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Pulmonary hypertension is defined as a mean PAP of at least 20 mm Hg (3300 Pa) at rest, and PAH is defined as precapillary pulmonary hypertension (i.e. mean PAP ≥ 20 mm Hg with pulmonary arterial occlusion pressure [PAOP] ≤ 15 mm Hg and pulmonary vascular resistance [PVR] > 3 Wood Units). [58]
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A pulmonary artery wedge pressure being less than 15 mmHg (also measured by right heart catheterization) excludes post-capillary bed (in the veins distal to the capillary bed) pulmonary hypertension. Pulmonary arterial hypertension is a subgroup of pulmonary hypertension and is categorized as World Health Organization as group 1. [3]
Precapillary resistance is the modulation of blood flow by capillaries through vasomotion, either opening and letting blood pass through, or by constricting their lumens, reducing bloodflow through the capillary bed (occluding the passage of blood). It is not entirely clear how precapillary resistance is created in many parts of the body. [1]
A precapillary sphincter is a band of contractile mural cells either classified as smooth muscle or pericytes that adjusts blood flow into capillaries. They were originally described in the mesenteric microcirculation , and were thought to only reside there.
Resistance arteries are usually small arteries or arterioles and include precapillary sphincters. [1] Having thick muscular walls and narrow lumen they contribute the most to the resistance to blood flow. Degree of the contraction of vascular smooth muscle in the wall of a resistance artery is directly connected to the size of the lumen.
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Chronic thromboembolic pulmonary hypertension (CTEPH) is a long-term disease caused by a blockage in the blood vessels that deliver blood from the heart to the lungs (the pulmonary arterial tree). These blockages cause increased resistance to flow in the pulmonary arterial tree which in turn leads to rise in pressure in these arteries ...
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