scholarly journals Long-Term Outcomes After Percutaneous Transluminal Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension

Circulation ◽  
2016 ◽  
Vol 134 (24) ◽  
pp. 2030-2032 ◽  
Author(s):  
Takumi Inami ◽  
Masaharu Kataoka ◽  
Ryoji Yanagisawa ◽  
Haruhisa Ishiguro ◽  
Nobuhiko Shimura ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Long Term Outcomes ◽  
Thromboembolic Pulmonary Hypertension ◽  
Percutaneous Transluminal

scholarly journals Long-term outcomes after percutaneous transluminal pulmonary angioplasty for chronic thromboembolic pulmonary hypertension

2019 ◽  
Vol 16 (4) ◽  
pp. 27-32 ◽  
Author(s):  
Madina B Karabasheva ◽  
Nikolai M Danilov ◽  
Olesia V Sagaidak ◽  
Yurii G Matchin ◽  
Irina E Chazova
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Arteries ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Treatment Method ◽  
Classical Type ◽  
Chronic Obstructive ◽  
Clinical Effects ◽  
Long Term Outcomes ◽  
Thromboembolic Pulmonary Hypertension

Introduction. Chronic thromboembolic pulmonary hypertension is a precapillary form of pulmonary hypertension that develops due to thrombotic mass obstruction of the pulmonary arteries. Balloon pulmonary angioplasty (BPA) is a new, alternative treatment method for inoperable chronic thromboembolic pulmonary hypertension (CTEPH), which demonstrated good hemodynamic and clinical effects. In this article we studied the long-term outcomes results after BPA. Material and methods. The study included 22 patients with inoperable CTEPH who were treated by BPA 6 (5; 8) interventions per patient. The results of the procedure were evaluated 2 months and 18 (12; 18) months after the last BPA. Results. A significant decrease in all important hemodynamic parameters was noted. There no difference between the date immediately after the operation and the long term period. However, the division of patients into groups with and without disease progression allow us to identify factors affecting the effectiveness of BPA (weight, the number of BPA procedures per patient, the total number of treated segmental arteries, the presence of coronary heart disease and chronic obstructive pulmonary disease, not the appointment of a concomitant pathogenetic pulmonary arterial hypertension (PAH) therapy. Conclusion. BPA is an effective method of treating patients with inoperable CTEPH, which demonstrates a good, sustainable long-term result. Patients with classical type 4 pulmonary hypertension receiving PAH-specific therapy are best responders to BPA.

Abstract 13941: Combined Assessment of Right Ventricular Function and Reverse Remodeling as Prognostic Marker after Administration of Medical Treatment for Pulmonary Hypertension

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Hiroyuki Sano ◽  
Hidekazu Tanaka ◽  
Yoshiki Motoji ◽  
Yuko Fukuda ◽  
Kumiko Dokuni ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Right Ventricular ◽  
Chronic Thromboembolic Pulmonary Hypertension ◽  
Reverse Remodeling ◽  
Long Term Outcomes ◽  
Cox Models ◽  
Pulmonary Capillary ◽  
Thromboembolic Pulmonary Hypertension ◽  
Longitudinal Strains

Background: Right ventricular (RV) dysfunction plays an important role in disease progression and prognosis of patients with pulmonary hypertension (PH). However, the association of RV reverse remodeling with long-term outcomes remains unclear. Our objective was thus to test the hypothesis that mid-term RV reverse remodeling after adding PH-specific drugs was linked to long-term outcomes in patients with PH. Methods: We studied 45 PH patients with resting mean pulmonary artery pressure (mPAP) of 35±10mmHg. PH patients with chronic thromboembolic pulmonary hypertension and left-sided heart failure including pulmonary capillary wedge pressure of >15mmHg were excluded. Echocardiography was performed at enrollment and mid-term of 5.7±4.1 months after adding PH-specific drugs. RV function was calculated by averaging the three regional peak speckle-tracking longitudinal strains from RV free-wall (RV-free). RV remodeling was assessed in terms of the RV area, which was traced planimetrically at the end-systole (RVESA) from RV-focused apical 4-chamber views. Mid-term RV reverse remodeling was defined as a relative decrease in RVESA of at least 15%. Long-term event-free survival was then tracked for 5 years. Results: Patients with mid-term RV reverse remodeling experienced favorable long-term outcomes than those without mid-term RV reverse remodeling (log-rank p<0.01). The incremental benefit using sequential Cox models in the prediction of long-term outcomes showed that a model based on clinical variables including mPAP and pulmonary vascular resistance (PVR) was improved by addition of RV-free (p=0.03), and further improved by addition of the parameter of mid-term RV reverse-remodeling (p=0.01). Conclusion: Mid-term RV reverse remodeling after adding PH-specific drugs was associated with long-term outcomes, and this combined approach may well have clinical implications for better management of PH patients.

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