty (BPA) has surged as an alternative treatment option in selected patients with inoperable CTEPH or persistent/recurrent PH after PEA. It consists in an endovascular procedure to widen narrowed or obstructed pulmonary arteries.<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">15</span></a> Several RCTs demonstrated improvements in hemodynamics (lowering PVR), improvement in right heart function, and exercise capacity.<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">15,16</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">However, a comparative efficacy of the treatment in men and women has not been carried out until now. The objective of our systematic review and meta-analysis was to compare the efficacy of PEA, BPA, riociguat and treprostinil between men and woman assessing hemodynamics, clinical and laboratory outcomes.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Material and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Study objectives</span><p id="par0030" class="elsevierStylePara elsevierViewall">The primary objective of our systematic review and meta-analysis was compare the efficacy of PEA, BPA, rocioguat and teprostinil between woman and men assessed by an improvement pulmonary vascular resistance (PVR). Secondary objectives were improvements in exercise capacity appraised with 6-min walk distance, functional class, cardiac biomarkers as NT-proBNP and BNP, cardiac index (CI) and mean pulmonary arterial pressure (mPAP).</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Search strategy</span><p id="par0035" class="elsevierStylePara elsevierViewall">The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42021268504).</p><p id="par0040" class="elsevierStylePara elsevierViewall">We conducted independent systematic searches of the MEDLINE (using the Ovid platform), PubMed, Embase, CINAHL (using the Ovid platform), and the Cochrane Library databases for eligible articles published between January 1, 2010, and April 30, 2021. Full articles of all potentially appropriate abstracts were reviewed. Searches were performed using the following strategy: chronic thromboembolic pulmonary hypertension OR thromboembolic pulmonary hypertension cteph AND pulmonary thromboendarterectomy OR balloon pulmonary angioplasty OR riociguat OR Treprostinil, including articles in English. The systematic review was completed by a manual search of the literature.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Study selection</span><p id="par0045" class="elsevierStylePara elsevierViewall">Two investigators (A.T. and A.G.-S.) independently assessed identified articles to determine study eligibility. Based on title and abstract review, the reviewers excluded non-relevant studies. For relevant studies, the reviewers independently carried out data extraction using a pre-piloted, standardized form. Consensus or discussion with a third reviewer (D.J.) resolved eligibility and data extraction discrepancies or uncertainties.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Data extraction and quality assessment</span><p id="par0050" class="elsevierStylePara elsevierViewall">For each study, two investigators (A.T. and A.G.-S.) extracted data on the baseline characteristics of the patients, and changes from baseline for each group. In the absence of information on events in each group, the corresponding author was contacted to obtain it. Discrepancies were resolved with the help of a third investigator (D.J.). The quality in prognosis studies (QUIPS) tool was used to assess the quality of the studies chosen.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">17</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Statistical analysis</span><p id="par0055" class="elsevierStylePara elsevierViewall">The meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">18</span></a> The Review Manager (RevMan) 5.4.1 software (Cochrane Collaboration, Copenhagen), which offers open-source statistical packages for meta-analysis, was used for data analysis. For primary analyses, continuous data will be pooled to estimate weighted mean differences with 95% confidence intervals (CIs) using a random-effects model with inverse variance weighting. In cases where only medians and interquartile ranges were reported, means and standard deviations (SDs) will be approximated using the method described in the Cochrane Handbook Statistical heterogeneity between groups will be measured using the Cochran's <span class="elsevierStyleItalic">Q</span> statistic and the Higgins <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> statistic. The heterogeneity of the original studies was assessed using the <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> statistic. We used Begg's test to determine publication bias. In all analyses, the significance levels were bilateral and considered significant with a <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05.