This study had some limitations. First, it had a retrospective single-center cohort design and low statistical power; this is inevitable, given that CTEPH is a relatively rare disease. Second, the medical and surgical treatment of CTEPH has been evolving yearly, so the clinical status of some of the patients in the early years of this study may not be comparable with that of those in the later years because of improvements in treatment over time. Third, it was difficult to guarantee accurate diagnoses of PDs. Even if the diagnosis was provided by a psychiatric specialist, some patients were diagnosed at other hospitals and we did not perform screening tests of PDs on patients with CTEPH.
Rika nishimura six years 58
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