Refined Balloon Pulmonary Angioplasty in Chronic Thromboembolic Pulmonary Hypertension: Initial Results of U.S. Regional Program.
Refined Balloon Pulmonary Angioplasty in Chronic Thromboembolic Pulmonary Hypertension: Initial Results of U.S. Regional Program.
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慢性血栓栓塞性肺动脉高压的改良球囊肺血管成形术：美国区域计划的初步结果。
DOI：
10.1016/j.jacadv.2023.100291
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Forfia,Paul
中科院分区：
文献类型：
--
作者：
Bashir,Riyaz;Noory,Ali;Oliveros,Estefania;Romero,Carlos;Maruthi,Rohit;Mirza,Arslan;Lakhter,Vladimir;Zhao,Huaqing;Brisco-Bacik,Meredith;Vaidya,Anjali;Auger,WilliamR;Forfia,Paul
背景球囊肺血管成形术（BPA）是非手术慢性血栓栓塞性肺动脉高压（CTEPH）患者快速发展的治疗选择。美国很少有研究报道这种新型治疗方案的结果。目的作者试图评估精制 BPA 在治疗 CTEPH 患者中的有效性和安全性。方法这是一项对接受 BPA 的 CTEPH 患者的回顾性研究。主要疗效终点是 BPA 后肺血管阻力与基线相比的变化，主要安全终点是 24 小时内咯血率。次要终点包括死亡、世界卫生组织功能等级和 6 分钟步行距离。 Logistic 回归用于评估与血流动力学和功能反应相关的因素。结果对 77 名患者总共进行了 211 次 BPA 治疗（平均每患者 2.7 ± 1.7 次治疗）。 BPA 后平均肺血管阻力改善了 26%（6.5 ± 3.4 WU 至 4.8 ± 2.9 WU，P< 0.001）。平均 6 分钟步行距离提高了 71.7 m（P < 0.001），WHO 功能等级提高了 1 个功能等级（P < 0.001）。 1 例死亡与再灌注肺损伤有关。十次（4.7%）因咯血而并发。与改善功能和血流动力学反应相关的独立因素包括术前使用利奥西呱、降低基线 PA 依从性以及每名患者 >3 次 BPA 疗程。结论这项来自美国的单中心研究表明，采用精细技术的 BPA 对 CTEPH 患者相对安全，并且与肺血流动力学和功能能力的显着改善相关。
BackgroundBalloon pulmonary angioplasty (BPA) is rapidly evolving therapeutic option for patients with nonsurgical chronic thromboembolic pulmonary hypertension (CTEPH). There are few U.S. studies that have reported on the outcomes of this novel therapeutic option.ObjectivesThe authors sought to evaluate the efficacy and safety of refined BPA in the treatment of patients with CTEPH.MethodsThis is a retrospective study of CTEPH patients that underwent BPA. The primary efficacy endpoint was the change in pulmonary vascular resistance after BPA as compared to baseline and the primary safety endpoint was the rate of hemoptysis within 24 hours. Secondary endpoints included death, World Health Organization functional class, and 6-minute walk distance. Logistic regression was used to evaluate factors associated with a hemodynamic and functional response.ResultsA total of 211 BPA sessions were performed on 77 patients (average 2.7 ± 1.7 sessions/patient). After BPA the mean pulmonary vascular resistance improved by 26% (6.5 ± 3.4 WU to 4.8 ± 2.9 WU,P< 0.001). The mean 6-minute walk distance improved by 71.7 m (P< 0.001), and WHO functional class improved by 1 functional class (P< 0.001). There was one death related to reperfusion lung injury. Ten sessions (4.7%) were complicated by hemoptysis. Independent factors associated with improved functional and hemodynamic response included preprocedural use of riociguat, reduce baseline PA compliance, and >3 BPA sessions/patient.ConclusionsThis single center study from the United States showed that BPA with refined techniques in patients with CTEPH was relatively safe and was associated with significant improvements in pulmonary hemodynamics and functional capacity.
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sn-1,2-二酰基甘油第二信使的减弱。
DOI：
--
发表时间：
1986
期刊：
The Journal of biological chemistry
影响因子：
--
作者：
Bishop,WR;Bell,RM
通讯作者：
Bell,RM
溶血磷脂酸的血小板聚集活性与其钙离子载体特性无关
影响因子：
3.5
作者：
M. Simon;H. Chap;L. Douste‐Blazy
通讯作者：
L. Douste‐Blazy
肌醇 1,4,5-三磷酸诱导高度纯化的人血小板细胞内膜中隔离的 Ca2 的释放。
影响因子：
4.1
作者：
K. Authi;N. Crawford
通讯作者：
N. Crawford
凝血酶刺激的血小板中磷脂酰肌醇 4,5-二磷酸快速减少。
影响因子：
4.8
作者：
M. Billah;E. Lapetina
通讯作者：
E. Lapetina
肌醇三磷酸在细胞内 Ca2 动员和血小板颗粒分泌中的作用。
影响因子：
4.8
作者：
L. Brass;S. Joseph
通讯作者：
S. Joseph