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HAL Id: tel-00660920

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Submitted on 18 Jan 2012

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Hypertension pulmonaire post-embolique : remodelage

vasculaire et ischémie chronique.

Edouard Sage

To cite this version:

Edouard Sage. Hypertension pulmonaire post-embolique : remodelage vasculaire et ischémie chronique.. Médecine humaine et pathologie. Université Paris-Est, 2010. Français. �NNT : 2010PEST0029�. �tel-00660920�

UNIVERSITÉ PARIS EST

Année 2010

THÈSE

Pour obtenir le grade de

DOCTEUR DE L’UNIVERSITÉ PARIS EST Spécialité : École doctorale Sciences de la Vie et de la Santé

Présentée et soutenue publiquement Par

SAGE Édouard

Le 16 Décembre 2010

Hypertension pulmonaire post-embolique : Remodelage vasculaire et ischémie chronique.

Directeur de thèse : Pr Elie FADEL

JURY

M. le Pr Philippe DARTEVELLE Président

M. le Pr Alain CHAPELIER Rapporteur

M. le Pr Philippe DEVILLIER Rapporteur

M. le Pr Marc HUMBERT Examinateur

M. le Dr Philippe HERVÉ Examinateur

Mme le Dr Saadia EDDAHIBI Examinateur

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=)B2')5!\S!i2)((+3+1)%+$0!4'!289;.'&%'0(+$0!.526$0)+&'!b^)0)!R$+0%!"]]gc!bOYc7! 1. Hypertension artérielle pulmonaire (HTP)

1.1. Idiopathique 1.2. Familiale

1.2.1. Mutations BMPR2

1.2.2. Mutations ALK1, endogline (avec ou sans maladie de Rendu-Osler) 1.2.3. Mutations inconnues

1.3. Induites par médicaments ou toxiques 1.4. Associée à :

1.4.1. Connectivites 1.4.2. Infection par le VIH 1.4.3. Hypertension portale

1.4.4. Cardiopathies congénitales avec shunt 1.4.5. Bilharziose

1.4.6. Anémie hémolytique chronique 1.5. HTAP persistante des nouveaux-nés

1’. Maladie veino-occlusive pulmonaire et/ou hémangiomatose capillaire pulmonaire !

2. Hypertension pulmonaire associée à une cardiopathie gauche 2.1. Dysfonction systolique

2.2. Dysfonction diastolique 2.3. Valvulopathies

!

3. Hypertension pulmonaire des maladies respiratoires et/ou hypoxémiques chroniques 3.1. Bronchopathie chronique obstructive

3.2. Maladies interstitielles chroniques

3.3. Autres maladies respiratoires restrictives et/ou obstructives 3.4. Pathologies du sommeil

3.5. Hypoventilation alvéolaire 3.6. Exposition chronique à l’altitude 3.7. Anomalies du développement !

4. Hypertension pulmonaire post-embolique chronique !

5. HTP de mécanisme multifactoriel ou incertain

5.1. Maladies hématologiques : syndromes myéloprolifératifs, splénectomie. 5.2. Maladies systémiques : sarcoïdose, histiocytose, lymphangioleiomyomatose, neurofibromatose, vascularites.

5.3. Maladies métaboliques : glycogénoses, maladie de Gaucher, dysthyroïdies. 5.4. Autres : obstructions vasc. pulm. tumorales, médiastinites fibreuses, insuffisance rénale chronique en dialyse.

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