Acute lung injury after balloon pulmonary angioplasty results in a similar haemodynamic response and possible clinical advantage at follow‐up
Abstract Acute lung injury (ALI) is a common but poorly defined and understood complication of balloon pulmonary angioplasty (BPA) for chronic thromboembolic pulmonary hypertension (CTEPH). Little data are available on the medium term clinical outcomes of BPA complicated by ALI. We analyzed per‐proc...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-10-01
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| Series: | Pulmonary Circulation |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/pul2.12166 |
| _version_ | 1797975763794788352 |
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| author | Matthew S. Rodgers Louise C. Kirkby Liliana Amaral‐Almeida Karen Sheares Mark Toshner Dolores Taboada Choo Ng John E. Cannon Luigia D'Errico Alessandro Ruggiero Nicholas Screaton David Jenkins John G. Coghlan Joanna Pepke‐Zaba Stephen P. Hoole |
| author_facet | Matthew S. Rodgers Louise C. Kirkby Liliana Amaral‐Almeida Karen Sheares Mark Toshner Dolores Taboada Choo Ng John E. Cannon Luigia D'Errico Alessandro Ruggiero Nicholas Screaton David Jenkins John G. Coghlan Joanna Pepke‐Zaba Stephen P. Hoole |
| author_sort | Matthew S. Rodgers |
| collection | DOAJ |
| description | Abstract Acute lung injury (ALI) is a common but poorly defined and understood complication of balloon pulmonary angioplasty (BPA) for chronic thromboembolic pulmonary hypertension (CTEPH). Little data are available on the medium term clinical outcomes of BPA complicated by ALI. We analyzed per‐procedure data from 282 procedures in 109 patients and per‐patient data from 85 patients. Serial right heart catheterization at baseline, after each BPA and at 3‐month follow‐up measured pulmonary vascular resistance (PVR), mean pulmonary artery pressure (mPAP), and cardiac output (CO). ALI (ALI+) was identified by chest radiography alone (ALIr+) or in association with hypoxia clinically (ALIcr+). Procedural predictors of ALI and patient outcomes at 3‐months were compared no ALI (ALI−). ALI+ occurred in 17/282 (6.0%) procedures (ALIcr+: 2.5%, ALIr+: 3.5%). Prevailing haemodynamics (PVR: p < 0.01; mPAP: p < 0.05) at a procedural and patient level, as well as number of BPA sessions (p < 0.01), total number of vessels (p < 0.05), and occlusions (p < 0.05) treated at a patient level predicted ALI+. Those with ALI had greater percentage improvement in ΔCAMPHOR symptoms score (ALI+: −63.5 ± 35.7% (p < 0.05); ALIcr+: −84.4 ± 14.5% (p < 0.01); ALI−: −27.2 ± 74.2%) and ΔNT‐proBNP (ALIcr+: −78.4 ± 11.9% (p < 0.01); ALI−: −42.9 ± 36.0%) at follow‐up. There was no net significant difference in haemodynamic changes in ALI+ versus ALI− at follow‐up. ALI is predicted by haemodynamic severity, number of vessels treated, number of BPA sessions, and treating occlusive disease. ALI in this cohort was associated with a clinical advantage at follow‐up. |
| first_indexed | 2024-04-11T04:40:36Z |
| format | Article |
| id | doaj.art-d5207a7ce6db4003b590a656726e1ecf |
| institution | Directory Open Access Journal |
| issn | 2045-8940 |
| language | English |
| last_indexed | 2024-04-11T04:40:36Z |
| publishDate | 2022-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Pulmonary Circulation |
| spelling | doaj.art-d5207a7ce6db4003b590a656726e1ecf2022-12-28T07:32:41ZengWileyPulmonary Circulation2045-89402022-10-01124n/an/a10.1002/pul2.12166Acute lung injury after balloon pulmonary angioplasty results in a similar haemodynamic response and possible clinical advantage at follow‐upMatthew S. Rodgers0Louise C. Kirkby1Liliana Amaral‐Almeida2Karen Sheares3Mark Toshner4Dolores Taboada5Choo Ng6John E. Cannon7Luigia D'Errico8Alessandro Ruggiero9Nicholas Screaton10David Jenkins11John G. Coghlan12Joanna Pepke‐Zaba13Stephen P. Hoole14Department of Medicine University of Cambridge Cambridge UKDepartment of Medicine University of Cambridge Cambridge UKPulmonary Vascular Disease Unit Royal Papworth Hospital NHS Foundation Trust Cambridge UKPulmonary Vascular Disease Unit Royal Papworth Hospital NHS Foundation Trust Cambridge UKDepartment of Medicine University of Cambridge Cambridge UKPulmonary Vascular Disease Unit Royal Papworth Hospital NHS Foundation Trust Cambridge UKDepartment of Cardiothoracic Surgery Royal Papworth Hospital NHS