Multiple Beneficial Effects of Balloon Pulmonary Angioplasty in Patients With Chronic Thromboembolic Pulmonary Hypertension
Multiple Beneficial Effects of Balloon Pulmonary Angioplasty in Patients With Chronic Thromboembolic Pulmonary Hypertension
复制标题
DOI：
10.1253/circj.cj-15-1212
复制
发表时间：
2016-04-01
影响因子：
3.3
通讯作者：
Shimokawa, Hiroaki
中科院分区：
文献类型：
--
作者：
Tatebe, Shunsuke;Sugimura, Koichiro;Shimokawa, Hiroaki
背景：肺动脉高压伴全身功能障碍，包括代谢紊乱和肾功能不全，预后差。然而，慢性血栓栓塞性肺动脉高压（CTEPH）是否也与全身功能障碍相关，以及如果是，球囊肺血管成形术（BPA）是否改善了这些功能障碍，仍有待阐明。方法和结果：从2012年3月至2014年12月，55名连续患者因全身功能障碍（包括血糖控制、血脂、肾和血管功能）接受BPA治疗，和营养状况进行检查。在BPA之前和之后进行分析（平均，3.5次/患者），并比较血流动力学参数的变化。平均随访时间为474+/-245天。高血压、糖尿病、血脂异常和晚期慢性肾脏病的基线患病率分别为58%、7%、33%和36%。BPA使CTEPH患者的血流动力学显著改善。重要的是，BPA还显著改善了代谢障碍（空腹血糖、血红蛋白A1 c和胰岛素抵抗的稳态评估模型）、肾功能（肌酐和估计的肾小球滤过率）和血管功能（心踝血管指数）以及营养状况（白蛋白、胆固醇和体重指数）。重要的是，有血流动力学的改善和其他improvements.Conclusions的程度之间的正相关性：这些结果表明，BPA可能发挥多种有益的影响，在CTEPH患者，不仅在血流动力学方面，但也在其他系统功能，与它们之间的正相关性。
Background: Pulmonary arterial hypertension with systemic dysfunctions, including metabolic disorders and renal dysfunction, has a poor prognosis. However, it remains to be elucidated whether chronic thromboembolic pulmonary hypertension (CTEPH) is also associated with systemic dysfunctions, and if so, whether balloon pulmonary angioplasty (BPA) improves them.Methods and Results: Fifty-five consecutive patients who underwent BPA from March 2012 to December 2014 for systemic dysfunctions, including glycemic control, lipid profiles, renal and vascular function, and nutritional status were examined. The analyses were performed before and after BPA (mean, 3.5 sessions/patient) and changes in hemodynamic parameters were compared. The average follow-up period was 474+/-245 days. Baseline prevalence of hypertension, diabetes mellitus, dyslipidemia and advanced chronic kidney disease was 58, 7, 33 and 36%, respectively. BPA caused marked hemodynamic improvements in the CTEPH patients. Importantly, BPA also significantly improved dysglycemia (fasting blood sugar, hemoglobin A1c and homeostatic assessment model of insulin resistance), renal (creatinine and estimated glomerular filtration rate) and vascular (cardio-ankle vascular index) functions and nutritional status (albumin, cholesterols, and body mass index). Importantly, there were positive correlations between the degrees of the hemodynamic improvements and those of other improvements.Conclusions: These results indicate that BPA may exert multiple beneficial effects in CTEPH patients, not only in terms of hemodynamics but also in other systemic functions, with positive correlations among them.