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1. A common gene signature of the right ventricle in failing rat and human hearts

Author

Jurida, Liane, Werner, Sebastian, Knapp, Fabienne, Niemann, Bernd, Li, Ling, Grün, Dimitri, Wirth, Stefanie, Weber, Axel, Beuerlein, Knut, Liebetrau, Christoph, Wiedenroth, Christoph B., Guth, Stefan, Kojonazarov, Baktybek, Jafari, Leili, Weissmann, Norbert, Günther, Stefan, Braun, Thomas, Bartkuhn, Marek, Schermuly, Ralph T., Dorfmüller, Peter, Yin, Xiaoke, Mayr, Manuel, Schmitz, M. Lienhard, Czech, Laureen, Schlüter, Klaus-Dieter, Schulz, Rainer, Rohrbach, Susanne, and Kracht, Michael

Published
2024
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2. Highlights from the International Chronic Thromboembolic Pulmonary Hypertension Congress 2021

Author

Simonneau, Gérald, Fadel, Elie, Noordegraaf, Anton Vonk, Toshner, Mark, Lang, Irene M, Klok, Frederikus A, McInnis, Micheal C, Screaton, Nicholas, Madani, Michael M, Martinez, Guillermo, Salaunkey, Kiran, Jenkins, David P, Matsubara, Hiromi, Brénot, Philippe, Hoeper, Marius M, Ghofrani, Hossein A, Jaïs, Xavier, Wiedenroth, Christoph B, Guth, Stefan, Kim, Nick H, Pepke-Zaba, Joanna, Delcroix, Marion, and Mayer, Eckhard

Subjects
Lung, Aetiology, 2.1 Biological and endogenous factors, Cardiovascular, Humans, Hypertension, Pulmonary, Chronic Disease, Pulmonary Embolism, Pulmonary Artery, Angioplasty, Balloon, Endarterectomy, Anticoagulants, Medical Physiology, Respiratory System
Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare complication of acute pulmonary embolism. It is caused by persistent obstruction of pulmonary arteries by chronic organised fibrotic clots, despite adequate anticoagulation. The pulmonary hypertension is also caused by concomitant microvasculopathy which may progress without timely treatment. Timely and accurate diagnosis requires the combination of imaging and haemodynamic assessment. Optimal therapy should be individualised to each case and determined by an experienced multidisciplinary CTEPH team with the ability to offer all current treatment modalities. This report summarises current knowledge and presents key messages from the International CTEPH Conference, Bad Nauheim, Germany, 2021. Sessions were dedicated to 1) disease definition; 2) pathophysiology, including the impact of the hypertrophied bronchial circulation, right ventricle (dys)function, genetics and inflammation; 3) diagnosis, early after acute pulmonary embolism, using computed tomography and perfusion techniques, and supporting the selection of appropriate therapies; 4) surgical treatment, pulmonary endarterectomy for proximal and distal disease, and peri-operative management; 5) percutaneous approach or balloon pulmonary angioplasty, techniques and complications; and 6) medical treatment, including anticoagulation and pulmonary hypertension drugs, and in combination with interventional treatments. Chronic thromboembolic pulmonary disease without pulmonary hypertension is also discussed in terms of its diagnostic and therapeutic aspects.

Published
2023

3. Worldwide CTEPH Registry: Long-Term Outcomes With Pulmonary Endarterectomy, Balloon Pulmonary Angioplasty, and Medical Therapy

Author

Delcroix, Marion, Pepke-Zaba, Joanna, D’Armini, Andrea M., Fadel, Elie, Guth, Stefan, Hoole, Stephen P., Jenkins, David P., Kiely, David G., Kim, Nick H., Madani, Michael M., Matsubara, Hiromi, Nakayama, Kazuhiko, Ogawa, Aiko, Ota-Arakaki, Jaquelina S., Quarck, Rozenn, Sadushi-Kolici, Roela, Simonneau, Gérald, Wiedenroth, Christoph B., Yildizeli, Bedrettin, Mayer, Eckhard, and Lang, Irene M.

