Effects of balloon pulmonary angioplasty on cardiac and pulmonary functions and complications in patients with chronic thromboembolic pulmonary hypertension.

OBJECTIVE

To explore the effects of balloon pulmonary angioplasty (BPA) on cardiac and pulmonary functions and complications in patients with chronic thromboembolic pulmonary hypertension (CTEPH).

METHODS

From February 2023 to December 2024, 100 patients with CTEPH at our hospital underwent BPA treatment were selected. The WHO cardiac function classification, right heart catheterization parameters, cardiac function indexes, levels of NT-proBNP, TNF-α and IL-6, exercise tolerance, pulmonary function indexes, pulmonary artery pressure, and blood gas indexes were compared before BPA and 3 months after the last BPA. The BPA-related complications were recorded.

RESULTS

Compared with before BPA, the WHO cardiac function classification of Grade I, Grade II and Grade III was significantly improved 3 months after the last BPA (p = 0.003, p = 0.020, p = 0.000), the mPAP and PVR were significantly lower (p < 0.001), the CI was significantly higher (p < 0.001), the TAPSE, RVFAC and EDV were significantly higher (p < 0.001), the TVR was significantly lower (p < 0.001), the 6-MWD was significantly longer (p < 0.001), the FVC, FEV1 and FEV1/FVC were significantly higher (p < 0.001), the levels of pulmonary artery systolic pressure and pulmonary artery diastolic pressure were significantly lower (p < 0.001), the levels of NT-proBNP, TNF-α and IL-6 were significantly lower, the PaO2 level was significantly higher (p < 0.001), as well as the PaCO2 level was significantly lower (p < 0.001). However, there were no significant differences in ESV and LVEF between before BPA and 3 months after the last BPA (p > 0.05). In addition, there were 5 cases of hemoptysis, 1 case of reperfusion pulmonary edema, and no other complications occurred.

CONCLUSION

BPA can improve the exercise tolerance, cardiac and pulmonary functions, and blood gas level of patients with CTEPH, and the incidence of complications is relatively low. However, due to the limitations of the single-arm design, the results of this study need to be further verified through randomized controlled trials.