Heart biomarkers as prognostic tools for chronic thromboembolic pulmonary hypertension: a step forward by the fatty acid-binding protein.

D uring the last 20 yrs, a tremendous amount of scientific discoveries have greatly improved our knowledge on the pathophysiology of pulmonary hypertension, and expanded our armamentarium of important novel medications that have substantially improved survival and the quality of life of patients suffering from this devastating disorder. Although most investigations have focused on pulmonary arterial hypertension (PAH), chronic thromboembolic pulmonary hypertension (CTEPH) has also gained increasing attention [1]. CTEPH could be viewed as an extension of the natural history of acute pulmonary embolism (PE). However, its pathophysiology is not entirely understood; only a minority of patients who have undergone acute PE will develop chronic thromboembolic disease, while disorders associated with abnormal fibrinolysis and/or a pro-thrombotic lung vascular phenotype appear to be predisposing factors for CTEPH development [2].