PDF(Pubmed)
Abstract：
Balloon pulmonary angioplasty (BPA) is beneficial for patients with chronic thromboembolic pulmonary disease (CTEPD) with pulmonary hypertension (PH). However, the clinical benefit of BPA for the patients with CTEPD without PH remains unknown. In this study, we aimed to evaluate the efficacy, safety, and long-term outcomes of BPA in patients with CTEPD without PH. We retrospectively analyzed the data from 84 CTEPD patients with mean pulmonary artery pressure (mPAP) < 25 mmHg and 39 CTEPD patients with mPAP ≤ 20 mmHg (without PH). Among the 39 patients with CTEPD without PH, 14 underwent BPA (BPA-treated group), and the remaining 25 received no treatment (untreated group). In the patients with CTEPD without PH, BPA led to improvements in symptoms, pulmonary vascular resistance (3.6 ± 1.6 to 2.6 ± 1.1 Wood units, p < 0.001), peak oxygen consumption (16.1 ± 4.0 to 18.8 ± 4.3 mL/kg/min, p = 0.033), minute ventilation versus carbon dioxide production slope (41.4 ± 12.2 to 35.1 ± 6.7, p = 0.026), and mPAP/cardiac output slope (7.0 ± 2.6 to 4.4 ± 2.0 mmHg/L/min, p = 0.004) and facilitated the discontinuation of home oxygenation therapy, with no serious complications. Kaplan-Meier analysis showed no significant difference in all-cause mortality between the untreated and BPA-treated groups. BPA may be a safe treatment option for the patients with CTEPD without PH that can alleviate symptoms, improve exercise capacity, and facilitate weaning from home oxygen therapy. Further prospective randomized trials are needed to confirm these findings.
摘要：
球囊肺血管成形术(BPA)有益于慢性血栓栓塞性肺疾病(CTEPD)伴肺动脉高压(PH)患者。然而,BPA对无PH的CTEPD患者的临床获益尚不清楚.在这项研究中,我们的目的是评估疗效，安全,和BPA在无PH的CTEPD患者中的长期结局。我们回顾性分析了84例平均肺动脉压（mPAP）<25mmHg的CTEPD患者和39例mPAP≤20mmHg（无PH）的CTEPD患者的数据。在39例无PH的CTEPD患者中，14例接受BPA治疗（BPA治疗组），其余25人未接受治疗（未治疗组）。在没有PH的CTEPD患者中，BPA导致症状改善，肺血管阻力（3.6±1.6至2.6±1.1木材单位，p<0.001)，峰值耗氧量（16.1±4.0至18.8±4.3mL/kg/min，p=0.033),分钟通气量与二氧化碳产生斜率（41.4±12.2至35.1±6.7，p=0.026），和mPAP/心输出量斜率（7.0±2.6至4.4±2.0mmHg/L/min，p=0.004)并促进了家庭氧合治疗的停止，无严重并发症。Kaplan-Meier分析显示，未治疗组和BPA治疗组之间的全因死亡率没有显着差异。对于没有PH的CTEPD患者，BPA可能是一种安全的治疗选择，可以缓解症状。提高运动能力,并促进家庭氧气疗法的断奶。需要进一步的前瞻性随机试验来证实这些发现。