Published
2024
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8. Current strategies for managing chronic thromboembolic pulmonary hypertension: results of the worldwide prospective CTEPH Registry

Author

Guth, Stefan, D'Armini, Andrea M, Delcroix, Marion, Nakayama, Kazuhiko, Fadel, Elie, Hoole, Stephen P, Jenkins, David P, Kiely, David G, Kim, Nick H, Lang, Irene M, Madani, Michael M, Matsubara, Hiromi, Ogawa, Aiko, Ota-Arakaki, Jaquelina S, Quarck, Rozenn, Sadushi-Kolici, Roela, Simonneau, Gérald, Wiedenroth, Christoph B, Yildizeli, Bedrettin, Mayer, Eckhard, and Pepke-Zaba, Joanna

Subjects
Rare Diseases, Lung, Cardiovascular
Abstract

Pulmonary endarterectomy (PEA), pulmonary arterial hypertension (PAH) therapy and balloon pulmonary angioplasty (BPA) are currently accepted therapies for chronic thromboembolic pulmonary hypertension (CTEPH). This international CTEPH Registry identifies clinical characteristics of patients, diagnostic algorithms and treatment decisions in a global context. 1010 newly diagnosed consecutive patients were included in the registry between February 2015 and September 2016. Diagnosis was confirmed by right heart catheterisation, ventilation-perfusion lung scan, computerised pulmonary angiography and/or invasive pulmonary angiography after at least 3 months on anticoagulation. Overall, 649 patients (64.3%) were considered for PEA, 193 (19.1%) for BPA, 20 (2.0%) for both PEA and BPA, and 148 (14.7%) for PAH therapy only. Reasons for PEA inoperability were technical inaccessibility (n=235), comorbidities (n=63) and patient refusal (n=44). In Europe and America and other countries (AAO), 72% of patients were deemed suitable for PEA, whereas in Japan, 70% of patients were offered BPA as first choice. Sex was evenly balanced, except in Japan where 75% of patients were female. A history of acute pulmonary embolism was reported for 65.6% of patients. At least one PAH therapy was initiated in 35.8% of patients (26.2% of PEA candidates, 54.5% of BPA candidates and 54.1% of those not eligible for either PEA or BPA). At the time of analysis, 39 patients (3.9%) had died of pulmonary hypertension-related causes (3.5% after PEA and 1.8% after BPA). The registry revealed noticeable differences in patient characteristics (rates of pulmonary embolism and sex) and therapeutic approaches in Japan compared with Europe and AAO.

Published
2021

13. Pulmonary Hypertension

Author

Wiedenroth, Christoph B., Mayer, Eckhard, Willerson, James T., Series Editor, Feldman, David S., editor, and Mohacsi, Paul, editor

Published
2019
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15. Chronisch thromboembolische pulmonale Hypertonie (Gruppe 4)

Author

Guth, Stefan, additional, Wilkens, Heinrike, additional, Halank, Michael, additional, Held, Matthias, additional, Hobohm, Lukas, additional, Konstantinides, Stavros, additional, Omlor, Albert, additional, Seyfarth, Hans-Jürgen, additional, Schäfers, Hans-Joachim, additional, Mayer, Eckhard, additional, and Wiedenroth, Christoph B., additional

Published
2023
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18. Endothelial Overexpression of TGF-β-Induced Protein Impairs Venous Thrombus Resolution

Author

Bochenek, Magdalena L., primary, Saar, Kathrin, additional, Nazari-Jahantigh, Maliheh, additional, Gogiraju, Rajinikanth, additional, Wiedenroth, Christoph B., additional, Münzel, Thomas, additional, Mayer, Eckhard, additional, Fink, Ludger, additional, Schober, Andreas, additional, Hübner, Norbert, additional, Guth, Stefan, additional, Konstantinides, Stavros, additional, and Schäfer, Katrin, additional

Published
2023
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21. Patient-Reported Long-Term Outcome of Balloon Pulmonary Angioplasty for Inoperable CTEPH

