Wojciech Magoń1, Jakub Stępniewski1, Marcin Waligóra1, Kamil Jonas1, Piotr Podolec1, Grzegorz Kopeć2. 1. Department of Cardiac and Vascular Diseases, Faculty of Medicine, Jagiellonian University Medical College at John Paul II Hospital, Krakow, Poland. 2. Department of Cardiac and Vascular Diseases, Faculty of Medicine, Jagiellonian University Medical College at John Paul II Hospital, Krakow, Poland. Electronic address: grzegorzkrakow1@gmail.com.
Abstract
BACKGROUND: A significant proportion of the right ventricular afterload is determined by the elastic properties of the pulmonary artery (PA). We aimed to assess the effect of balloon pulmonary angioplasty (BPA) on PA elastic properties in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). METHODS: We enrolled adult patients with CTEPH treated with BPA and controls without PH. Total PA compliance (CPa) was calculated as stroke volume/PA pulse pressure. PA distensibility (DC) and compliance (CC) coefficients were assessed by intravascular ultrasound to denote local elastic properties of the treated PA segments. RESULTS: We performed 103 BPA sessions in 17 patients with CTEPH (5 men [29%], aged 66 [64 to 73] years) who were followed for 6 (5 to 7) months after the last BPA. The median time between BPA sessions was 39 (28 to 52) days. The CPa, CC, and DC were lower in patients with CTEPH than in controls without PH (n = 10). Complete BPA treatment led to increase of CPa from 1.02 (0.70 to 1.39) to 2.08 (1.49 to 2.39) mL/mm Hg (P < 0.001) at the 6-month follow up, and this increase was in proportion to a decrease in pulmonary vascular resistance (PVR) (R2 = 0.74; P = 0.001). CPa increased immediately after BPA session by 0.13 (-0.05; 0.33) mL/mm Hg (P = 0.001) and remained unchanged until the next BPA session. CC and DC exhibited no immediate change after catheter balloon inflation (Δ=0 [-0.03; 0.02] mm2/mm Hg, P = 0.52, and Δ = 0 [-0.13; 0.13] %/mm Hg, P = 0.91, respectively) and remained unchanged at the 6-month follow-up. CONCLUSIONS: BPA improved total CPa in proportion to a decrease in PVR despite no improvement in local elastic properties of the treated PA segments.
BACKGROUND: A significant proportion of the right ventricular afterload is determined by the elastic properties of the pulmonary artery (PA). We aimed to assess the effect of balloon pulmonary angioplasty (BPA) on PA elastic properties in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). METHODS: We enrolled adult patients with CTEPH treated with BPA and controls without PH. Total PA compliance (CPa) was calculated as stroke volume/PA pulse pressure. PA distensibility (DC) and compliance (CC) coefficients were assessed by intravascular ultrasound to denote local elastic properties of the treated PA segments. RESULTS: We performed 103 BPA sessions in 17 patients with CTEPH (5 men [29%], aged 66 [64 to 73] years) who were followed for 6 (5 to 7) months after the last BPA. The median time between BPA sessions was 39 (28 to 52) days. The CPa, CC, and DC were lower in patients with CTEPH than in controls without PH (n = 10). Complete BPA treatment led to increase of CPa from 1.02 (0.70 to 1.39) to 2.08 (1.49 to 2.39) mL/mm Hg (P < 0.001) at the 6-month follow up, and this increase was in proportion to a decrease in pulmonary vascular resistance (PVR) (R2 = 0.74; P = 0.001). CPa increased immediately after BPA session by 0.13 (-0.05; 0.33) mL/mm Hg (P = 0.001) and remained unchanged until the next BPA session. CC and DC exhibited no immediate change after catheter balloon inflation (Δ=0 [-0.03; 0.02] mm2/mm Hg, P = 0.52, and Δ = 0 [-0.13; 0.13] %/mm Hg, P = 0.91, respectively) and remained unchanged at the 6-month follow-up. CONCLUSIONS:BPA improved total CPa in proportion to a decrease in PVR despite no improvement in local elastic properties of the treated PA segments.
Authors: Wojciech Magoń; Jakub Stępniewski; Marcin Waligóra; Kamil Jonas; Roman Przybylski; Piotr Podolec; Grzegorz Kopeć Journal: Cells Date: 2022-04-29 Impact factor: 7.666
Authors: Grzegorz Kopeć; Olga Dzikowska-Diduch; Ewa Mroczek; Tatiana Mularek-Kubzdela; Łukasz Chrzanowski; Ilona Skoczylas; Michał Tomaszewski; Małgorzata Peregud-Pogorzelska; Danuta Karasek; Ewa Lewicka; Wojciech Jacheć; Zbigniew Gąsior; Piotr Błaszczak; Katarzyna Ptaszyńska-Kopczyńska; Katarzyna Mizia-Stec; Andrzej Biederman; Dariusz Zieliński; Roman Przybylski; Piotr Kędzierski; Marcin Waligóra; Marek Roik; Marek Grabka; Joanna Orłowska; Aleksander Araszkiewicz; Marta Banaszkiewicz; Sylwia Sławek-Szmyt; Szymon Darocha; Wojciech Magoń; Alicja Dąbrowska-Kugacka; Jakub Stępniewski; Kamil Jonas; Karol Kamiński; Jarosław D Kasprzak; Piotr Podolec; Piotr Pruszczyk; Adam Torbicki; Marcin Kurzyna Journal: Ther Adv Chronic Dis Date: 2021-03-25 Impact factor: 5.091