TY  - JOUR
A1  - Wiedenroth, Christoph B.
A1  - Rieth, Andreas J.
A1  - Kriechbaum, Steffen
A1  - Ghofrani, H.- Ardeschir
A1  - Breithecker, Andreas
A1  - Haas, Moritz
A1  - Roller, Fritz
A1  - Richter, Manuel J.
A1  - Lankeit, Mareike
A1  - Mielzarek, Lisa
A1  - Rolf, Andreas
A1  - Hamm, Christian
A1  - Mayer, Eckhard
A1  - Guth, Stefan
A1  - Liebetrau, Christoph
T1  - Exercise right heart catheterization before and after balloon pulmonary angioplasty in inoperable patients with chronic thromboembolic pulmonary hypertension
T2  - Pulmonary circulation
N2  - Background: Balloon pulmonary angioplasty is an evolving, interventional treatment option for inoperable patients with chronic thromboembolic pulmonary hypertension (CTEPH). Pulmonary hypertension at rest as well as exercise capacity is considered to be relevant outcome parameters. The aim of the present study was to determine whether measurement of pulmonary hemodynamics during exercise before and six months after balloon pulmonary angioplasty have an added value.
Methods: From March 2014 to July 2018, 172 consecutive patients underwent balloon pulmonary angioplasty. Of these, 64 consecutive patients with inoperable CTEPH underwent a comprehensive diagnostic workup that included right heart catheterization at rest and during exercise before balloon pulmonary angioplasty treatments and six months after the last intervention.
Results: Improvements in pulmonary hemodynamics at rest and during exercise, in quality of life, and in exercise capacity were observed six months after balloon pulmonary angioplasty: WHO functional class improved in 78% of patients. The mean pulmonary arterial pressure (mPAP) at rest was reduced from 41 ± 9 to 31 ± 9 mmHg (p < 0.0001). The mPAP/cardiac output slope decreased after balloon pulmonary angioplasty (11.2 ± 25.6 WU to 7.7 ± 4.1 WU; p < 0.0001), and correlated with N-terminal fragment of pro-brain natriuretic peptide (p = 0.035) and 6-minute walking distance (p = 0.01).
Conclusions: Exercise right heart catheterization provides valuable information on the changes of pulmonary hemodynamics after balloon pulmonary angioplasty in inoperable CTEPH patients that are not obtainable by measuring resting hemodynamics.
KW  - chronic thromboembolic pulmonary hypertension
KW  - balloon pulmonary angioplasty
KW  - right heart catheter
KW  - exercise
Y1  - 2020
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/55584
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-555845
SN  - 2045-8940
VL  - 10
IS  - 3
SP  - 1
EP  - 9
PB  - SAGE Publications
CY  - Thousand Oaks, CA
ER  -