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Right ventricular reverse remodelling after balloon pulmonary angioplasty
Shigefumi Fukui1, Takeshi Ogo, Yoshiaki Morita
1National Cerebral and Cardiovascular Center, Suita.
The European Respiratory Journal
|March 15, 2014
Summary
Balloon pulmonary angioplasty (BPA) safely improves hemodynamics and exercise capacity in chronic thromboembolic pulmonary hypertension (CTEPH). The procedure also reverses right ventricular remodeling and dysfunction, as shown by cardiovascular magnetic resonance.
Area of Science:
- Cardiology
- Pulmonary Hypertension Research
- Medical Imaging
Background:
- Chronic thromboembolic pulmonary hypertension (CTEPH) poses risks to right ventricular (RV) function.
- Balloon pulmonary angioplasty (BPA) is an option for inoperable CTEPH patients, but its effect on RV function needs clarification.
Purpose of the Study:
- To assess the impact of BPA on RV remodeling and dysfunction in inoperable CTEPH patients.
- To correlate RV changes with hemodynamic improvements post-BPA.
Main Methods:
- Retrospective study of 20 inoperable CTEPH patients undergoing BPA.
- Cardiovascular magnetic resonance (CMR) imaging before and after BPA.
- Evaluation of hemodynamic parameters, RV function, and remodeling.
Main Results:
- BPA significantly improved mean pulmonary arterial pressure, cardiac index, and pulmonary vascular resistance (PVR).
- RV remodeling and systolic dysfunction were markedly improved, evidenced by changes in RV volumes, ejection fraction, and mass.
- RV volume changes correlated strongly with improvements in cardiac index and PVR.
Conclusions:
- BPA safely induces reverse RV remodeling and improves systolic function in inoperable CTEPH by ameliorating hemodynamics.
- CMR is effective for noninvasive monitoring of BPA efficacy on RV function.
