Percutaneous transluminal pulmonary angioplasty improves biventricular cardiac functions in patients with chronic thromboembolic pulmonary hypertension - A cardiac magnetic resonance study-

Abstract

Background: Percutaneous transluminal pulmonary angioplasty (PTPA) is known to improve pulmonary hemodynamics and right ventricular (RV) cardiac function in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). However, the effect of PTPA on left ventricular (LV) function and volume remains unknown. Aims and Objectives: To evaluate whether PTPA improves biventricular cardiac functions as measured by cardiac MR (CMR). Methods: We enrolled 26 patients with inoperable CTEPH who underwent PTPA after optimal medication (female, 77.8%, median age, 62.3 years). We evaluated clinical status, pulmonary hemodynamics and CMR findings before and after the treatment. Results: No patient died during the treatment or a follow-up period. PTPA markedly improved WHO functional class (III/IV, 77.7 to 0%, P 5 , P 2 , P=0.04). Furthermore, CMR showed improvement of RV ejection fraction (39.5 to 51.0%, P 2 , P=0.03) and end-systolic volume index (68 to 42ml/m 2 , P=0.02) and increase in LVEDV index (64 to 76 ml/m 2 , P=0.004) and LVCI (2.4 to 2.8L/min/m 2 , P=0.001). Conclusions: PTPA improves biventricular cardiac functions and volumes in addition to clinical status and pulmonary hemodynamics in patients with inoperable CTEPH.