National Cerebral and Cardiovascular Center, Suita, Japan
Copyright 2016, American College of Chest Physicians. All Rights Reserved.
SESSION TITLE: Pulmonary Arterial Hypertension
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Sunday, April 17, 2016 at 01:00 PM - 02:00 PM
PURPOSE: Chronic thromboembolic pulmonary hypertension (CTEPH) patients with mean pulmonary arterial pressure (MPAP) ≦30 mmHg had a better prognosis than those with MPAP >30 mmHg. Recently, balloon pulmonary angioplasty (BPA) developed as an alternative therapy for inoperable CTEPH patients. Therefore, the purpose of this study was to clarify predicting factors for MPAP ≦30 mmHg following BPA.
METHODS: Between April 2012 and February 2014, 35 CTEPH patients with inoperable reasons qualified for this retrospective study. We collected clinical and hemodynamic data to divide patients into the following two groups; 27 patients of follow - up MPAP ≦30 mmHg and 8 patients of follow - up MPAP >30 mmHg. Parameters associated with follow-up MPAP ≦30 mmHg were evaluated.
RESULTS: In 35 patients, 148 BPA sessions (average 4.2 ± 1.4 sessions/patient) were performed; 569 lesions were treated. No patients needed mechanical respiratory or circulatory support, and there were no deaths during the BPA procedures and follow-up period (average 4.3 ± 2.4 months). In the multivariate analysis, the duration from symptom onset and diastolic pulmonary arterial pressure (DPAP) at baseline was the only factors predicting follow - up MPAP ≦30 mmHg.
CONCLUSIONS: These findings indicated that BPA was effective to reduce MPAP to less than 30 mmHg, for which duration from symptom onset and diastolic pulmonary arterial pressure were the determinant factors.
CLINICAL IMPLICATIONS: It is imporant to evaluate the predicting factor of effectiveness before BPA. The evaluation may lead to the therapeutic option or combination (e.g., BPA alone, medical therapy alone, or both)
DISCLOSURE: The following authors have nothing to disclose: Akihiro Tsuji, Takeshi Ogo, Shigefumi Fukui, Tetsuya Fukuda, Jin Ueda, Norifumi Nakanishi
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