</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Results</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Study identification and selection</span><p id="par0060" class="elsevierStylePara elsevierViewall">Study selection process has been shown in flow diagram in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>. We identified 681 studies of PEA, BPA, riociguat, and Treprostinil s.c. once duplicate studies were excluded. Of these, 570 studies were excluded after titles and abstracts were screened for the selection criteria. One hundred eleven reports were assessed for eligibility, then we excluded conference abstracts, reviews, case reports, animal trials, letters, and other unrelated topics. The Begg's test did not evidence publication bias. We eventually included 19 studies in the final analysis. Neither of the studies reported the results according to sex, so we ask the corresponding authors for the data. Only three authors reply to the data request.<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">16,19,20</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Characteristics and quality of included studies</span><p id="par0065" class="elsevierStylePara elsevierViewall">Characteristic of patients in the included trials have been presented in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. Two studies evaluated the efficacy of BPA, and one study evaluated the efficacy of riociguat (129 patients). Overall, 57.3% of patients were women and 62.6% were in functional class III. Most patients were in functional class II/III. Mean time of follow-up was 55.5 (SD 26.1) weeks.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">The efficacy of treatments according to sex</span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Pulmonary vascular resistance</span><p id="par0070" class="elsevierStylePara elsevierViewall">Analyzing the data provided, it was shown that the response in the PVR was in favor of men against women, with an inverse variance (IV) of 161.17 (67.99, 254.35, <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0%, <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.0007) (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>), this data was extracted from two studies that involved BPA.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Exercise capacity</span><p id="par0075" class="elsevierStylePara elsevierViewall">For the capacity for exercise measure with the 6MWD it shown an IV 19.8 (−23.38, 62.97, <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>80%, <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.37) (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>) and showed a signal to have a better response to treatments in men.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Hemodynamics parameters</span><p id="par0080" class="elsevierStylePara elsevierViewall">In regard of the other hemodynamics parameters (PAPm and CI), we obtain a response in favor of response to treatment for women in CI (IV −0.10 (−0.16, −0.04), <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0%, <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.001) but show no difference according to sex in the response in PAPm (IV 1.50 (−0.32, 3.32), <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>89%, <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.11) but showing certain better effectiveness for men (<a class="elsevierStyleCrossRefs" href="#fig0020">Figs. 4 and 5</a>). All this data was collected from two studies involving the BPA.</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Biomarkers and functional class</span><p id="par0085" class="elsevierStylePara elsevierViewall">It was shown no difference in the response of serum biomarkers (such as BNP and NT-proBNP) regarding to sex (IV 31.97 (−250.50, 314.45), <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>83%, <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.82) (<a class="elsevierStyleCrossRef" href="#sec0120">supplemental Fig. 1</a>), involving the data provided from BPA. The change in the functional class (demonstrating an improvement from baseline to a better class) shown a OR of 0.44 (0.14, 1.43), <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>40%, <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.17, providing a signal of better response in women (<a class="elsevierStyleCrossRef" href="#sec0120">supplemental Fig. 2</a>), involving data from the two therapies (BPA and riociguat).</p></span></span></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Discussion</span><p id="par0090" class="elsevierStylePara elsevierViewall">Our study provides some information about the effect of the treatments available for the treatment of the CTEPH and the difference in the effect according to sex. The reduction in PVR is more noticeable in men and there is also some favorable effect in the PAPm and 6MWD from the data collected. In regard of the women, shown evidence of better response in the CI and probably in functional class representing maybe a different pathway to make improvements with the medical and interventional therapies. This data might show different response to treatments, that can be explained for adaptation of men and women, that has not been established before, and can explain differences in survival, according to the severity of the disease.</p><p id="par0095" class="elsevierStylePara elsevierViewall">Previous studies have shown a difference in hemodynamics characteristics of men and women who have CTEPH. Yang et al.<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">21</span></a> demonstrated that women have a better compliance of the pulmonary vascular demonstrated by a higher response to acute vasodilator test in the PVR (ΔPVR/PVR), however our data do not evidence a better response in PVR (in women) as in CI and functional class, but we have to take on account that the data provided only has the efficacy of two therapies (BPA and riociguat) and only one analysis take the three.