Author

Wiedenroth, Christoph B., additional, Steinhaus, Kristin, additional, Rolf, Andreas, additional, Breithecker, Andreas, additional, Adameit, Miriam S. D., additional, Kriechbaum, Steffen D., additional, Haas, Moritz, additional, Roller, Fritz, additional, Hamm, Christian W., additional, Ghofrani, H.-Ardeschir, additional, Mayer, Eckhard, additional, Guth, Stefan, additional, and Liebetrau, Christoph, additional

Published
2023
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22. Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension: a clinical consensus statement of the ESC working group on pulmonary circulation and right ventricular function

Author

Lang, Irene M, primary, Andreassen, Arne K, additional, Andersen, Asger, additional, Bouvaist, Helene, additional, Coghlan, Gerry, additional, Escribano-Subias, Pilar, additional, Jansa, Pavel, additional, Kopec, Grzegorz, additional, Kurzyna, Marcin, additional, Matsubara, Hiromi, additional, Meyer, Bernhard Christian, additional, Palazzini, Massimiliano, additional, Post, Marco C, additional, Pruszczyk, Piotr, additional, Räber, Lorenz, additional, Roik, Marek, additional, Rosenkranz, Stephan, additional, Wiedenroth, Christoph B, additional, Redlin-Werle, Carlo, additional, and Brenot, Philippe, additional

Published
2023
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23. Evaluation of diagnostic accuracy of dual-energy computed tomography in patients with chronic thromboembolic pulmonary hypertension compared to V/Q-SPECT and pulmonary angiogram

Author

Schüssler, Armin, primary, Lug, Quirin, additional, Kremer, Nils, additional, Harth, Sebastian, additional, Kriechbaum, Steffen D., additional, Richter, Manuel J., additional, Guth, Stefan, additional, Wiedenroth, Christoph B., additional, Tello, Khodr, additional, Steiner, Dagmar, additional, Seeger, Werner, additional, Krombach, Gabriele Anja, additional, and Roller, Fritz Christian, additional

Published
2023
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27. A common gene signature of the right ventricle in failing rat and human hearts

Author

Jurida, Liane, primary, Werner, Sebastian, additional, Knapp, Fabienne, additional, Niemann, Bernd, additional, Li, Ling, additional, Gruen, Dimitri, additional, Wirth, Stefanie, additional, Weber, Axel, additional, Beuerlein, Knut, additional, Liebetrau, Christoph, additional, Wiedenroth, Christoph B., additional, Guth, Stefan, additional, Kojonazarov, Baktybek, additional, Jafari, Leili, additional, Weissmann, Norbert, additional, Guenther, Stefan, additional, Braun, Thomas, additional, Rohrbach, Susanne, additional, and Kracht, Michael, additional

Published
2023
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28. 3D Visualization, Skeletonization and Branching Analysis of Blood Vessels in Angiogenesis

Author

Ramakrishnan, Vignesh, primary, Schönmehl, Rebecca, additional, Artinger, Annalena, additional, Winter, Lina, additional, Böck, Hendrik, additional, Schreml, Stephan, additional, Gürtler, Florian, additional, Daza, Jimmy, additional, Schmitt, Volker H., additional, Mamilos, Andreas, additional, Arbelaez, Pablo, additional, Teufel, Andreas, additional, Niedermair, Tanja, additional, Topolcan, Ondrej, additional, Karlíková, Marie, additional, Sossalla, Samuel, additional, Wiedenroth, Christoph B., additional, Rupp, Markus, additional, and Brochhausen, Christoph, additional

Published
2023
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29. Value of Right and Left Ventricular T1 and T2 Blood Pool Mapping in Patients with Chronic Thromboembolic Hypertension before and after Balloon Pulmonary Angioplasty

Author

Roller, Fritz C., primary, Schüßler, Armin, additional, Kremer, Nils, additional, Harth, Sebastian, additional, Kriechbaum, Steffen D., additional, Wiedenroth, Christoph B., additional, Guth, Stefan, additional, Breithecker, Andreas, additional, Richter, Manuel, additional, Tello, Khodr, additional, Seeger, Werner, additional, Mayer, Eckhard, additional, and Krombach, Gabriele A., additional

