Effect of balloon pulmonary angioplasty on cardio-ankle vascular index and biventricular remodeling in patients with chronic thromboembolic pulmonary hypertension
BackgroundChronic thromboembolic pulmonary hypertension (CTEPH) is caused by organized pulmonary thrombi, and pulmonary endarterectomy is the only curative treatment. Since balloon pulmonary angioplasty (BPA) has become an established therapeutic option for inoperable CTEPH, prognosis has improved....
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-12-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1325846/full |
| _version_ | 1797322343851229184 |
|---|---|
| author | Shuji Sato Takuro Ito Tsuyoshi Tabata Akihiro Ogawa Atsuhito Saiki Kazuhiro Shimizu |
| author_facet | Shuji Sato Takuro Ito Tsuyoshi Tabata Akihiro Ogawa Atsuhito Saiki Kazuhiro Shimizu |
| author_sort | Shuji Sato |
| collection | DOAJ |
| description | BackgroundChronic thromboembolic pulmonary hypertension (CTEPH) is caused by organized pulmonary thrombi, and pulmonary endarterectomy is the only curative treatment. Since balloon pulmonary angioplasty (BPA) has become an established therapeutic option for inoperable CTEPH, prognosis has improved. Recent reports suggest that arterial stiffness evaluated using the cardio-ankle vascular index (CAVI) may play an important role in the cardio-vascular interaction in CTEPH; however, the details remain unclear. This study aimed to clarify the role of CAVI in CTEPH through hemodynamic changes and ventricular remodeling after BPA.Methods and resultsA total of 23 patients with CTEPH who had undergone BPA were enrolled in this study. The mean pulmonary artery pressure (mPAP) and CAVI significantly decreased after BPA [mPAP, 34 (26–45) mmHg to 20 (19–24) mmHg, p < 0.0001; CAVI, 9.4 (8.0–10.3) to 8.3 (7.5–9.6), p = 0.004]. The echocardiographic right ventricle was significantly decreased, and the left ventricular volume was significantly increased after BPA, indicating significant biventricular remodeling after BPA. Changes in CAVI (ΔCAVI) significantly correlated with changes in mPAP (r = 0.45, p = 0.03). Additionally, ΔCAVI was significantly correlated with changes in both right ventricular area and left ventricular volume.ConclusionsArterial stiffness, evaluated using the CAVI, improved after BPA. Changes in CAVI were significantly correlated with changes in pulmonary arterial pressure and biventricular remodeling. CAVI may play an important role in cardiovascular interactions in patients with CTEPH. |
| first_indexed | 2024-03-08T05:11:55Z |
| format | Article |
| id | doaj.art-341e0308c19e4f58968d58a6587890c4 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-08T05:11:55Z |
| publishDate | 2023-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-341e0308c19e4f58968d58a6587890c42024-02-07T05:35:00ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-12-011010.3389/fcvm.2023.13258461325846Effect of balloon pulmonary angioplasty on cardio-ankle vascular index and biventricular remodeling in patients with chronic thromboembolic pulmonary hypertensionShuji Sato0Takuro Ito1Tsuyoshi Tabata2Akihiro Ogawa3Atsuhito Saiki4Kazuhiro Shimizu5Division of Cardiology, Department of Internal Medicine, Toho University Sakura Medical Center, Chiba, JapanDivision of Cardiology, Department of Internal Medicine, Toho University Sakura Medical Center, Chiba, JapanDepartment of Clinical Functional Physiology, Toho University Sakura Medical Center, Chiba, JapanDepartment of Rehabilitation, Toho University Sakura Medical Center, Chiba, JapanCenter of Diabetes, Endocrine and Metabolism, Toho University Sakura Medical Center, Chiba, JapanDivision of Cardiology, Department of Internal Medicine, Toho University Sakura Medical Center, Chiba, JapanBackgroundChronic thromboembolic pulmonary hypertension (CTEPH) is caused by organized pulmonary thrombi, and pulmonary endarterectomy is the only curative treatment. Since balloon pulmonary angioplasty (BPA) has become an established therapeutic option for inoperable