</p><p id="par0100" class="elsevierStylePara elsevierViewall">The PVR is one of the most important outcomes that we take account after diagnosed and treat a patient with CTEPH and has implications in the prognostic and the treatment options in some centers with expertise. Some data demonstrated a higher PVR in women with CTEPH, that can predict a worse response for PVR against men.<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">6,22</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">Besides the response of PVR, there is evidence that women have a better long-term survival compared to men and has been seen in previous registries publications by Barco et al.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">6</span></a> and Cruz-Utrilla et al.<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">22</span></a> In than same direction, for PAH, it has been demonstrated that women maybe have better adaptive remodeling of the RV in response to increased afterload.<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">23</span></a> Even further, some data describes that women undergo less surgical treatment (PEA) due to evidence of more distal disease.<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">6,22</span></a> This confusion of survival but less invasive procedures (PEA) can maybe evidence better response to other treatment options, such as riociguat or BPA, that perhaps are used more in this group.</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Limitations</span><p id="par0110" class="elsevierStylePara elsevierViewall">This study has several limitations. Firstly, we do not have the data for several studies, to complete the comparison in the respond to the treatment and maybe have better conclusions. Secondly, we only compared two therapies and maybe the results reflect the efficacy of each one instead of the effectiveness for men and women, even further, maybe we are only comparing the efficacy of BPA between men and women. However, there are evidence of survival differences between men and women, that this study may bring some light. Thirdly, the sample size differs in the different treatment options. Therefore, our conclusions should be taken with caution since there are no randomized controlled trials comparing the efficacy of treatment options between men and women.</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Conclusions</span><p id="par0115" class="elsevierStylePara elsevierViewall">Among patients with CTEPH, women and men might show different hemodynamic responses to riociguat and BPA for CTEPH. Women response better in hemodynamics and maybe clinical outcomes, compared to men, but them, have a better response in vascular resistance.</p></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Ethical considerations</span><p id="par0120" class="elsevierStylePara elsevierViewall">we do not obtain written informed consent, because of the nature or the study.</p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Funding</span><p id="par0125" class="elsevierStylePara elsevierViewall">This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.</p></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0170">Authors’ contributions</span><p id="par0130" class="elsevierStylePara elsevierViewall">Tenes had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.</p><p id="par0135" class="elsevierStylePara elsevierViewall">Concept and design: Tenes, García-Sanchez, Jiménez.</p><p id="par0140" class="elsevierStylePara elsevierViewall">Acquisition, analysis, or interpretation of data; statistical analysis: Tenes, García-Sanchez.</p><p id="par0145" class="elsevierStylePara elsevierViewall">Drafting of the manuscript: Tenes, García-Sanchez, Jiménez.</p><p id="par0150" class="elsevierStylePara elsevierViewall">Critical revision of the manuscript for important intellectual content: Tenes, García-Sanchez, Pintado-Cort, González, Briceño, Duran, Morillo, Jiménez.</p><p id="par0155" class="elsevierStylePara elsevierViewall">Study supervision: Jiménez.</p></span><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0175">Conflict of interest</span><p id="par0160" class="elsevierStylePara elsevierViewall">A.T. has served as an advisor or consultant for Janssen.</p><p id="par0165" class="elsevierStylePara elsevierViewall">A.G.-S., B.P.-C., S.G., W.B., D.D., and R.M. have nothing to disclose.</p><p id="par0170" class="elsevierStylePara elsevierViewall">D.J. has served as an advisor or consultant for Pfizer, MSD, Sanofi.