Evaluation of the efficacy of balloon pulmonary angioplasty in patients with chronic thromboembolic pulmonary hypertension by echocardiography
10.3760/cma.j.issn.1004-4477.2019.09.001
- VernacularTitle: 超声心动图评价慢性血栓栓塞性肺动脉高压球囊肺血管成形术疗效的研究
- Author:
Yidan LI
1
;
Yuanhua YANG
2
;
Jianfeng WANG
3
;
Juanni GONG
2
;
Dichen GUO
1
;
Zhe JIANG
1
;
Yuanzhi LI
1
;
Xiuzhang LYU
1
Author Information
1. Department of Echocardiography, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
2. Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
3. Department of Intervention, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, China
- Publication Type:Clinical Trail
- Keywords:
Echocardiography;
Pulmonary hypertension;
Balloon pulmonary angioplasty;
Cardiac function, right
- From:
Chinese Journal of Ultrasonography
2019;28(9):737-741
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the cardiac hemodynamics and function before and after balloon pulmonary angioplasty (BPA) treatment in patients with chronic thromboembolic pulmonary hypertension (CTEPH) using echocardiography, and to discuss the clinical value of the treatment.
Methods:A total of 36 CTEPH patients with medium-high risk stratification underwent BPA during the period of September 2016 to January 2019 in Beijing Chao-Yang Hospital, Capital Medical University were recruited. The following conventional echocardiographic parameters including right ventricular basal diameter (RVD), left ventricular basal diameter (LVD), right atrial diameter (RAD), left atrial diameter (LAD), main pulmonary artery diameter (DMPA), left ventricular eccentricity index (LVEI), left ventricular ejection fraction (LVEF) and pulmonary artery systolic pressure (PASP) were recorded.Echocardiographic parameters of right ventricular (RV) function including tricuspid annular plane systolic excursion (TAPSE), right ventricular fractional area change (RVFAC), tissue Doppler–derived tricuspid lateral annular systolic velocity (S′), RV index of myocardial performance (RIMP) and right ventricular free wall longitudinal strain (GLS) were measured. The patients were divided into 2 groups according to the threshold value of postoperative SPAP of 50 mmHg (group Ⅰ: SPAP ≤ 50 mmHg, group Ⅱ: SPAP>50 mmHg). Changes between each parameter before and after BPA were analyzed.
Results:①The frequency of BPA treatment for CTEPH patients ranged from 1 to 6 times. After BPA treatment, SPAP decreased significantly, and the measurements of RV function including TAPSE, RVFAC, RIMP and GLS improved significantly (all P<0.05). ②Patients in group Ⅰ showed significantly better RV function including TAPSE, RVFAC and GLS compared with group Ⅱ before BPA (P<0.05). ③Univariate logistic regression showed that parameters of preoperative RV function TAPSE, RVFAC and GLS had certain effects on the curative effect of interventional surgery.
Conclusions:Echocardiography can evaluate the hemodynamics and RV function in CTEPH patients with BPA.After BPA, pulmonary artery pressure decreases and RV function improves to some extent, suggesting that the treatment of BPA has certain clinical application and popularization value.
