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Original Research |

Effect of balloon pulmonary angioplasty on respiratory function in patients with chronic thromboembolic pulmonary hypertension

Mina Akizuki, PT; Naoki Serizawa, MD, PhD; Atsuko Ueno, MD, PhD; Taku Adachi, PT, MS; Nobuhisa Hagiwara, MD, PhD
Author and Funding Information

1Department of Rehabilitation, Tokyo Women’s Medical University

2Department of Cardiology, Tokyo Women's Medical University

3Department of Internal Medicine & Rehabilitation Science Disability Science, Tohoku University Graduate School of Medicine

Address for correspondence: Mina AKIZUKI, Department of Rehabilitation, Tokyo Women’s Medical University, 8-1 Kawadacho, Shinjuku-ku, Tokyo 162-0054, Japan.


Copyright 2016, . All Rights Reserved.


Chest. 2016. doi:10.1016/j.chest.2016.10.002
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Abstract

Rationale  Balloon pulmonary angioplasty (BPA) in chronic thromboembolic pulmonary hypertension (CTEPH) improves hemodynamics and exercise capacity. However, its effect on respiratory function is unclear.

Objectives  To investigate the effect of BPA on respiratory function.

Methods  We enrolled inoperable CTEPH who underwent BPA primarily in lower lobe arteries (first series) and upper and middle lobe arteries (second series). We compared changes in hemodynamics and respiratory function between different BPA fields.

Measurements and Main Results  Sixty-two BPA sessions were performed in 13 consecutive patients. Mean pulmonary artery pressure and pulmonary vasculature resistance significantly improved from 44 ± 8 to 23 ± 5 mmHg and 818 ± 383 to 311 ± 117 dyne/s/cm−5. The percentage of predicted carbon monoxide lung diffusion capacity (%DLco) decreased after BPA in the lower-lung field (from 60 ± 8% to 54 ± 8%) with no recovery. %DLco increased after BPA in the upper-middle lung field (from 53 ± 6% to 58 ± 6%) and continued to improve during the follow-up (from 58 ± 6% to 64 ± 11%). The VE/VCO2 slope significantly improved after BPA in the lower-lung field (from 51 ± 13 to 41 ± 8) and continued to improve during the follow-up (from 41 ± 8 to 35 ± 7); however, the VE/VCO2 slope remained unchanged after BPA in the upper-middle lung field. Changes in %DLco and the VE/VCO2 slope significantly differed between lower and upper-middle lung fields.

Conclusions  The effect of BPA on respiratory function in patients with CTEPH differed depending on the lung field.


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