THE ROLE OF ECHOCARDIOGRAPHY TO DEMONSTRATE THE EFFECTS OF THE BALLOON PULMONARY ANGIOPLASTY IN PATIENTS WITH CHRONIC THROMBOEMBOLIC HYPERTENSION
B. Lichodziejewska [1], O. Dzikowska-Diduch [1], M. Roik [1], S. Goliszek [1], K. Kurnicka [1], D. Wretowski [1], A. Łabyk [1], K. Irzyk [1], P. Pruszczyk [1]
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
Echocardiography is widely used technique for the assessment of the hemodynamic consequences of pulmonary hypertension (PH). Balloon pulmonary angioplasty (BPA) is an emerging therapeutic method of chronic thromboembolic hypertension (CTEPH). Aim: To demonstrate the changes of echocardiographic parameters in CTEPH patients before and after BPA. Material and methods: The study group consisted of 24 patients with CTEPH (age 49-88, mean 72; 12 men). All patients underwent 1-5 BPA sessions. Echocardiography was performed before and after BPA. Seventeen standard echocardiographic parameters and signs useful for assessing the presence of PH were estimated. Results: Before BPA mean pulmonary artery pressure (mPAP) was 42±7.5mmHg in right heart catheterization. After BPA mPAP decreased to 25.4±6mmHg. We observed echocardiographic improvement of all 17 signs and parameters, 9 of them significant: right and left ventricle diameters ratio (RV/LV): 1.3±0.4 vs 1.1±0.2, p=0.01; inferior vena cava: 21.9±5.6mm vs 17.8±5.6mm, p=0.001; tricuspid annulus plane systolic excursion (TAPSE): 17.8±3.6mm vs 19.9±4.4mm, p=0.02; pulmonary valve flow (PVF) acceleration time: 69±16.2ms vs 79.4±13.9ms, p=0.01; tricuspid regurgitation (TR) peak gradient: 79.9±20.4mmHg vs 62.8±21.5mmHg, p<0.001; RV systolic pressure: 89.9±21.7mmHg vs 70.8±23.6mmHg, p<0.001; the presence: of interventricular septum reverse curvature: 38% vs 17%, p=0.02; of PVF systolic notch: 67% vs 33%, p=0.01; of TR grade moderate or severe: 71% vs 38%, p=0.01. Conclusion: Echocardiographic signs and parameters revealing right heart hemodynamics improved markedly in CTEPH patients after BPA treatment.
THE ROLE OF ECHOCARDIOGRAPHY TO DEMONSTRATE THE EFFECTS OF THE BALLOON PULMONARY ANGIOPLASTY IN PATIENTS WITH CHRONIC THROMBOEMBOLIC HYPERTENSION
Echocardiography is widely used technique for the assessment of the hemodynamic consequences of pulmonary hypertension (PH). Balloon pulmonary angioplasty (BPA) is an emerging therapeutic method of chronic thromboembolic hypertension (CTEPH).
Aim: To demonstrate the changes of echocardiographic parameters in CTEPH patients before and after BPA.
Material and methods: The study group consisted of 24 patients with CTEPH (age 49-88, mean 72; 12 men). All patients underwent 1-5 BPA sessions. Echocardiography was performed before and after BPA. Seventeen standard echocardiographic parameters and signs useful for assessing the presence of PH were estimated.
Results: Before BPA mean pulmonary artery pressure (mPAP) was 42±7.5mmHg in right heart catheterization. After BPA mPAP decreased to 25.4±6mmHg. We observed echocardiographic improvement of all 17 signs and parameters, 9 of them significant: right and left ventricle diameters ratio (RV/LV): 1.3±0.4 vs 1.1±0.2, p=0.01; inferior vena cava: 21.9±5.6mm vs 17.8±5.6mm, p=0.001; tricuspid annulus plane systolic excursion (TAPSE): 17.8±3.6mm vs 19.9±4.4mm, p=0.02; pulmonary valve flow (PVF) acceleration time: 69±16.2ms vs 79.4±13.9ms, p=0.01; tricuspid regurgitation (TR) peak gradient: 79.9±20.4mmHg vs 62.8±21.5mmHg, p<0.001; RV systolic pressure: 89.9±21.7mmHg vs 70.8±23.6mmHg, p<0.001; the presence: of interventricular septum reverse curvature: 38% vs 17%, p=0.02; of PVF systolic notch: 67% vs 33%, p=0.01; of TR grade moderate or severe: 71% vs 38%, p=0.01.
Conclusion: Echocardiographic signs and parameters revealing right heart hemodynamics improved markedly in CTEPH patients after BPA treatment.
bpa, cteph, echo
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