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Balloon pulmonary angioplasty reverse right ventricular remodelling and dysfunction in patients with inoperable chronic thromboembolic pulmonary hypertension: a systematic review and meta-analysis.
- Source :
- European Radiology; Jun2021, Vol. 31 Issue 6, p3898-3908, 11p, 6 Diagrams, 1 Chart
- Publication Year :
- 2021
-
Abstract
- <bold>Objectives: </bold>Right ventricular (RV) function is considered the major determinant of prognosis in patients with chronic thromboembolic pulmonary hypertension (CTEPH). The aim of this meta-analysis was to evaluate RV remodelling and function following balloon pulmonary angioplasty (BPA) in patients with inoperable CTEPH or persistent/recurrent pulmonary hypertension (PH) after pulmonary endarterectomy (PEA).<bold>Methods: </bold>We reviewed all studies evaluating RV function by cardiac magnetic resonance (CMR) and/or echocardiography pre- and post-BPA from PubMed/Medline prior to 15 December 2019. Ten (299 patients) of the 29 studies retrieved met the inclusion criteria: 5 CMR and 5 echocardiography studies. The systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines.<bold>Results: </bold>Pooled data from CMR studies revealed BPA resulted in a significantly decreased RV end-diastolic volume index (weighted mean difference (WMD) - 28.33 ml/m2, p < 0.00001) and RV end-systolic volume index (WMD - 29.06 ml/m2, p < 0.00001) accompanied by an increased RV ejection fraction (RVEF, WMD 8.97%, p < 0.00001). Data from the echocardiography studies showed BPA resulted in decreased RV basal diameter (WMD - 0.37 cm, p = 0.0009) and an increase of RV fractional area change (WMD 5.97 %, p = 0.003), but improvements of tricuspid annular plane systolic excursion (TAPSE) and S' were not significant.<bold>Conclusions: </bold>BPA improves RVEF and decreases RV volumes in patients with inoperable CTEPH or persistent/recurrent PH after PEA.<bold>Key Points: </bold>• Balloon pulmonary angioplasty improves RVEF and decreases RV volumes in patients with inoperable CTEPH or persistent/recurrent PH after PEA. [ABSTRACT FROM AUTHOR]
- Subjects :
- TRANSLUMINAL angioplasty
PULMONARY hypertension
VENTRICULAR remodeling
CARDIAC magnetic resonance imaging
THROMBOEMBOLISM
PULMONARY hypertension treatment
RESEARCH
PULMONARY embolism
META-analysis
RIGHT heart ventricle
RESEARCH methodology
SYSTEMATIC reviews
MEDICAL cooperation
EVALUATION research
COMPARATIVE studies
RIGHT ventricular dysfunction
RESEARCH funding
HEART physiology
DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 09387994
- Volume :
- 31
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- European Radiology
- Publication Type :
- Academic Journal
- Accession number :
- 150343614
- Full Text :
- https://doi.org/10.1007/s00330-020-07481-6