Right ventricular remodelling and long-term survival after pulmonary endarterectomy versus balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension

医学 心脏病学 内科学 肺动脉高压 肺动脉 血管成形术 波生坦 气球 慢性血栓栓塞性肺高压 内皮素受体 受体
作者
Håvard Ravnestad,Klaus Murbræch,Eyvind Gjønnæss,Rune Andersen,Narve Moe,S Birkeland,Morten Svalebjørg,Per Snorre Lingaas,Einar Gude,Lars Gullestad,John‐Peder Escobar Kvitting,Kaspar Broch,Arne K. Andreassen
出处
期刊:Heart [BMJ]
卷期号:: heartjnl-324243 被引量:2
标识
DOI:10.1136/heartjnl-2024-324243
摘要

Background Pulmonary endarterectomy (PEA) is the treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH), while balloon pulmonary angioplasty (BPA) is an alternative for inoperable patients. We aimed to compare right ventricular (RV) remodelling and late survival after PEA and BPA. Methods In this prospective observational cohort study, we performed echocardiography at baseline and follow-up in patients with CTEPH treated with PEA (n=54) or BPA (n=44) between 2011 and 2022. Results Follow-up echocardiography was performed at 5 months (IQR 4–7) after PEA and 3 months (IQR 2–4) after the last BPA. Both groups showed significant improvements in left ventricular end-systolic eccentricity index, RV basal diameter and RV fractional area change (RV FAC). Tricuspid regurgitation pressure decreased by 26±18 mm Hg after PEA and 13±21 mm Hg after BPA (p=0.02 for between-group difference). Tricuspid annular systolic excursion (TAPSE) decreased by 4±5 mm after PEA but increased by 1±4 mm after BPA (p<0.001). The TAPSE/systolic pulmonary artery pressure ratio improved similarly in both groups. Five-year survival was 96% (95% CI 86% to 99%) for PEA and 79% (95% CI 61% to 89%) for BPA (p=0.25). Change in RV FAC was an independent predictor of survival (HR 0.9, 95% CI 0.82 to 0.99, p=0.03). Conclusions Both PEA and BPA led to significant RV reverse remodelling, with no clear evidence of a difference in survival rates. Improvement in RV function, particularly RV FAC, was associated with better outcomes, highlighting the importance of RV recovery in CTEPH treatment.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
1秒前
小姚完成签到,获得积分10
1秒前
1秒前
面包完成签到 ,获得积分10
1秒前
Nami完成签到,获得积分10
2秒前
MES完成签到,获得积分20
2秒前
1234发布了新的文献求助10
2秒前
3秒前
3秒前
3秒前
4秒前
4秒前
maizhenpeng发布了新的文献求助30
5秒前
捏个小雪团完成签到 ,获得积分10
5秒前
5秒前
峥2发布了新的文献求助10
7秒前
。。完成签到,获得积分10
7秒前
zz完成签到,获得积分10
7秒前
传奇3应助写得出发的中采纳,获得30
7秒前
fgh发布了新的文献求助10
8秒前
1234完成签到,获得积分10
8秒前
8秒前
自然初露完成签到 ,获得积分10
9秒前
10秒前
KingXing发布了新的文献求助10
10秒前
TH1223完成签到,获得积分10
10秒前
bei完成签到 ,获得积分10
11秒前
Bio应助混子小高采纳,获得30
11秒前
yao学渣完成签到 ,获得积分10
12秒前
不二臣发布了新的文献求助10
13秒前
可爱的函函应助kkk采纳,获得10
13秒前
斯文败类应助偷乐采纳,获得10
13秒前
Ava应助mariawang采纳,获得10
14秒前
girl发布了新的文献求助10
14秒前
orixero应助szl采纳,获得10
14秒前
自然初露关注了科研通微信公众号
15秒前
yu完成签到 ,获得积分10
15秒前
KingXing完成签到,获得积分10
16秒前
粗犷的灵松完成签到 ,获得积分10
16秒前
yyyyy关注了科研通微信公众号
18秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3988786
求助须知:如何正确求助?哪些是违规求助? 3531116
关于积分的说明 11252493
捐赠科研通 3269766
什么是DOI,文献DOI怎么找? 1804771
邀请新用户注册赠送积分活动 881870
科研通“疑难数据库(出版商)”最低求助积分说明 809021