Published
2023
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31. Exercise MR-proANP unmasks latent right heart failure in CTEPH

Author

Kriechbaum, Steffen D., primary, Birmes, Judith, additional, Wiedenroth, Christoph B., additional, Adameit, Miriam S.D., additional, Gruen, Dimitri, additional, Vietheer, J., additional, Richter, Manuel J., additional, Guth, Stefan, additional, Roller, Fritz C., additional, Rademann, Matthias, additional, Fischer-Rasokat, Ulrich, additional, Rolf, Andreas, additional, Liebetrau, Christoph, additional, Hamm, Christian W., additional, Keller, Till, additional, and Rieth, Andreas J., additional

Published
2022
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32. GDF-15 and soluble ST2 as biomarkers of right ventricular dysfunction in pulmonary hypertension

Author

Keranov, Stanislav, primary, Widmann, Laila, additional, Jafari, Leili, additional, Liebetrau, Christoph, additional, Keller, Till, additional, Troidl, Christian, additional, Kriechbaum, Steffen, additional, Voss, Sandra, additional, Bauer, Pascal, additional, Richter, Manuel J, additional, Tello, Khodr, additional, Gall, Henning, additional, Ghofrani, Hossein A, additional, Wiedenroth, Christoph B, additional, Guth, Stefan, additional, Seeger, Werner, additional, Hamm, Christian W, additional, Nef, Holger, additional, and Dörr, Oliver, additional

Published
2022
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33. Balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension: a clinical consensus statement of the ESC working group on pulmonary circulation and right ventricular function

Author

Lang, Irene M, Andreassen, Arne K, Andersen, Asger, Bouvaist, Helene, Coghlan, Gerry, Escribano-Subias, Pilar, Jansa, Pavel, Kopec, Grzegorz, Kurzyna, Marcin, Matsubara, Hiromi, Meyer, Bernhard Christian, Palazzini, Massimiliano, Post, Marco C, Pruszczyk, Piotr, Räber, Lorenz, Roik, Marek, Rosenkranz, Stephan, Wiedenroth, Christoph B, Redlin-Werle, Carlo, and Brenot, Philippe

Subjects
610 Medicine & health
Abstract

The current treatment algorithm for chronic thromboembolic pulmonary hypertension (CTEPH) as depicted in the 2022 European Society of Cardiology (ESC)/European Respiratory Society (ERS) guidelines on the diagnosis and treatment of pulmonary hypertension (PH) includes a multimodal approach of combinations of pulmonary endarterectomy (PEA), balloon pulmonary angioplasty (BPA) and medical therapies to target major vessel pulmonary vascular lesions, and microvasculopathy. Today, BPA of >1700 patients has been reported in the literature from centers in Asia, the US, and also Europe; many more patients have been treated outside literature reports. As BPA becomes part of routine care of patients with CTEPH, benchmarks for safe and effective care delivery become increasingly important. In light of this development, the ESC Working Group on Pulmonary Circulation and Right Ventricular Function has decided to publish a document that helps standardize BPA to meet the need of uniformity in patient selection, procedural planning, technical approach, materials and devices, treatment goals, complications including their management, and patient follow-up, thus complementing the guidelines. Delphi methodology was utilized for statements that were not evidence based. First, an anatomical nomenclature and a description of vascular lesions are provided. Second, treatment goals and definitions of complete BPA are outlined. Third, definitions of complications are presented which may be the basis for a standardized reporting in studies involving BPA. The document is intended to serve as a companion to the official ESC/ERS guidelines.

