title: Significance of echocardiographic assessment for right ventricular function after balloon pulmonary angioplasty in patients with chronic thromboembolic induced pulmonary hypertension.
abstract: Balloon pulmonary angioplasty (BPA) may improve hemodynamics and exercise tolerance in patients with chronic thromboembolic pulmonary hypertension (CTEPH). We studied consecutive 25 patients with CTEPH who underwent BPA and evaluated hemodynamics by right-sided heart catheterization. Right ventricular (RV) function was assessed before and after BPA by echocardiography including speckle-tracking echocardiography and 3-dimensional echocardiography. BPA improved the mean pulmonary artery pressure, pulmonary vascular resistance, and cardiac index. BPA also ameliorated the 3-dimentional RV volume, RV ejection fraction, and RV systolic peak strain, all of which were significantly correlated with hemodynamic parameters. The changes in cardiac index were significantly correlated with those in 3-dimentional RV volume index. Furthermore, RV dyssynchrony quantified by the RV strain analyses was ameliorated after BPA even in patients with mild pulmonary hypertension, implicating the merit of BPA in this patient population with CTEPH. BPA not only improved the hemodynamics in patients with CTEPH, but also ameliorated RV remodeling and dyssynchrony as assessed by 3-dimensional echocardiography or speckle-tracking echocardiography. Thus, the assessment of RV function may provide valuable information about the appropriate indication for BPA, its efficacy, and the therapeutic goal for patients with CTEPH.
authors.affiliation: Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan; Department of Cardiology, Hino Municipal Hospital, Tokyo, Japan.
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Tsugu
authors.affiliation: Department of Laboratory Medicine, School of Medicine, Keio University, Tokyo, Japan. Electronic address: muratam@a7.keio.jp.
authors.forename: Mitsushige
authors.initials: M
authors.lastname: Murata
authors.affiliation: Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawakami
authors.affiliation: Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Risako
authors.initials: R
authors.lastname: Yasuda
authors.affiliation: Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Hanako
authors.initials: H
authors.lastname: Tokuda
authors.affiliation: Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Yugo
authors.initials: Y
authors.lastname: Minakata
authors.affiliation: Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Tamura
authors.affiliation: Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Kataoka
authors.affiliation: Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Hayashida
authors.affiliation: Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Hikaru
authors.initials: H
authors.lastname: Tsuruta
authors.affiliation: Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Maekawa
authors.affiliation: Department of Cardiology, Hino Municipal Hospital, Tokyo, Japan.
authors.forename: Soushin
authors.initials: S
authors.lastname: Inoue
authors.affiliation: Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Fukuda
mesh_terms: D000800:Angioplasty, Balloon / Q000379:methods*; D006328:Cardiac Catheterization; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013923:Thromboembolism / Q000150:complications* / Q000503:physiopathology / Q000601:surgery; D016278:Ventricular Function, Right / Q000502:physiology*