CTEPH, prognosis has improved. Recent reports suggest that arterial stiffness evaluated using the cardio-ankle vascular index (CAVI) may play an important role in the cardio-vascular interaction in CTEPH; however, the details remain unclear. This study aimed to clarify the role of CAVI in CTEPH through hemodynamic changes and ventricular remodeling after BPA.Methods and resultsA total of 23 patients with CTEPH who had undergone BPA were enrolled in this study. The mean pulmonary artery pressure (mPAP) and CAVI significantly decreased after BPA [mPAP, 34 (26–45) mmHg to 20 (19–24) mmHg, p < 0.0001; CAVI, 9.4 (8.0–10.3) to 8.3 (7.5–9.6), p = 0.004]. The echocardiographic right ventricle was significantly decreased, and the left ventricular volume was significantly increased after BPA, indicating significant biventricular remodeling after BPA. Changes in CAVI (ΔCAVI) significantly correlated with changes in mPAP (r = 0.45, p = 0.03). Additionally, ΔCAVI was significantly correlated with changes in both right ventricular area and left ventricular volume.ConclusionsArterial stiffness, evaluated using the CAVI, improved after BPA. Changes in CAVI were significantly correlated with changes in pulmonary arterial pressure and biventricular remodeling. CAVI may play an important role in cardiovascular interactions in patients with CTEPH.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1325846/fullCTEPHBPACAVIarterial stiffnessventricular remodeling |
| spellingShingle | Shuji Sato Takuro Ito Tsuyoshi Tabata Akihiro Ogawa Atsuhito Saiki Kazuhiro Shimizu Effect of balloon pulmonary angioplasty on cardio-ankle vascular index and biventricular remodeling in patients with chronic thromboembolic pulmonary hypertension Frontiers in Cardiovascular Medicine CTEPH BPA CAVI arterial stiffness ventricular remodeling |
| title | Effect of balloon pulmonary angioplasty on cardio-ankle vascular index and biventricular remodeling in patients with chronic thromboembolic pulmonary hypertension |
| title_full | Effect of balloon pulmonary angioplasty on cardio-ankle vascular index and biventricular remodeling in patients with chronic thromboembolic pulmonary hypertension |
| title_fullStr | Effect of balloon pulmonary angioplasty on cardio-ankle vascular index and biventricular remodeling in patients with chronic thromboembolic pulmonary hypertension |
| title_full_unstemmed | Effect of balloon pulmonary angioplasty on cardio-ankle vascular index and biventricular remodeling in patients with chronic thromboembolic pulmonary hypertension |
| title_short | Effect of balloon pulmonary angioplasty on cardio-ankle vascular index and biventricular remodeling in patients with chronic thromboembolic pulmonary hypertension |
| title_sort | effect of balloon pulmonary angioplasty on cardio ankle vascular index and biventricular remodeling in patients with chronic thromboembolic pulmonary hypertension |
| topic | CTEPH BPA CAVI arterial stiffness ventricular remodeling |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1325846/full |
| work_keys_str_mv | AT shujisato effectofballoonpulmonaryangioplastyoncardioanklevascularindexandbiventricularremodelinginpatientswithchronicthromboembolicpulmonaryhypertension AT takuroito effectofballoonpulmonaryangioplastyoncardioanklevascularindexandbiventricularremodelinginpatientswithchronicthromboembolicpulmonaryhypertension AT tsuyoshitabata effectofballoonpulmonaryangioplastyoncardioanklevascularindexandbiventricularremodelinginpatientswithchronicthromboembolicpulmonaryhypertension AT akihiroogawa effectofballoonpulmonaryangioplastyoncardioanklevascularindexandbiventricularremodelinginpatientswithchronicthromboembolicpulmonaryhypertension AT atsuhitosaiki effectofballoonpulmonaryangioplastyoncardioanklevascularindexandbiventricularremodelinginpatientswithchronicthromboembolicpulmonaryhypertension AT kazuhiroshimizu effectofballoonpulmonaryangioplastyoncardioanklevascularindexandbiventricularremodelinginpatientswithchronicthromboembolicpulmonaryhypertension |