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Percutaneous Transluminal Pulmonary Angioplasty is Effective for the Treatment of Chronic Thromboembolic Pulmonary Hypertension

Takumi Inami

Masaharu Kataoka

Tsunehiko Shimura

Haruhisa Ishiguro

Ryoji Yanagisawa

Hiroki Taguchi

Hideyasu Kohshoh

Kentaro Hayashida

Takashi Kawakami

Yuichi Tamura

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Conference: 2012 International PHA Conference and Scientific Sessions

Release Date: 06.22.2012

Presentation Type: Abstracts

Takumi Inami, MD;1 Masaharu Kataoka, MD;1,2Nobuhiko Shimura, MD;1 Haruhisa Ishiguro, MD;1 Ryoji Yanagisawa, MD; 1 Hiroki Taguchi, MD; 1 Hideyasu Kohshoh, MD; 1 Kentaro Hayashida, MD;1,2 Takashi Kawakami, MD;2 Yuichi Tamura, MD;2 Hideaki Yoshino, MD;1 Keiichi Fukuda, MD;2 Toru Satoh, MD1

1. Division of Cardiology, Department of Medicine, Kyorin University School of Medicine, Tokyo, Japan
2. Department of Cardiology, Keio University School of Medicine, Tokyo, Japan

BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) leads to pulmonary hypertension and right-sided heart failure. The purpose of this study was to investigate the efficacy of percutaneous transluminal pulmonary angioplasty (PTPA) for the treatment of CTEPH.

METHODS AND RESULTS: In the 28 enrolled patients with CTEPH who underwent PTPA (average follow-up period, 6.0 ± 6.9 months), New York Heart Association functional classifications were improved from 3.3 ± 0.5 to 2.1 ± 0.5 (P<0.01). The six-minute walk distance significantly lengthened from 279 ± 110 to 369 ± 104 m (P<0.01), and levels of plasma brain natriuretic peptide significantly decreased (306 ± 271 vs. 98 ± 197 pg/mL, respectively; P<0.01). Hemodynamic parameters also significantly improved after PTPA (mean right atrial pressure, 5.9 ± 4.9 vs. 3.5 ± 1.7 mmHg; mean pulmonary arterial pressure, 45.3 ± 9.8 vs. 31.8 ± 10.0 mmHg; pulmonary vascular resistance, 11.7 ± 5.3 vs. 6.0 ± 3.0 Wood units; cardiac output, 3.6 ± 1.2 vs. 4.6 ± 1.7 L/min, before and after PTPA, respectively; all P<0.01). Analysis of flow grades revealed that the degree of flow in the pulmonary veins just after PTPA was a good marker for predicting hemodynamic improvement.

CONCLUSIONS: PTPA markedly improved subjective symptoms and objective variables including pulmonary hemodynamics. The flow appearance of pulmonary veins just after PTPA was important in predicting the efficacy of PTPA. PTPA may be a promising therapeutic strategy for the treatment of CTEPH.