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Right heart remodeling in patients with inoperable chronic thromboembolic pulmonary hypertension, after balloon angioplasty of the pulmonary arteries


International Journal of Radiology & Radiation Therapy
Madina B Karabasheva,1 Nikolay M Danilov,2 Olesya V Sagaydak,3 Yuriy G Matchin,4 Marina A Saidova,5 Irina E Chazova5

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Abstract

Introduction: Chronic thromboembolic pulmonary hypertension (CTEPH) is a precapillary form of pulmonary hypertension (PH) that develops due to thrombotic mass obstruction of the pulmonary arteries. In the absence of appropriate treatment which aims to reduce the pressure in the pulmonary artery and pulmonary vascular resistance, the disease progresses leading to hypertrophy and then dilatation of the right heart chambers with right ventricular heart failure. Heart failure determines the extremely unfavorable prognosis of these patients. We aimed to study the dynamics of RV remodeling in patients with inoperable CTEPH (one year after final BPA) by using echocardiography.
 
Materials and methods: 22 consecutive patients with inoperable CTEPH who underwent BPA with echocardiography before, after 1 month and 12 month after final BPA were retrospectively studied.
 
Result: BPA led to significantly ameliorated right-sided heart failure symptoms and signs, and exercise capacity. The results obtained in the long-term period did not significantly differ from the results immediately after the BPA, which proves the persistent effect after BPA procedure.
 
Conclusion: Echocardiography is useful method for assess effectiveness of BPA. The BPA procedure not only stops the progression of right ventricular failure, thereby stabilizing the disease with a persistent long-term result.

Keywords

pulmonary hypertension, echocardiography, chronic thromboembolic pulmonary hypertension, balloon angioplasty of pulmonary arteries, thromboendarterectomy

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