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:16 [ 0 => array:3 [ "identificador" => "xres2245179" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background and objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1877886" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xpalclavsec1877885" "titulo" => "Abbreviations" ] 3 => array:3 [ "identificador" => "xres2245180" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Antecedentes y objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 4 => array:2 [ "identificador" => "xpalclavsec1877887" "titulo" => "Palabras clave" ] 5 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 6 => array:3 [ "identificador" => "sec0010" "titulo" => "Material and methods" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Study objectives" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Search strategy" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Study selection" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Data extraction and quality assessment" ] 4 => array:2 [ "identificador" => "sec0035" "titulo" => "Statistical analysis" ] ] ] 7 => array:3 [ "identificador" => "sec0040" "titulo" => "Results" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0045" "titulo" => "Study identification and selection" ] 1 => array:2 [ "identificador" => "sec0050" "titulo" => "Characteristics and quality of included studies" ] 2 => array:3 [ "identificador" => "sec0055" "titulo" => "The efficacy of treatments according to sex" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0060" "titulo" => "Pulmonary vascular resistance" ] 1 => array:2 [ "identificador" => "sec0065" "titulo" => "Exercise capacity" ] 2 => array:2 [ "identificador" => "sec0070" "titulo" => "Hemodynamics parameters" ] 3 => array:2 [ "identificador" => "sec0075" "titulo" => "Biomarkers and functional class" ] ] ] ] ] 8 => array:2 [ "identificador" => "sec0080" "titulo" => "Discussion" ] 9 => array:2 [ "identificador" => "sec0085" "titulo" => "Limitations" ] 10 => array:2 [ "identificador" => "sec0090" "titulo" => "Conclusions" ] 11 => array:2 [ "identificador" => "sec0095" "titulo" => "Ethical considerations" ] 12 => array:2 [ "identificador" => "sec0100" "titulo" => "Funding" ] 13 => array:2 [ "identificador" => "sec0105" "titulo" => "Authors’ contributions" ] 14 => array:2 [ "identificador" => "sec0110" "titulo" => "Conflict of interest" ] 15 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2024-01-29" "fechaAceptado" => "2024-03-11" "PalabrasClave" => array:2 [ "en" => array:2 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1877886" "palabras" => array:6 [ 0 => "Chronic thromboembolic hypertension" 1 => "Chronic thomboembolic pulmonary hypertension" 2 => "Balloon pulmonary angioplasty" 3 => "Riociguat" 4 => "Treatment" 5 => "Sex" ] ] 1 => array:4 [ "clase" => "abr" "titulo" => "Abbreviations" "identificador" => "xpalclavsec1877885" "palabras" => array:11 [ 0 => "CTEPH" 1 => "PEA" 2 => "BPA" 3 => "PE" 4 => "VTE" 5 => "Pas" 6 => "6MWD" 7 => "PVR" 8 => "RCTs" 9 => "mPAP" 10 => "CI" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1877887" "palabras" => array:6 [ 0 => "Hipertensión tromboembólica crónica" 1 => "Hipertensión pulmonar tromboembólica crónica" 2 => "Angioplastia con balón" 3 => "Riociguat" 4 => "Tratamiento" 5 => "Sexo" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background and objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Chronic thromboembolic pulmonary hypertension (CTEPH) is a complication of pulmonary embolism and a major cause of chronic pulmonary hypertension leading to right heart failure and death. While pulmonary endarterectomy is the treatment of choice, some patients might benefit from medical therapy or balloon pulmonary angioplasty. Sex differences in outcomes of these therapies are not well characterized.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We conducted a systematic review and meta-analysis to investigate sex differences in outcomes of various therapies for CTEPH. We searched MEDLINE, PubMed, Embase, CINAHL and the Cochrane Library databases between January 1, 2010 and April 30, 2021, published in English. We pooled incidence estimates using random-effects meta-analyses. We evaluated heterogeneity using the <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span> statistic. We assessed publication bias using Begg's and Egger's tests. This study is registered in PROSPERO, CRD42021268504.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 19 studies met the eligibility criteria, but only 3 trials provided separate outcomes for women and men. Two studies evaluated the efficacy of BPA, and one study evaluated the efficacy of riociguat (129 patients). Overall, 57.3% of patients were women and 62.6% were in functional class III. Mean time of follow-up was 55.5 (SD 26.1) weeks. Women showed a significantly better response in cardiac index (mean difference [MD], 0.10<span class="elsevierStyleHsp" style=""></span>L/min/m<span class="elsevierStyleSup">2</span>; 95% confidence interval [CI], 0.04–0.16; <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0%; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.001). Alternatively, the reduction of pulmonary vascular resistances was significantly higher for men than for women (MD, 161.17<span class="elsevierStyleHsp" style=""></span>dyn<span class="elsevierStyleHsp" style=""></span>s<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleSup">−5</span>; 95% CI, 67.99–254.35; <span class="elsevierStyleItalic">I</span><span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0%; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.0007).</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Women and men might show different hemodynamic responses to riociguat or BPA for CTEPH.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background and objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Antecedentes y objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La hipertensión pulmonar tromboembólica crónica (HPTEC) es una patología grave que puede conducir a insuficiencia cardiaca derecha y muerte. La endarterectomía pulmonar es el tratamiento de elección, pero algunos pacientes pueden beneficiarse de medicamentos o de angioplastia pulmonar con balón (APB). No se ha valorado la diferencia en respuesta a las terapias por sexos, por lo que es el objetivo de este estudio.