Multiple Beneficial Effects of Balloon Pulmonary Angioplasty in Patients With Chronic Thromboembolic Pulmonary Hypertension

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Author(s)

    • Shimokawa Hiroaki
    • Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
    • Sugimura Koichiro
    • Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
    • Aoki Tatsuo
    • Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
    • Miura Masanobu
    • Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
    • Nochioka Kotaro
    • Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
    • Yaoita Nobuhiro
    • Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
    • Suzuki Hideaki
    • Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
    • Sato Haruka
    • Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
    • Yamamoto Saori
    • Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine

Abstract

<b><i>Background:</i></b>Pulmonary arterial hypertension with systemic dysfunctions, including metabolic disorders and renal dysfunction, has a poor prognosis. However, it remains to be elucidated whether chronic thromboembolic pulmonary hypertension (CTEPH) is also associated with systemic dysfunctions, and if so, whether balloon pulmonary angioplasty (BPA) improves them.<b><i>Methods and Results:</i></b>Fifty-five consecutive patients who underwent BPA from March 2012 to December 2014 for systemic dysfunctions, including glycemic control, lipid profiles, renal and vascular function, and nutritional status were examined. The analyses were performed before and after BPA (mean, 3.5 sessions/patient) and changes in hemodynamic parameters were compared. The average follow-up period was 474±245 days. Baseline prevalence of hypertension, diabetes mellitus, dyslipidemia and advanced chronic kidney disease was 58, 7, 33 and 36%, respectively. BPA caused marked hemodynamic improvements in the CTEPH patients. Importantly, BPA also significantly improved dysglycemia (fasting blood sugar, hemoglobin A1c and homeostatic assessment model of insulin resistance), renal (creatinine and estimated glomerular filtration rate) and vascular (cardio-ankle vascular index) functions and nutritional status (albumin, cholesterols, and body mass index). Importantly, there were positive correlations between the degrees of the hemodynamic improvements and those of other improvements.<b><i>Conclusions:</i></b>These results indicate that BPA may exert multiple beneficial effects in CTEPH patients, not only in terms of hemodynamics but also in other systemic functions, with positive correlations among them. (<i>Circ J</i> 2016; <b>80:</b> 980–988)

Journal

  • Circulation Journal

    Circulation Journal 80(4), 980-988, 2016

    The Japanese Circulation Society

Codes

  • NII Article ID (NAID)
    130005139581
  • NII NACSIS-CAT ID (NCID)
    AA11591968
  • Text Lang
    ENG
  • ISSN
    1346-9843
  • NDL Article ID
    027203488
  • NDL Call No.
    Z54-B860
  • Data Source
    NDL  J-STAGE 
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