title: Multiple Beneficial Effects of Balloon Pulmonary Angioplasty in Patients With Chronic Thromboembolic Pulmonary Hypertension.
abstract: BACKGROUND
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Tatebe
authors.forename: Koichiro
authors.initials: K
authors.lastname: Sugimura
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Aoki
authors.forename: Masanobu
authors.initials: M
authors.lastname: Miura
authors.forename: Kotaro
authors.initials: K
authors.lastname: Nochioka
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Yaoita
authors.forename: Hideaki
authors.initials: H
authors.lastname: Suzuki
authors.forename: Haruka
authors.initials: H
authors.lastname: Sato
authors.forename: Saori
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Kimio
authors.initials: K
authors.lastname: Satoh
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Fukumoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Shimokawa
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon; D002908:Chronic Disease; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology / Q000601:surgery; D050171:Dyslipidemias / Q000097:blood / Q000453:epidemiology / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000453:epidemiology / Q000601:surgery; D006976:Hypertension, Pulmonary / Q000097:blood / Q000453:epidemiology / Q000601:surgery; D008875:Middle Aged; D015995:Prevalence; D011655:Pulmonary Embolism / Q000097:blood / Q000453:epidemiology / Q000601:surgery; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000453:epidemiology / Q000601:surgery