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se realizó una revisión sistemática y un metaanálisis para investigar las diferencias entre hombres y mujeres en los resultados de diversas terapias para la HPTEC. Se buscaron en las bases de datos Medline, PubMed, Embase, CINAHL y Cochrane entre el 1 de enero de 2010 y el 30 de abril de 2021, artículos publicados en inglés. Este estudio se encuentra registrado en PROSPERO, CRD42021268504.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se encontraron un total de 19 estudios que cumplían con los criterios de elegibilidad, de los cuales tres proporcionaron los datos segregados. Dos estudios evaluaron la eficacia de la APB y uno evaluó la eficacia de Riociguat (129 pacientes). 57,3% de los pacientes eran mujeres y el 62,6% se encontraban en clase funcional III. El tiempo medio de seguimiento fue de 55,5 semanas (DE 26,1). Las mujeres mostraron una respuesta significativamente mejor en el índice cardiaco (diferencia media [DM] 0,10 L/min/m<span class="elsevierStyleSup">2</span>; IC 95%, 0,04-0,16; 120%; p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,001). Por otro lado, la reducción de las resistencias vasculares pulmonares fue significativamente mayor en los hombres que en las mujeres (DM, 161,17 dyn/sec/cm<span class="elsevierStyleSup">2</span>; IC 95%, 67,99-254,35; F<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0%; p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,0007).</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los resultados de este estudio sugieren que existen diferencias entre mujeres y hombres en la respuesta a APB y Riociguat para la HPTEC.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Antecedentes y objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0180" class="elsevierStylePara elsevierViewall">The following are the supplementary data to this article:<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0120" ] ] ] ] "multimedia" => array:7 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2367 "Ancho" => 2158 "Tamanyo" => 329304 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Flow chart according to PRISMA recommendations.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 646 "Ancho" => 3590 "Tamanyo" => 162074 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Pulmonary vascular resistance response to treatment according to sex.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 764 "Ancho" => 3576 "Tamanyo" => 190435 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">6MWD response to treatment according to sex.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 757 "Ancho" => 3341 "Tamanyo" => 165520 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">PAPm response to treatment according to sex.</p>" ] ] 4 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Fig. 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 764 "Ancho" => 3425 "Tamanyo" => 175781 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Cardiac index response to treatment according to sex.</p>" ] ] 5 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">First author \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Year \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Country \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study design \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Treatment \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">No. patients \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Proportions of female (%) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean PVR (dyn<span class="elsevierStyleHsp" style=""></span>s<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleSup">−5</span>) SD \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean PAPm (mmHg) SD \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean cardiac index (L<span class="elsevierStyleHsp" style=""></span>min<span class="elsevierStyleSup">−1</span><span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">−2</span>) SD \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean 6MWD (m) SD \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean NT-proBNP/BNP (pg/ml) SD \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">NYHA/WHO functional class (%) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean/longest follow-up (weeks) SD \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mizoguchi<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">16</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2012 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Japan \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prospective study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BPA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">68 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">78.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">942<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>367 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>9.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">296<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>108 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">I: 0.0II: 0.0III: 72.00IV: 28.