title: Effects of Balloon Pulmonary Angioplasty on Oxygenation in Patients With Chronic Thromboembolic Pulmonary Hypertension　- Importance of Intrapulmonary Shunt.
abstract: BACKGROUND
  Although balloon pulmonary angioplasty (BPA) improves the hemodynamics and prognosis of patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH), the mechanisms of improvement in oxygenation remain to be elucidated.
  
  
  RESULTS
  From August 2013 to May 2015, we performed a total of 113 BPA procedures in 24 patients with inoperable CTEPH (mean 4.7 procedures per patient). Median age was 70 [60, 74] years and 18 were female (75%). We examined hemodynamics, respiratory functions, and intrapulmonary shunt before and after the BPA procedure. Mean pulmonary arterial pressure (37 [28, 45] to 23[19, 27] mmHg, P<0.01), pulmonary vascular resistance (517 [389, 696] to 268 [239, 345] dyne/s/cm(5)) and 6-min walk distance (390 [286, 484] to 490 [411, 617] m, P<0.01) were significantly improved after BPA therapy. Furthermore, arterial oxygen partial pressure (PaO2, 54.8 [50.0, 60.8] to 65.2 [60.6, 73.2] %, P<0.01) and intrapulmonary shunt (23.4±6.0% to 19.3±5.0%, P<0.01) were also significantly ameliorated. In the multivariate analysis, decrease in intrapulmonary shunt after BPA was significantly correlated with improvement of both PaO2(r(2)=0.26, P<0.01) and SaO2(r(2)=0.49, P<0.01) after BPA.
  
  
  CONCLUSIONS
  These results indicated that BPA improved not only pulmonary hemodynamics but also oxygenation with a resultant decrease in intrapulmonary shunt. (Circ J 2016; 80: 2227-2234).
authors: Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine.
authors: Tatsuo
authors: T
authors: Aoki
authors: Koichiro
authors: K
authors: Sugimura
authors: Kotaro
authors: K
authors: Nochioka
authors: Masanobu
authors: M
authors: Miura
authors: Shunsuke
authors: S
authors: Tatebe
authors: Saori
authors: S
authors: Yamamoto
authors: Nobuhiro
authors: N
authors: Yaoita
authors: Hideaki
authors: H
authors: Suzuki
authors: Haruka
authors: H
authors: Sato
authors: Katsuya
authors: K
authors: Kozu
authors: Satoshi
authors: S
authors: Miyata
authors: Kimio
authors: K
authors: Satoh
authors: Hiroaki
authors: H
authors: Shimokawa
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon; D002908:Chronic Disease; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D011655:Pulmonary Embolism / Q000097:blood / Q000601:surgery
chemical_list: D010100:Oxygen