Increased Pulmonary Arterial Compliance after Balloon Pulmonary Angioplasty Predicts Exercise Tolerance Improvement in Inoperable CTEPH Patients with Lower Pulmonary Arterial Pressure

Shintaro Umemoto; Kohtaro Abe; Kazuya Hosokawa; Koshin Horimoto; Keita Saku; Takafumi Sakamoto; Hiroyuki Tsutsui

doi:10.1016/j.hrtlng.2021.11.003

Increased Pulmonary Arterial Compliance after Balloon Pulmonary Angioplasty Predicts Exercise Tolerance Improvement in Inoperable CTEPH Patients with Lower Pulmonary Arterial Pressure

Heart Lung. 2022 Mar-Apr:52:8-15. doi: 10.1016/j.hrtlng.2021.11.003. Epub 2021 Nov 18.

Authors

Shintaro Umemoto¹, Kohtaro Abe², Kazuya Hosokawa³, Koshin Horimoto⁴, Keita Saku³, Takafumi Sakamoto³, Hiroyuki Tsutsui¹

Affiliations

¹ Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
² Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Cardiovascular Medicine, Research Institute of Angiocardiology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan. Electronic address: koabe@cardiol.med.kyushu-u.ac.jp.
³ Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
⁴ Department of Cardiovascular Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan; Department of Cardiology, Matsuyama Red Cross Hospital, Ehime, Japan.

PMID: 34801772
DOI: 10.1016/j.hrtlng.2021.11.003

Abstract

Background: Balloon pulmonary angioplasty (BPA) improved pulmonary arterial compliance (C_PA) and exercise tolerance in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH).

Objectives: To investigate whether C_PA is a useful index to indicate exercise tolerance improvement by BPA in CTEPH patients.

Methods: The correlation between changes in C_PA and improvements in 6-minute walk distance (6MWD) by BPA was retrospectively analyzed in 70 patients (Analysis 1), and it was sequentially analyzed in 46 symptomatic patients who achieved mean pulmonary arterial pressure (mPAP)<30mmHg (Analysis 2).

Results: We enrolled 70 patients (female/male:57/13, mean age:59 years) who underwent a total of 352 BPA sessions which significantly increased C_PA (1.5±0.8 vs. 3.0±1.0 mL/mmHg) and decreased pulmonary vascular resistance (PVR) (8.0 ± 3.9 vs. 3.6 ± 1.7 wood units). The correlation coefficient between improvement in 6MWD and changes in PVR and C_PA were r=0.21 (p=0.09) and r=0.14 (p=0.26) (Analysis 1). In Analysis 2, those were r=0.32 (p=0.06) and r=0.38 (p=0.02), respectively.

Conclusions: C_PA can be a useful index to indicate the improvement in exercise tolerance by BPA in symptomatic patients with lower mPAP.

Keywords: Chronic thromboembolic pulmonary hypertension; balloon pulmonary angioplasty; exercise tolerance; pulmonary arterial compliance; pulmonary vascular resistance.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Angioplasty, Balloon*
Arterial Pressure
Chronic Disease
Exercise Tolerance
Female
Humans
Hypertension, Pulmonary*
Male
Middle Aged
Pulmonary Artery / surgery
Pulmonary Embolism* / complications
Pulmonary Embolism* / therapy
Retrospective Studies
Treatment Outcome