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>38.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Andreassen<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">19</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2013 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Norway \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Observational study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">BPA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.0<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">NT-proBNP 90<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>119 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">I: 0.0II: 15.0III: 70.0IV: 15.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">51<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>30 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Halank<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">20</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2017 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Germany \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prospective study \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Riociguat \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">447.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>187 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">I: 2.0II: 51.0III: 46.0IV: 0.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">77<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3658569.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Characteristics of included studies.</p>" ] ] 6 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:2 [ "fichero" => "mmc1.doc" "ficheroTamanyo" => 478720 ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:23 [ 0 => array:3 [ "identificador" => "bib0120" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary arterial hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P.M. Hassoun" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMra2000348" "Revista" => array:5 [ "tituloSerie" => "N Engl J Med" "fecha" => "2021" "volumen" => "385" "paginaInicial" => "2361" "paginaFinal" => "2376" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0125" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic thromboembolic disease and chronic thromboembolic pulmonary hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "I.M. Lang" 1 => "I.A. Campean" 2 => "R. Sadushi-Kolici" 3 => "R. Badr-Eslam" 4 => "C. Gerges" 5 => "N. Skoro-Sajer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ccm.2020.11.014" "Revista" => array:6 [ "tituloSerie" => "Clin Chest Med" "fecha" => "2021" "volumen" => "42" "paginaInicial" => "81" "paginaFinal" => "90" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33541619" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0130" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Humbert" 1 => "G. Kovacs" 2 => "M.M. Hoeper" 3 => "R. Badagliacca" 4 => "R.M.F. Berger" 5 => "M. Brida" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/13993003.00879-2022" "Revista" => array:5 [ "tituloSerie" => "Eur Respir J" "fecha" => "2023" "volumen" => "61" "paginaInicial" => "2200879" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/36028254" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0135" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Factors associated with diagnosis and operability of chronic thromboembolic pulmonary hypertension: a case–control study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I. Lang" 1 => "G. Simonneau" 2 => "J. Pepke-Zaba" 3 => "E. Mayer" 4 => "D. Ambrož" 5 => "I. Blanco" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1160/TH13-02-0097" "Revista" => array:6 [ "tituloSerie" => "Thromb Haemost" "fecha" => "2013" "volumen" => "110" "paginaInicial" => "83" "paginaFinal" => "91" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23677493" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0140" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic thromboembolic pulmonary hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Dartevelle" 1 => "E. Fadel" 2 => "S. Mussot" 3 => "A. Chapelier" 4 => "P. Herve" 5 => "M. De Perrot" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/09031936.04.00079704" "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2004" "volumen" => "23" "paginaInicial" => "637" "paginaFinal" => "648" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15083767" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0145" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sex-specific differences in chronic thromboembolic pulmonary hypertension. Results from the European CTEPH registry" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Barco" 1 => "F.A. Klok" 2 => "S.V. Konstantinides" 3 => "P. Dartevelle" 4 => "E. Fadel" 5 => "D. Jenkins" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/jth.14629" "Revista" => array:6 [ "tituloSerie" => "J Thromb Haemost" "fecha" => "2020" "volumen" => "18" "paginaInicial" => "151" "paginaFinal" => "161" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31479557" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0150" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Current strategies for managing chronic thromboembolic pulmonary hypertension: results of the worldwide prospective CTEPH