Foundation Trust Cambridge UKPulmonary Vascular Disease Unit Royal Papworth Hospital NHS Foundation Trust Cambridge UKDepartment of Radiology Royal Papworth Hospital Cambridge UKDepartment of Radiology Royal Papworth Hospital Cambridge UKDepartment of Radiology Royal Papworth Hospital Cambridge UKDepartment of Cardiothoracic Surgery Royal Papworth Hospital NHS Foundation Trust Cambridge UKDepartment of Interventional Cardiology Royal Free Hospital London UKPulmonary Vascular Disease Unit Royal Papworth Hospital NHS Foundation Trust Cambridge UKDepartment of Interventional Cardiology Royal Papworth Hospital NHS Foundation Trust Cambridge UKAbstract Acute lung injury (ALI) is a common but poorly defined and understood complication of balloon pulmonary angioplasty (BPA) for chronic thromboembolic pulmonary hypertension (CTEPH). Little data are available on the medium term clinical outcomes of BPA complicated by ALI. We analyzed per‐procedure data from 282 procedures in 109 patients and per‐patient data from 85 patients. Serial right heart catheterization at baseline, after each BPA and at 3‐month follow‐up measured pulmonary vascular resistance (PVR), mean pulmonary artery pressure (mPAP), and cardiac output (CO). ALI (ALI+) was identified by chest radiography alone (ALIr+) or in association with hypoxia clinically (ALIcr+). Procedural predictors of ALI and patient outcomes at 3‐months were compared no ALI (ALI−). ALI+ occurred in 17/282 (6.0%) procedures (ALIcr+: 2.5%, ALIr+: 3.5%). Prevailing haemodynamics (PVR: p < 0.01; mPAP: p < 0.05) at a procedural and patient level, as well as number of BPA sessions (p < 0.01), total number of vessels (p < 0.05), and occlusions (p < 0.05) treated at a patient level predicted ALI+. Those with ALI had greater percentage improvement in ΔCAMPHOR symptoms score (ALI+: −63.5 ± 35.7% (p < 0.05); ALIcr+: −84.4 ± 14.5% (p < 0.01); ALI−: −27.2 ± 74.2%) and ΔNT‐proBNP (ALIcr+: −78.4 ± 11.9% (p < 0.01); ALI−: −42.9 ± 36.0%) at follow‐up. There was no net significant difference in haemodynamic changes in ALI+ versus ALI− at follow‐up. ALI is predicted by haemodynamic severity, number of vessels treated, number of BPA sessions, and treating occlusive disease. ALI in this cohort was associated with a clinical advantage at follow‐up.https://doi.org/10.1002/pul2.12166acute lung injury (ALI)balloon pulmonary angioplasty (BPA)chronic thromboembolic pulmonary hypertension (CTEPH)mean pulmonary artery pressure (mPAP)pulmonary vascular resistance (PVR) |
| spellingShingle | Matthew S. Rodgers Louise C. Kirkby Liliana Amaral‐Almeida Karen Sheares Mark Toshner Dolores Taboada Choo Ng John E. Cannon Luigia D'Errico Alessandro Ruggiero Nicholas Screaton David Jenkins John G. Coghlan Joanna Pepke‐Zaba Stephen P. Hoole Acute lung injury after balloon pulmonary angioplasty results in a similar haemodynamic response and possible clinical advantage at follow‐up Pulmonary Circulation acute lung injury (ALI) balloon pulmonary angioplasty (BPA) chronic thromboembolic pulmonary hypertension (CTEPH) mean pulmonary artery pressure (mPAP) pulmonary vascular resistance (PVR) |
| title | Acute lung injury after balloon pulmonary angioplasty results in a similar haemodynamic response and possible clinical advantage at follow‐up |
| title_full | Acute lung injury after balloon pulmonary angioplasty results in a similar haemodynamic response and possible clinical advantage at follow‐up |
| title_fullStr | Acute lung injury after balloon pulmonary angioplasty results in a similar haemodynamic response and possible clinical advantage at follow‐up |
| title_full_unstemmed | Acute lung injury after balloon pulmonary angioplasty results in a similar haemodynamic response and possible clinical advantage at follow‐up |
| title_short | Acute lung injury after balloon pulmonary angioplasty results in a similar haemodynamic response and possible clinical advantage at follow‐up |
| title_sort | acute lung injury after balloon pulmonary angioplasty results in a similar haemodynamic response and possible clinical advantage at follow up |
| topic | acute lung injury (ALI) balloon pulmonary angioplasty (BPA) chronic thromboembolic pulmonary hypertension (CTEPH) mean pulmonary artery pressure (mPAP) pulmonary vascular resistance (PVR) |
| url | https://doi.org/10.1002/pul2.12166 |
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