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Improved hemodynamics and cardiopulmonary function in patients with inoperable chronic thromboembolic pulmonary hypertension after balloon pulmonary angioplasty
- Source :
- Respiratory Research, Respiratory Research, Vol 20, Iss 1, Pp 1-11 (2019)
- Publication Year :
- 2019
- Publisher :
- BioMed Central, 2019.
-
Abstract
- BackgroundBalloon pulmonary angioplasty (BPA) has been demonstrated to improve cardiac function and exercise capacity in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH), but its instant impact on cardiopulmonary function has seldom been evaluated. This study aims to determine the safety and efficacy of BPA and its immediate and lasting effects on cardiopulmonary function among CTEPH patients.MethodsFrom May 2018 to January 2019, patients with inoperable CTEPH who underwent BPA sessions were consecutively enrolled. Hemodynamics were measured by right heart catheterization, selective pulmonary angiography and BPA were successively conducted. Hemodynamic variables, WHO functional class (WHO-FC), 6-min walk distance (6MWD) and serum NT-proBNP were evaluated before and after BPA sessions during hospitalization. Pulmonary function testing (PFT) and cardiopulmonary exercise testing (CPET) were performed within 1–3 days pre and post BPA to evaluate the effect of BPA on cardiopulmonary function.ResultsTwenty-five patients with inoperable CTEPH who underwent a total of forty BPA sessions were consecutively enrolled. A total of 183 segmental or subsegmental vessels (4.6 ± 1.9 vessels per session) in 137 segments (3.4 ± 1.6 segments per session) were dilated. No procedure-related complications occurred. Instant hemodynamics, WHO-FC, 6MWD and NT-proBNP were all significantly improved after a single BPA session. Significant improvement in cardiopulmonary function was also evident as assessed by PFT indexes (forced vital capacity, forced expiratory volume in the first second, maximal voluntary ventilation) and CPET parameters (peak work rate, peak VO2, oxygen uptake efficiency slope). Further analysis among ten CTEPH patients receiving multiple BPA sessions (2–4 sessions) indicated BPA resulted in lasting improvements in hemodynamics and cardiopulmonary function.ConclusionsBPA, a safe and effective approach, can bring instant improvements after a single session and lasting benefits after multiple sessions to hemodynamics and cardiopulmonary function for patients with inoperable CTEPH.
- Subjects :
- Cardiac function curve
Male
Vital capacity
medicine.medical_specialty
endocrine system
Pulmonary Circulation
Time Factors
medicine.medical_treatment
Chronic thromboembolic pulmonary hypertension
Hemodynamics
030204 cardiovascular system & hematology
Work rate
Pulmonary Artery
Balloon
Pulmonary function testing
03 medical and health sciences
0302 clinical medicine
Angioplasty
Internal medicine
Natriuretic Peptide, Brain
Pulmonary angiography
Medicine
Balloon pulmonary angioplasty
Humans
Aged
lcsh:RC705-779
Pulmonary Arterial Hypertension
Exercise Tolerance
business.industry
Research
lcsh:Diseases of the respiratory system
Recovery of Function
Middle Aged
Peptide Fragments
Treatment Outcome
030228 respiratory system
Chronic Disease
Cardiology
Cardiopulmonary function
Female
business
Pulmonary Embolism
hormones, hormone substitutes, and hormone antagonists
Angioplasty, Balloon
Biomarkers
Subjects
Details
- Language :
- English
- ISSN :
- 1465993X and 14659921
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- Respiratory Research
- Accession number :
- edsair.doi.dedup.....f479ff641aaabfc2552a4e292f30ae21