Registry" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Guth" 1 => "A.M. D’Armini" 2 => "M. Delcroix" 3 => "K. Nakayama" 4 => "E. Fadel" 5 => "S.P. Hoole" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/23120541.00850-2020" "Revista" => array:3 [ "tituloSerie" => "ERJ Open Res" "fecha" => "2021" "volumen" => "7" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0155" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic thromboembolic pulmonary hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N.H. Kim" 1 => "M. Delcroix" 2 => "X. Jais" 3 => "M.M. Madani" 4 => "H. Matsubara" 5 => "E. Mayer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/13993003.01915-2018" "Revista" => array:5 [ "tituloSerie" => "Eur Respir J" "fecha" => "2019" "volumen" => "53" "paginaInicial" => "1801915" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30545969" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0160" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Interventional and pharmacological management of chronic thromboembolic pulmonary hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "H.-A. Ghofrani" 1 => "A.M. D’Armini" 2 => "N.H. Kim" 3 => "E. Mayer" 4 => "G. Simonneau" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rmed.2020.106293" "Revista" => array:5 [ "tituloSerie" => "Respir Med" "fecha" => "2021" "volumen" => "177" "paginaInicial" => "106293" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33465538" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0165" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Residual pulmonary hypertension after pulmonary endarterectomy: a meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "W.C. Hsieh" 1 => "P. Jansa" 2 => "W.C. Huang" 3 => "M. Nižnanský" 4 => "M. Omara" 5 => "J. Lindner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jtcvs.2018.04.110" "Revista" => array:6 [ "tituloSerie" => "J Thorac Cardiovasc Surg" "fecha" => "2018" "volumen" => "156" "paginaInicial" => "1275" "paginaFinal" => "1287" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29903403" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0170" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary endarterectomy in chronic thromboembolic pulmonary hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Lankeit" 1 => "V. Krieg" 2 => "L. Hobohm" 3 => "S. Kölmel" 4 => "C. Liebetrau" 5 => "S. Konstantinides" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.healun.2017.06.011" "Revista" => array:6 [ "tituloSerie" => "J Heart Lung Transplant" "fecha" => "2018" "volumen" => "37" "paginaInicial" => "250" "paginaFinal" => "258" "itemHostRev" => array:3 [ "pii" => "S0196064416309350" "estado" => "S300" "issn" => "01960644" ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0175" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term outcome of patients with chronic thromboembolic pulmonary hypertension: results from an International Prospective Registry" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Delcroix" 1 => "I. Lang" 2 => "J. Pepke-Zaba" 3 => "P. Jansa" 4 => "A.M. D’Armini" 5 => "R. Snijder" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.115.016522" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2016" "volumen" => "133" "paginaInicial" => "859" "paginaFinal" => "871" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26826181" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0180" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Riociguat for the treatment of chronic thromboembolic pulmonary hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.-A. Ghofrani" 1 => "A.M. D’Armini" 2 => "F. Grimminger" 3 => "M.M. Hoeper" 4 => "P. Jansa" 5 => "N.H. Kim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa1209657" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2013" "volumen" => "369" "paginaInicial" => "319" "paginaFinal" => "329" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23883377" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0185" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Subcutaneous treprostinil for the treatment of severe non-operable chronic thromboembolic pulmonary hypertension (CTREPH): a double-blind, phase 3, randomised controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Sadushi-Kolici" 1 => "P. Jansa" 2 => "G. Kopec" 3 => "A. Torbicki" 4 => "N. Skoro-Sajer" 5 => "I.-A. Campean" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S2213-2600(18)30367-9" "Revista" => array:6 [ "tituloSerie" => "Lancet Respir Med" "fecha" => "2019" "volumen" => "7" "paginaInicial" => "239" "paginaFinal" => "248" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30477763" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0190" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "French experience of balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P. Brenot" 1 => "X. Jaïs" 2 => "Y. Taniguchi" 3 => "C. Garcia Alonso" 4 => "B. Gerardin" 5 => "S. Mussot" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1183/13993003.02095-2018" "Revista" => array:4 [ "tituloSerie" => "Eur Respir J" "fecha" => "2019" "volumen" => "53" "paginaInicial" => "1802095" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0195" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Refined balloon pulmonary angioplasty for inoperable patients with chronic thromboembolic pulmonary hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "H. Mizoguchi" 1 => "A. Ogawa" 