Dursun Akaslan1, Halil Ataş1, Emre Aslanger1, Batur Gönenç Kanar1, Derya Kocakaya2, Bedrettin Yıldızeli3, Bülent Mutlu4. 1. Departments of Cardiology, Marmara University, Pendik Training and Research Hospital; İstanbul-Turkey. 2. Departments of Pulmonology, Marmara University, Pendik Training and Research Hospital; İstanbul-Turkey. 3. Departments of Thoracic Surgery, Marmara University, Pendik Training and Research Hospital; İstanbul-Turkey. 4. Departments of Cardiology Marmara University, Pendik Training and Research Hospital; İstanbul-Turkey.
Abstract
OBJECTIVE: Although the underlying pathology of chronic thromboembolic pulmonary hypertension (CTEPH) is mechanical obliteration of the major pulmonary vessels, high pulsatile stress penetrating into the normal distal pulmonary microvasculature resulting from reduced pulmonary arterial compliance (CPA) may cause progressive deterioration in pulmonary hemodynamics. Hypothetically, balloon pulmonary angioplasty (BPA) may be beneficial in reducing CPA and pulsatile stress in patients with CTEPH. METHODS: In total, 26 patients with available pre- and post-BPA right heart catheterization results were included in the study. BPA was performed in a series of staged procedures by 2 experienced interventional cardiologists. RESULTS: The median CPA showed a 59.2% increase (1.03 to 1.64 mL/mm Hg, p=0.005). The median pre-BPA pulsatile stress product decreased by 20.7% (4,266 to 3,380 mm Hg/min, p=0.003). A linear regression model established that the percent change in CPA after BPA accounted for 21.8% of the explained variability in the change in 6-minute walk test (p=0.009). CONCLUSION: Our results indicate that BPA decreases CPA and pulmonary pulsatile stress. These changes may be partly responsible for the improvement in functional capacity after BPA.
OBJECTIVE: Although the underlying pathology of chronic thromboembolic pulmonary hypertension (CTEPH) is mechanical obliteration of the major pulmonary vessels, high pulsatile stress penetrating into the normal distal pulmonary microvasculature resulting from reduced pulmonary arterial compliance (CPA) may cause progressive deterioration in pulmonary hemodynamics. Hypothetically, balloon pulmonary angioplasty (BPA) may be beneficial in reducing CPA and pulsatile stress in patients with CTEPH. METHODS: In total, 26 patients with available pre- and post-BPA right heart catheterization results were included in the study. BPA was performed in a series of staged procedures by 2 experienced interventional cardiologists. RESULTS: The median CPA showed a 59.2% increase (1.03 to 1.64 mL/mm Hg, p=0.005). The median pre-BPA pulsatile stress product decreased by 20.7% (4,266 to 3,380 mm Hg/min, p=0.003). A linear regression model established that the percent change in CPA after BPA accounted for 21.8% of the explained variability in the change in 6-minute walk test (p=0.009). CONCLUSION: Our results indicate that BPA decreases CPA and pulmonary pulsatile stress. These changes may be partly responsible for the improvement in functional capacity after BPA.
Authors: Wojciech Magoń; Jakub Stępniewski; Marcin Waligóra; Kamil Jonas; Piotr Podolec; Grzegorz Kopeć Journal: Can J Cardiol Date: 2019-02-02 Impact factor: 5.223
Authors: C Tji-Joong Gan; Jan-Willem Lankhaar; Nico Westerhof; J Tim Marcus; Annemarie Becker; Jos W R Twisk; Anco Boonstra; Pieter E Postmus; Anton Vonk-Noordegraaf Journal: Chest Date: 2007-11-07 Impact factor: 9.410
Authors: Nazzareno Galiè; Marc Humbert; Jean-Luc Vachiery; Simon Gibbs; Irene Lang; Adam Torbicki; Gérald Simonneau; Andrew Peacock; Anton Vonk Noordegraaf; Maurice Beghetti; Ardeschir Ghofrani; Miguel Angel Gomez Sanchez; Georg Hansmann; Walter Klepetko; Patrizio Lancellotti; Marco Matucci; Theresa McDonagh; Luc A Pierard; Pedro T Trindade; Maurizio Zompatori; Marius Hoeper Journal: Eur Heart J Date: 2015-08-29 Impact factor: 29.983
Authors: Anton Vonk Noordegraaf; Kelly Marie Chin; François Haddad; Paul M Hassoun; Anna R Hemnes; Susan Roberta Hopkins; Steven Mark Kawut; David Langleben; Joost Lumens; Robert Naeije Journal: Eur Respir J Date: 2019-01-24 Impact factor: 16.671