TY - JOUR
T1 - Balloon pulmonary angioplasty improves right atrial reservoir and conduit functions in chronic thromboembolic pulmonary hypertension
AU - Yamasaki, Yuzo
AU - Abe, Kohtaro
AU - Kamitani, Takeshi
AU - Hosokawa, Kazuya
AU - Kawakubo, Masateru
AU - Sagiyama, Koji
AU - Hida, Tomoyuki
AU - Matsuura, Yuko
AU - Murayama, Yuriko
AU - Funatsu, Ryohei
AU - Tsutsui, Hiroyuki
AU - Yabuuchi, Hidetake
N1 - Funding Information:
This work was supported by the Japan Society for the Promotion of Science (JSPS) KAKENHI (17K16452). This work was in part supported by Grants-in-Aid for study on rare/intractable diseases from Japan Agency for Medical Research and Development (18ek0109371h0001).
Publisher Copyright:
Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020
PY - 2020/8/1
Y1 - 2020/8/1
N2 - Aims Right atrial (RA) function largely contributes to the maintenance of right ventricular (RV) function. This study investigated the effect of balloon pulmonary angioplasty (BPA) on RA functions in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) using cardiac magnetic resonance imaging (CMRI). Methods and results CMRI and RV catheterization were performed before BPA sessions and at the follow-up periods in 29 CTEPH patients. Reservoir [RA longitudinal strain (RA-LS)], passive conduit [RA early LS rate (LSR)], and active (RA late LSR) phases were assessed by using cine CMRI and a feature-tracking algorithm. The relationships between the changes in RA functions and in brain natriuretic peptide (BNP) were evaluated in both the dilated and non-dilated RA groups. RA-LS (32.4% vs. 42.7%), RA LSR (6.3% vs. 8.3%), and RA early LSR (-2.3% vs. -4.3%) were improved after BPA, whereas no significant change was seen in RA late LSR. The changes in RA peak LS and in RA early LSR were significantly correlated with the changes in BNP (ΔRA-LS: r = -0.63, DRA-early LSR: r = 0.65) and pulmonary vascular resistance (PVR) (ΔRA-LS: r = -0.69, DRA-early LSR: r = 0.66) in the nondilated RA group. Conclusion The RA reservoir and passive conduit functions were impaired in inoperable CTEPH, whereas RA active function was preserved. BPA markedly reversed these impaired functions. The improvements in RA reservoir and conduit functions were significantly correlated with the changes in BNP levels and PVR in CTEPH patients with normal RA sizes.
AB - Aims Right atrial (RA) function largely contributes to the maintenance of right ventricular (RV) function. This study investigated the effect of balloon pulmonary angioplasty (BPA) on RA functions in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH) using cardiac magnetic resonance imaging (CMRI). Methods and results CMRI and RV catheterization were performed before BPA sessions and at the follow-up periods in 29 CTEPH patients. Reservoir [RA longitudinal strain (RA-LS)], passive conduit [RA early LS rate (LSR)], and active (RA late LSR) phases were assessed by using cine CMRI and a feature-tracking algorithm. The relationships between the changes in RA functions and in brain natriuretic peptide (BNP) were evaluated in both the dilated and non-dilated RA groups. RA-LS (32.4% vs. 42.7%), RA LSR (6.3% vs. 8.3%), and RA early LSR (-2.3% vs. -4.3%) were improved after BPA, whereas no significant change was seen in RA late LSR. The changes in RA peak LS and in RA early LSR were significantly correlated with the changes in BNP (ΔRA-LS: r = -0.63, DRA-early LSR: r = 0.65) and pulmonary vascular resistance (PVR) (ΔRA-LS: r = -0.69, DRA-early LSR: r = 0.66) in the nondilated RA group. Conclusion The RA reservoir and passive conduit functions were impaired in inoperable CTEPH, whereas RA active function was preserved. BPA markedly reversed these impaired functions. The improvements in RA reservoir and conduit functions were significantly correlated with the changes in BNP levels and PVR in CTEPH patients with normal RA sizes.
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U2 - 10.1093/ehjci/jeaa064
DO - 10.1093/ehjci/jeaa064
M3 - Article
C2 - 32359071
AN - SCOPUS:85088493694
VL - 21
SP - 855
EP - 862
JO - European Heart Journal Cardiovascular Imaging
JF - European Heart Journal Cardiovascular Imaging
SN - 2047-2404
IS - 8
ER -