2 => "M. Munemasa" 3 => "H. Mikouchi" 4 => "H. Ito" 5 => "H. Matsubara" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCINTERVENTIONS.112.971077" "Revista" => array:5 [ "tituloSerie" => "Circ Cardiovasc Interv" "fecha" => "2012" "volumen" => "5" "paginaInicial" => "748" "paginaFinal" => "755" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0200" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evaluation of the quality of prognosis studies in systematic reviews" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.A. Hayden" 1 => "P. Côté" 2 => "C. Bombardier" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7326/0003-4819-144-6-200603210-00010" "Revista" => array:5 [ "tituloSerie" => "Ann Intern Med" "fecha" => "2006" "volumen" => "144" "paginaInicial" => "427" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16549855" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0205" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D. Moher" 1 => "A. Liberati" 2 => "J. Tetzlaff" 3 => "D.G. Altman" 4 => "The PRISMA Group" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pmed.1000097" "Revista" => array:5 [ "tituloSerie" => "PLoS Med" "fecha" => "2009" "volumen" => "6" "paginaInicial" => "e1000097" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19621072" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0210" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Balloon pulmonary angioplasty in patients with inoperable chronic thromboembolic pulmonary hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.K. Andreassen" 1 => "A. Ragnarsson" 2 => "E. Gude" 3 => "O. Geiran" 4 => "R. Andersen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/heartjnl-2012-303549" "Revista" => array:6 [ "tituloSerie" => "Heart" "fecha" => "2013" "volumen" => "99" "paginaInicial" => "1415" "paginaFinal" => "1420" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23846611" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0215" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Riociguat for pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: results from a phase II long-term extension study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Halank" 1 => "M.M. Hoeper" 2 => "H.-A. Ghofrani" 3 => "F.J. Meyer" 4 => "G. Stähler" 5 => "J. Behr" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rmed.2017.05.008" "Revista" => array:6 [ "tituloSerie" => "Respir Med" "fecha" => "2017" "volumen" => "128" "paginaInicial" => "50" "paginaFinal" => "56" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28610669" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0220" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sex differences of hemodynamics during acute vasoreactivity testing to predict the outcomes of chronic thromboembolic pulmonary hypertension" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Yang" 1 => "Y. Yu" 2 => "P. Yuan" 3 => "S. Gong" 4 => "C. Wang" 5 => "Y. Li" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/crj.13173" "Revista" => array:6 [ "tituloSerie" => "Clin Respir J" "fecha" => "2020" "volumen" => "14" "paginaInicial" => "611" "paginaFinal" => "621" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32090459" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0225" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sex differences in chronic thromboembolic pulmonary hypertension. Treatment options over time in a National Referral Center" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Cruz-Utrilla" 1 => "M.J. Cristo-Ropero" 2 => "M. Calderón-Flores" 3 => "M. Velázquez" 4 => "M.J. López-Gude" 5 => "Y. Revilla Ostolaza" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3390/jcm10184251" "Revista" => array:5 [ "tituloSerie" => "JCM" "fecha" => "2021" "volumen" => "10" "paginaInicial" => "4251" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34575363" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0230" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Right ventricular sex differences in patients with idiopathic pulmonary arterial hypertension characterised by magnetic resonance imaging: pair-matched case controlled study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.J. Swift" 1 => "D. Capener" 2 => "C. Hammerton" 3 => "S.M. Thomas" 4 => "C. Elliot" 5 => "R. Condliffe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pone.0127415" "Revista" => array:6 [ "tituloSerie" => "PLoS One" "fecha" => "2015" "volumen" => "10" "paginaInicial" => "e0127415" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25996939" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0953620519304170" "estado" => "S300" "issn" => "09536205" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00257753/0000016300000006/v1_202409180457/S0025775324002756/v1_202409180457/en/main.assets" "Apartado" => array:4 [ "identificador" => "66429" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Originales" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00257753/0000016300000006/v1_202409180457/S0025775324002756/v1_202409180457/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775324002756?idApp=UINPBA00004N" ]
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Original article
Chronic thromboembolic pulmonary hypertension treatment and sex: Systematic review and meta-analysis
Tratamiento de la hipertensión pulmonar tromboembólica crónica y sexo: revisión sistemática y metaanálisis