球囊肺动脉血管成形术后肺动脉顺应性增加可预测肺动脉压力较低的无法手术的慢性血栓栓塞性肺动脉高压患者运动耐量的改善。

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

作者信息

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

机构信息

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.

出版信息

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

DOI:10.1016/j.hrtlng.2021.11.003

PMID:34801772

Abstract

BACKGROUND

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

OBJECTIVES

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

METHODS

The correlation between changes in C 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 (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 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 can be a useful index to indicate the improvement in exercise tolerance by BPA in symptomatic patients with lower mPAP.

摘要

背景

球囊肺动脉血管成形术（BPA）改善了无法手术的慢性血栓栓塞性肺动脉高压（CTEPH）患者的肺动脉顺应性（C）和运动耐量。

目的

研究C是否是一个有用的指标，以表明BPA对CTEPH患者运动耐量的改善情况。

方法

回顾性分析70例患者中C的变化与BPA导致的6分钟步行距离（6MWD）改善之间的相关性（分析1），并对46例平均肺动脉压（mPAP）<30mmHg的有症状患者进行序贯分析（分析2）。

结果

我们纳入了70例患者（女性/男性：57/13，平均年龄：59岁），共进行了352次BPA治疗，显著增加了C（1.5±0.8 vs. 3.0±1.0 mL/mmHg）并降低了肺血管阻力（PVR）（8.0±3.9 vs. 3.6±1.7伍德单位）。6MWD改善与PVR和C变化之间的相关系数分别为r=0.21（p=0.09）和r=0.14（p=0.26）（分析1）。在分析2中，分别为r=0.32（p=0.06）和r=0.38（p=0.02）。