Improvements of right ventricular function and hemodynamics after balloon pulmonary angioplasty in patients with chronic thromboembolic pulmonary hypertension.
Angioplasty, Balloon
/ methods
Cardiac Catheterization
Echocardiography
/ methods
Exercise Test
Female
Follow-Up Studies
Heart Ventricles
/ diagnostic imaging
Humans
Hypertension, Pulmonary
/ etiology
Male
Middle Aged
Postoperative Period
Prognosis
Pulmonary Artery
/ physiopathology
Pulmonary Embolism
/ complications
Vascular Resistance
/ physiology
Ventricular Function, Right
/ physiology
balloon pulmonary angioplasty
chronic thromboembolic pulmonary hypertension
echocardiography
electromechanical delay
strain
Journal
Echocardiography (Mount Kisco, N.Y.)
ISSN: 1540-8175
Titre abrégé: Echocardiography
Pays: United States
ID NLM: 8511187
Informations de publication
Date de publication:
11 2019
11 2019
Historique:
received:
16
05
2019
revised:
30
08
2019
accepted:
23
09
2019
pubmed:
15
10
2019
medline:
14
7
2020
entrez:
15
10
2019
Statut:
ppublish
Résumé
Right ventricular (RV) function is an important factor in the prognosis of chronic thromboembolic pulmonary hypertension (CTEPH) in patients. In our study, we aimed to evaluate the timing and magnitude of regional RV function before and after balloon pulmonary angioplasty (BPA) using speckle tracking echocardiography (STE) and their relation to clinical and hemodynamic parameters in patients with CTEPH. We enrolled 20 CTEPH patients and 19 healthy subjects in our study. Enrolled patients underwent echocardiography, right heart catheterization (RHC), and 6-minute walk distance (6MWD) test at baseline and after the BPA. In hemodynamic RHC measurements and clinical evaluations, mean pulmonary artery pressure (median: 53.5 mm Hg vs 37.0 mm Hg, P = .001) and pulmonary vascular resistance (median: 12 Wood units [WU] vs 7 WU, P = .001) and pro-brain natriuretic peptide level decreased and 6MWD increased after BPA sessions. There was no statistically significant difference between before and after the BPA sessions in conventional echocardiographic measurements. In STE analysis, the electromechanical delay (EMD) between RV free wall (RVF) and LV lateral wall (LVL) (median: 65 ms vs 47.5 ms, P = .01) and RV peak systolic strain dispersion index (52 ms vs 29 ms, P = .001) were higher in patients with CTEPH than healthy controls before the BPA. Both these parameters decreased significantly after BPA. Chronic thromboembolic pulmonary hypertension was associated with RV electromechanical delay and dispersion based on the STE analysis. Balloon pulmonary angioplasty might have an important impact on the improvement of both RV function and hemodynamics.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2050-2056Informations de copyright
© 2019 Wiley Periodicals, Inc.
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