Applicability study of CT pulmonary angiography in evaluating treatment effect after balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension
10.3760/cma.j.cn112149-20240801-00458
- VernacularTitle:CT肺动脉成像评价肺动脉球囊扩张成形术治疗慢性血栓栓塞性肺动脉高压的疗效
- Author:
Zhihui LU
1
;
Chen ZHANG
;
Jun WAN
;
Yao XIAO
;
Lei ZHAO
;
Guanyu LU
;
Hongbo ZHANG
;
Lanling WANG
;
Xiaohai MA
Author Information
1. 首都医科大学附属北京安贞医院介入诊疗科，北京 100029
- Publication Type:Journal Article
- Keywords:
Hypertension, pulmonary;
Balloon pulmonary angioplasty;
Thromboembolism;
CT pulmonary angiography
- From:
Chinese Journal of Radiology
2025;59(4):447-453
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate whether changes in CT pulmonary angiography (CTPA) parameters before and after balloon pulmonary angioplasty (BPA) are correlated with treatment effects in patients with chronic thromboembolic pulmonary hypertension (CTEPH).Methods:A retrospective study was conducted, including patients with CTEPH who underwent BPA treatment at Beijing Anzhen Hospital from November 2021 to Febbruary 2024. Clinical data and CTPA parameters were analyzed before the initial BPA session and at least 6 months after the final BPA session. Clinical data included WHO functional class, 6-minute walk distance (6MWD), and plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. The CTPA parameters included the widest diameter of the pulmonary artery diameter (dPA), ascending aorta diameter (dAA), the widest transverse diameter of the right atrium (dRA), the widest short-axis diameter of the right ventricle (dRV), the widest short-axis diameter of the left ventricle (dLV), and the diameter of right ventricular free wall thickness(dRVW). Multiple linear regression was applied to identify variables associated with the decrease in mean pulmonary artery pressure (mPAP) among the CTPA parameters.Results:All CTEPH patients underwent a total of 115 BPA treatments. Postoperatively, the WHO functional class of the patients improved compared to preoperative levels ( χ2=5.01, P<0.001), 6MWD improved ( t=4.50, P<0.001), and NT-proBNP levels decreased ( Z=4.47, P<0.001). Hemodynamic parameters, including mPAP, pulmonary vascular resistance, cardiac output, and cardiac index, were significantly improved postoperatively (all P<0.001). CTPA-related parameters, including dPA, dRA, dRV, dRVW, dPA/dAA, dRV/dLV, and dRA/dPA, significantly decreased compared to preoperative values (all P<0.001). Multiple linear regression analysis showed that the decrease in dPA ( β=0.314, P=0.037) and dRA ( β=0.334, P=0.046) were significantly correlated with the improvement in mPAP. Conclusions:Exercise tolerance, hemodynamics, and CTPA parameters in patients with CTEPH significantly improved after BPA treatment. The decrease in dPA and dRA were significantly correlated with the improvement in mPAP, suggesting that CTPA is a potentially novel, objective, effective, and noninvasive method for evaluating the therapeutic efficacy of BPA.