Published
2023
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34. Value of Right and Left Ventricular T1 and T2 Blood Pool Mapping in Patients with Chronic Thromboembolic Hypertension before and after Balloon Pulmonary Angioplasty

Author

Roller, Fritz C., Schüßler, Armin, Kremer, Nils, Harth, Sebastian, Kriechbaum, Steffen D., Wiedenroth, Christoph B., Guth, Stefan, Breithecker, Andreas, Richter, Manuel, Tello, Khodr, Seeger, Werner, Mayer, Eckhard, Krombach, Gabriele A., and Justus Liebig University Giessen

Subjects
T2 mapping, ddc:610, CTEPH, parametric imaging, CMR, T1 mapping
Abstract

Background: Parametric imaging has taken a steep rise in recent years and non-cardiac applications are of increasing interest. Therefore, the aim of our study was to assess right (RV) and left ventricular (LV) blood pool T1 and T2 values in patients with chronic thromboembolic pulmonary hypertension (CTEPH) compared to control subjects and their correlation to pulmonary hemodynamic. Methods: 26 patients with CTEPH (mean age 64.8 years ± 12.8 SD; 15 female), who underwent CMR and right heart catheterization (RHC) before and 6-months after balloon pulmonary angioplasty (BPA), were retrospectively included. Ventricular blood pool values were measured, compared to control subjects (mean age 40.5 years ± 12.8 SD; 16 female) and correlated to invasive measures (CI, mPAP, PVR). Results: In both, control subjects and CTEPH patients, RVT1 and RVT2 were significantly reduced compared to LVT1 and LVT2. Compared to control subjects, RVT2 was significantly reduced in CTEPH patients (p = 0.0065) and increased significantly after BPA (p = 0.0048). Moreover, RVT2 was positively correlated with CI and negatively correlated with mPAP and PVR before (r = 0.5155, r = −0.2541, r = −0.4571) and after BPA (r = 0.4769, r = −0.2585, r = −0.4396). Conclusion: Ventricular blood pool T2 mapping might be novel non-invasive CMR imaging marker for assessment of disease severity, prognosis, follow-up and even therapy monitoring in PH.

Published
2023
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36. Right ventricular–pulmonary arterial coupling and its relationship to exercise haemodynamics in a continuum of patients with pulmonary vascular disease due to chronic thromboembolism

Author

Douschan, Philipp, primary, Tello, Khodr, additional, Rieth, Andreas J., additional, Wiedenroth, Christoph B., additional, Sassmann, Teresa, additional, Kovacs, Gabor, additional, Ghofrani, Hossein A., additional, Seeger, Werner, additional, Richter, Manuel, additional, and Guth, Stefan, additional

Published
2022
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37. Complications of balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension: Impact on the outcome

Author

Wiedenroth, Christoph B., primary, Deissner, Henrike, additional, Adameit, Miriam S.D., additional, Kriechbaum, Steffen D., additional, Ghofrani, H.-Ardeschir, additional, Breithecker, Andreas, additional, Haas, Moritz, additional, Roller, Fritz, additional, Rolf, Andreas, additional, Hamm, Christian W., additional, Mayer, Eckhard, additional, Guth, Stefan, additional, and Liebetrau, Christoph, additional

Published
2022
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38. Unmasking right ventricular-arterial uncoupling during fluid challenge in pulmonary hypertension

Author

Kremer, Nils, primary, Rako, Zvonimir, additional, Douschan, Philipp, additional, Gall, Henning, additional, Ghofrani, Hossein A., additional, Grimminger, Friedrich, additional, Guth, Stefan, additional, Naeije, Robert, additional, Rieth, Andreas, additional, Schulz, Rainer, additional, Seeger, Werner, additional, Tedford, Ryan J., additional, Vadász, István, additional, Vanderpool, Rebecca, additional, Wiedenroth, Christoph B., additional, Richter, Manuel J., additional, and Tello, Khodr, additional

Published
2022
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39. Cardiac biomarkers as indicators of right ventricular dysfunction and recovery in chronic thromboembolic pulmonary hypertension patients after balloon pulmonary angioplasty therapy – a cardiac magnetic resonance imaging cohort study

Author

Kriechbaum, Steffen D., Vietheer, Julia M., Wiedenroth, Christoph B., Rudolph, Felix, Barde, Marta, Wolter, Jan-Sebastian, Haas, Moritz, Fischer-Rasokat, Ulrich, Weferling, Maren, Rolf, Andreas, Hamm, Christian W., Mayer, Eckhard, Guth, Stefan, Keller, Till, Roller, Fritz C., and Liebetrau, Christoph

