Chest · 2026
Comparison of Hemodynamic Responses to Balloon Pulmonary Angioplasty in Chronic Thromboembolic Pulmonary Hypertension in Japan and The Netherlands: A Multicenter Study.
СтатьяМногоцентровое исследованиеСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Higuchi Satoshi, Mantzios Konstantinos, Kiko Takatoyo, Satoh Taijyu, Rodenburg Tamara C, Staal Diederik P, Fukuda Tetsuya, Ota Hideki, Breuning Aleid M, Takano Ryo, Beijk Marcel A M, Lely Rutger J, van Haersma de With Jan, Oosterveer Frank, Nossent Esther, Aman Jurjan, Boerman Sanne, van Kuijk Jan-Peter, Sugiyama Shuhei, Yaoita Nobuhiro, Horinouchi Hiroki, Hayashi Hiroya, Fujisaki Shinya, de Man Frances S, Vonk Noordegraaf Anton, Post Marco C, Meijboom Lilian J, Ogo Takeshi, Bogaard Harm Jan
Аннотация
BACKGROUND: Mean pulmonary arterial pressure (mPAP) after balloon pulmonary angioplasty (BPA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) consistently has been lower in Japan compared with non-Japanese cohorts.
RESEARCH QUESTION: What factors are associated with higher mPAP after BPA?
STUDY DESIGN AND METHODS: This retrospective multicenter study screened 200 consecutive patients with CTEPH who underwent BPA at 2 centers in The Netherlands and 2 centers in Japan. After excluding patients with prior pulmonary endarterectomy or lacking follow-up hemodynamic data, 138 patients were analyzed. Comorbidities, lesion distribution and morphologic features, PH medication, procedural details, and hemodynamic parameters were compared between the 2 countries' cohorts. Multivariable regression analysis was performed to identify factors associated with high mPAP at follow-up.
RESULTS: The proportion of male patients (55% vs 24%), BMI (mean [SD], 26 [4] kg/m2 vs 23 [5] kg/m2), the prevalence of atrial fibrillation (9% vs 0%), and smoking rate (43% vs 23%) were higher and diffusing capacity of the lung for carbon monoxide (Dlco) was lower (mean [SD], 69% [15%] vs 79% [19%]) in the cohort from The Netherlands. Proximal lesion distribution and severity on CT imaging were comparable between the 2 countries. The Japanese cohort demonstrated a greater mPAP reduction (-16 mm Hg [40%] vs -10 mm Hg [28%]; P < .01 ), with a lower mPAP at follow-up (mean [SE], 22 [1] mm Hg vs 30 [1] mm Hg; P < .01). Independent factors associated with higher follow-up mPAP included lower Dlco, higher right atrial pressure, higher pulmonary arterial wedge pressure at follow-up, a greater number of BPA sessions, and less frequent use of intermediate-sized balloons.
INTERPRETATION: Our results show that higher mPAP after BPA was associated with impaired lung and left-sided heart function and procedural parameters, rather than nationality or lesion distribution. These findings suggest that occult cardiopulmonary comorbidities are important contributors to international differences in BPA outcomes and that differences in procedural practice may play a role.
RESEARCH QUESTION: What factors are associated with higher mPAP after BPA?
STUDY DESIGN AND METHODS: This retrospective multicenter study screened 200 consecutive patients with CTEPH who underwent BPA at 2 centers in The Netherlands and 2 centers in Japan. After excluding patients with prior pulmonary endarterectomy or lacking follow-up hemodynamic data, 138 patients were analyzed. Comorbidities, lesion distribution and morphologic features, PH medication, procedural details, and hemodynamic parameters were compared between the 2 countries' cohorts. Multivariable regression analysis was performed to identify factors associated with high mPAP at follow-up.
RESULTS: The proportion of male patients (55% vs 24%), BMI (mean [SD], 26 [4] kg/m2 vs 23 [5] kg/m2), the prevalence of atrial fibrillation (9% vs 0%), and smoking rate (43% vs 23%) were higher and diffusing capacity of the lung for carbon monoxide (Dlco) was lower (mean [SD], 69% [15%] vs 79% [19%]) in the cohort from The Netherlands. Proximal lesion distribution and severity on CT imaging were comparable between the 2 countries. The Japanese cohort demonstrated a greater mPAP reduction (-16 mm Hg [40%] vs -10 mm Hg [28%]; P < .01 ), with a lower mPAP at follow-up (mean [SE], 22 [1] mm Hg vs 30 [1] mm Hg; P < .01). Independent factors associated with higher follow-up mPAP included lower Dlco, higher right atrial pressure, higher pulmonary arterial wedge pressure at follow-up, a greater number of BPA sessions, and less frequent use of intermediate-sized balloons.
INTERPRETATION: Our results show that higher mPAP after BPA was associated with impaired lung and left-sided heart function and procedural parameters, rather than nationality or lesion distribution. These findings suggest that occult cardiopulmonary comorbidities are important contributors to international differences in BPA outcomes and that differences in procedural practice may play a role.