Usefulness of ventilatory gas analysis for the non-invasive evaluation of the severity of chronic thromboembolic pulmonary hypertension.


Journal

International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291

Informations de publication

Date de publication:
01 12 2019
Historique:
received: 09 01 2019
revised: 28 05 2019
accepted: 05 07 2019
pubmed: 28 7 2019
medline: 11 8 2020
entrez: 28 7 2019
Statut: ppublish

Résumé

Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by organic thrombotic obstructions in the pulmonary arteries with reduced pulmonary vascular reserve. This study aimed to examine whether postural changes in ventilatory gas analysis parameters are useful for assessing pulmonary hemodynamics in patients with CTEPH. A total of 44 patients with newly diagnosed CTEPH (CTEPH group), 33 patients with improved CTEPH (mean pulmonary arterial pressure [mPAP] <25 mm Hg), and 25 controls were enrolled. Patients with improved CTEPH referred to patients without residual PH who were previously diagnosed with CTEPH and already received optimal therapies. Various pulmonary function parameters were examined in supine and sitting positions, and postural changes were calculated (Δ[supine - sitting]). In 32 patients with CTEPH, we examined hemodynamic and ventilatory gas analysis parameters before the first balloon pulmonary angioplasty (BPA) and during follow-up. Patients with CTEPH had significantly lower supine end-tidal carbon dioxide pressure (P These results indicate that postural changes in ventilatory gas analysis parameters are useful and non-invasive method for the evaluation of mPAP, which is one of the hemodynamic parameters of CTEPH severity.

Sections du résumé

BACKGROUND
Chronic thromboembolic pulmonary hypertension (CTEPH) is characterized by organic thrombotic obstructions in the pulmonary arteries with reduced pulmonary vascular reserve. This study aimed to examine whether postural changes in ventilatory gas analysis parameters are useful for assessing pulmonary hemodynamics in patients with CTEPH.
METHODS
A total of 44 patients with newly diagnosed CTEPH (CTEPH group), 33 patients with improved CTEPH (mean pulmonary arterial pressure [mPAP] <25 mm Hg), and 25 controls were enrolled. Patients with improved CTEPH referred to patients without residual PH who were previously diagnosed with CTEPH and already received optimal therapies. Various pulmonary function parameters were examined in supine and sitting positions, and postural changes were calculated (Δ[supine - sitting]). In 32 patients with CTEPH, we examined hemodynamic and ventilatory gas analysis parameters before the first balloon pulmonary angioplasty (BPA) and during follow-up.
RESULTS
Patients with CTEPH had significantly lower supine end-tidal carbon dioxide pressure (P
CONCLUSION
These results indicate that postural changes in ventilatory gas analysis parameters are useful and non-invasive method for the evaluation of mPAP, which is one of the hemodynamic parameters of CTEPH severity.

Identifiants

pubmed: 31350036
pii: S0167-5273(19)30008-7
doi: 10.1016/j.ijcard.2019.07.018
pii:
doi:

Substances chimiques

Carbon Dioxide 142M471B3J
Oxygen S88TT14065

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

149-154

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2019 Elsevier B.V. All rights reserved.

Auteurs

Mina Akizuki (M)

Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Japan.

Koichiro Sugimura (K)

Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.

Tatsuo Aoki (T)

Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.

Takaaki Kakihana (T)

Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Japan.

Shunsuke Tatebe (S)

Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.

Saori Yamamoto (S)

Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.

Haruka Sato (H)

Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.

Kimio Satoh (K)

Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.

Hiroaki Shimokawa (H)

Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.

Masahiro Kohzuki (M)

Department of Internal Medicine and Rehabilitation Science, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: kohzuki@med.tohoku.ac.jp.

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