Subjects
Diseases of the respiratory system, RC705-779, RC666-701, right ventricle function and dysfunction, Diseases of the circulatory (Cardiovascular) system, risk stratification and biomarkers, Original Research Article, balloon pulmonary angioplasty, Pulmonary hypertension
Abstract

Background In chronic thromboembolic pulmonary hypertension, right heart failure determines outcome. Balloon pulmonary angioplasty therapy allows right heart recovery, which can be monitored by cardiac magnetic resonance imaging. This study evaluates whether cardiac biomarkers (NT-proBNP, MR-proANP, sST2, and PAPP-A) are associated with cardiac magnetic resonance imaging findings prior to and after balloon pulmonary angioplasty therapy. Methods This observational cohort study enrolled 22 chronic thromboembolic pulmonary hypertension patients who underwent balloon pulmonary angioplasty therapy and completed a six-month follow-up including cardiac magnetic resonance imaging. Biomarker levels were compared with findings for right heart morphology and function derived from cardiac magnetic resonance imaging. Results Pulmonary hemodynamics improved after balloon pulmonary angioplasty therapy [pulmonary vascular resistance: 7.7 (6.0–9.0) vs. 4.7 (3.5–5.5) wood units, p

Published
2021

40. Effects of BPA on right ventricular mechanical dysfunction in patients with inoperable CTEPH – A cardiac magnetic resonance study

Author

Roller, Fritz C., primary, Schüssler, Armin, additional, Hasse, Alexander, additional, Kriechbaum, Steffen, additional, Richter, Manuel, additional, Guth, Stefan, additional, Tello, Khodr, additional, Breithecker, Andreas, additional, Liebetrau, Christoph, additional, Hamm, Christian W., additional, Mayer, Eckhard, additional, Seeger, Werner, additional, Krombach, Gabriele A., additional, and Wiedenroth, Christoph B., additional

Published
2022
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42. Evaluation and management of patients with chronic thromboembolic pulmonary hypertension - consensus statement from the ISHLT

Author

de Perrot, Marc, primary, Gopalan, Deepa, additional, Jenkins, David, additional, Lang, Irene M., additional, Fadel, Elie, additional, Delcroix, Marion, additional, Benza, Raymond, additional, Heresi, Gustavo A., additional, Kanwar, Manreet, additional, Granton, John T., additional, McInnis, Micheal, additional, Klok, Frederikus A., additional, Kerr, Kim M., additional, Pepke-Zaba, Joanna, additional, Toshner, Mark, additional, Bykova, Anastasia, additional, D’Armini, Andrea M., additional, Robbins, Ivan M., additional, Madani, Michael, additional, McGiffin, David, additional, Wiedenroth, Christoph B., additional, Mafeld, Sebastian, additional, Opitz, Isabelle, additional, Mercier, Olaf, additional, Uber, Patricia A., additional, Frantz, Robert P., additional, and Auger, William R., additional

Published
2021
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43. Neuroprotective effects of dynamic bubble trap use in patients undergoing pulmonary endarterectomy: a two-arm randomized controlled trial

Author

El Shazly, Jasmin, primary, Gerriets, Tibo, additional, Hennig, Juergen, additional, Butz, Marius, additional, Kastaun, Sabrina, additional, Wiedenroth, Christoph B., additional, Schoenburg, Markus, additional, Wollenschlaeger, Marc, additional, Bachmann, Georg, additional, Guth, Stefan, additional, and Juenemann, Martin, additional

Published
2021
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45. Exercise Hemodynamic Profiling Is Associated With Outcome in Patients Undergoing Percutaneous Mitral Valve Repair

Author

Rieth, Andreas J., primary, Kriechbaum, Steffen D., additional, Richter, Manuel J., additional, Wenninger, Elena, additional, Fischer-Rasokat, Ulrich, additional, Tello, Khodr, additional, Gall, Henning, additional, Ghofrani, Hossein A., additional, Guth, Stefan, additional, Wiedenroth, Christoph B., additional, Mitrovic, Veselin, additional, Hamm, Christian W., additional, Liebetrau, Christoph, additional, and Walther, Claudia, additional

