Heart & lung : the journal of critical care · 2026
Exercise tolerance in patients with chronic thromboembolic pulmonary hypertension after balloon pulmonary angioplasty.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Lu Zhihui, Zhang Chen, Wan Jun, Xiao Yao, Zhao Lei, Lu Guanyu, Zhang Hongbo, Wang Lanling, Yi Yuhan, Wang Lili, Ma Xiaohai
Аннотация
BACKGROUND: Balloon pulmonary angioplasty (BPA) is an effective therapeutic alternative for patients with chronic thromboembolic pulmonary hypertension (CTEPH), which improved pulmonary arterial compliance (CPA) and pulmonary vascular resistance (PVR).
OBJECTIVE: To investigate whether the CPA is a predictor of exercise tolerance after BPA.
METHODS: The correlations between changes in each parameter and changes in six-minute walking distance (6MWD) were evaluated by Pearson's test. The determinants of functional capacity that was defined as 6MWD ≥440 m were assessed with a logistic regression model. Multiple linear regression analysis was used to identify the independent variables related to △6MWD.
RESULTS: We enrolled 70 patients (female/male: 40/30, mean age: 64 years) who underwent a total of 271 BPA sessions which significantly increased CPA [1.0 (0.7, 1.3) vs. 2.1 (1.7, 2.5) mL/mmHg], and decreased PVR [6.7 (3.6, 9.7) vs. 3.0 (2.1, 4.3) wood units]. The correlation coefficient between improvement in 6MWD and changes in CPA was r = 0.328 (P = 0.006). At univariate analysis, duration of pulmonary hypertension symptoms and pulmonary arterial compliance were found to be associated with good exercise tolerance. Multivariate analysis demonstrated that CPA (95 %CI: 1.23 to 3.75, P = 0.026) was an independent predictor of exercise tolerance after BPA. The multiple linear regression analysis demonstrated that △CPA (β= 0.292, P = 0.019) was an independent predictor of △6MWD.
CONCLUSION: BPA significantly improved CPA in inoperable patients with CTEPH and the resistance-compliance relationship maintained inversely associated. After successful BPA, baseline CPA is an important determinant of exercise tolerance.
OBJECTIVE: To investigate whether the CPA is a predictor of exercise tolerance after BPA.
METHODS: The correlations between changes in each parameter and changes in six-minute walking distance (6MWD) were evaluated by Pearson's test. The determinants of functional capacity that was defined as 6MWD ≥440 m were assessed with a logistic regression model. Multiple linear regression analysis was used to identify the independent variables related to △6MWD.
RESULTS: We enrolled 70 patients (female/male: 40/30, mean age: 64 years) who underwent a total of 271 BPA sessions which significantly increased CPA [1.0 (0.7, 1.3) vs. 2.1 (1.7, 2.5) mL/mmHg], and decreased PVR [6.7 (3.6, 9.7) vs. 3.0 (2.1, 4.3) wood units]. The correlation coefficient between improvement in 6MWD and changes in CPA was r = 0.328 (P = 0.006). At univariate analysis, duration of pulmonary hypertension symptoms and pulmonary arterial compliance were found to be associated with good exercise tolerance. Multivariate analysis demonstrated that CPA (95 %CI: 1.23 to 3.75, P = 0.026) was an independent predictor of exercise tolerance after BPA. The multiple linear regression analysis demonstrated that △CPA (β= 0.292, P = 0.019) was an independent predictor of △6MWD.
CONCLUSION: BPA significantly improved CPA in inoperable patients with CTEPH and the resistance-compliance relationship maintained inversely associated. After successful BPA, baseline CPA is an important determinant of exercise tolerance.