Published
2021
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46. Exercise hemodynamics in heart failure patients with preserved and mid-range ejection fraction: key role of the right heart

Author

Rieth, Andreas J., primary, Richter, Manuel J., additional, Tello, Khodr, additional, Gall, Henning, additional, Ghofrani, Hossein A., additional, Guth, Stefan, additional, Wiedenroth, Christoph B., additional, Seeger, Werner, additional, Kriechbaum, Steffen D., additional, Mitrovic, Veselin, additional, Schulze, P. Christian, additional, and Hamm, Christian W., additional

Published
2021
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47. Role of angiopoietin-2 in venous thrombus resolution and chronic thromboembolic disease

Author

Hobohm, Lukas, primary, Kölmel, Sebastian, additional, Niemann, Caroline, additional, Kümpers, Philipp, additional, Krieg, Valentin J., additional, Bochenek, Magdalena L., additional, Lukasz, Alexander H., additional, Reiss, Yvonne, additional, Plate, Karl-Heinz, additional, Liebetrau, Christoph, additional, Wiedenroth, Christoph B., additional, Guth, Stefan, additional, Münzel, Thomas, additional, Hasenfuß, Gerd, additional, Wenzel, Philip, additional, Mayer, Eckhard, additional, Konstantinides, Stavros V., additional, Schäfer, Katrin, additional, and Lankeit, Mareike, additional

Published
2021
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49. Exercise right heart catheterization before and after balloon pulmonary angioplasty in inoperable patients with chronic thromboembolic pulmonary hypertension

Author

Wiedenroth, Christoph B., Rieth, Andreas J., Kriechbaum, Steffen, Ghofrani, H.- Ardeschir, Breithecker, Andreas, Haas, Moritz, Roller, Fritz, Richter, Manuel J., Lankeit, Mareike, Mielzarek, Lisa, Rolf, Andreas, Hamm, Christian W., Mayer, Eckhard, Guth, Stefan, Liebetrau, Christoph, Wiedenroth, Christoph B., Rieth, Andreas J., Kriechbaum, Steffen, Ghofrani, H.- Ardeschir, Breithecker, Andreas, Haas, Moritz, Roller, Fritz, Richter, Manuel J., Lankeit, Mareike, Mielzarek, Lisa, Rolf, Andreas, Hamm, Christian W., Mayer, Eckhard, Guth, Stefan, and Liebetrau, Christoph

Abstract

Background: Balloon pulmonary angioplasty is an evolving, interventional treatment option for inoperable patients with chronic thromboembolic pulmonary hypertension (CTEPH). Pulmonary hypertension at rest as well as exercise capacity is considered to be relevant outcome parameters. The aim of the present study was to determine whether measurement of pulmonary hemodynamics during exercise before and six months after balloon pulmonary angioplasty have an added value. Methods: From March 2014 to July 2018, 172 consecutive patients underwent balloon pulmonary angioplasty. Of these, 64 consecutive patients with inoperable CTEPH underwent a comprehensive diagnostic workup that included right heart catheterization at rest and during exercise before balloon pulmonary angioplasty treatments and six months after the last intervention. Results: Improvements in pulmonary hemodynamics at rest and during exercise, in quality of life, and in exercise capacity were observed six months after balloon pulmonary angioplasty: WHO functional class improved in 78% of patients. The mean pulmonary arterial pressure (mPAP) at rest was reduced from 41 ± 9 to 31 ± 9 mmHg (p < 0.0001). The mPAP/cardiac output slope decreased after balloon pulmonary angioplasty (11.2 ± 25.6 WU to 7.7 ± 4.1 WU; p < 0.0001), and correlated with N-terminal fragment of pro-brain natriuretic peptide (p = 0.035) and 6-minute walking distance (p = 0.01). Conclusions: Exercise right heart catheterization provides valuable information on the changes of pulmonary hemodynamics after balloon pulmonary angioplasty in inoperable CTEPH patients that are not obtainable by measuring resting hemodynamics.

Published
2020

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