Assessment of oxygenation after balloon pulmonary angioplasty for patients with inoperable chronic thromboembolic pulmonary hypertension

Matsuoka, Yoichiro; Taniguchi, Yu; Miwa, Keisuke; Sumimoto, Keiko; Tsuboi, Yasunori; Onishi, Hiroyuki; Yanaka, Kenichi; Emoto, Noriaki; Hirata, Kenichi

https://hdl.handle.net/20.500.14094/90008883

このアイテムのアクセス数:38件（2025-04-24 11:55 集計）

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メタデータID	90008883
アクセス権	open access
出版タイプ	Version of Record
タイトル	Assessment of oxygenation after balloon pulmonary angioplasty for patients with inoperable chronic thromboembolic pulmonary hypertension
著者	Matsuoka, Yoichiro ; Taniguchi, Yu ; Miwa, Keisuke ; Sumimoto, Keiko ; Tsuboi, Yasunori ; Onishi, Hiroyuki ; Yanaka, Kenichi ; Emoto, Noriaki ; Hirata, Kenichi
著者名 Matsuoka, Yoichiro
著者ID A2310 研究者ID 1000080823046 KUID https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=9b780c14f185ecec520e17560c007669 著者名 Taniguchi, Yu 谷口, 悠タニグチ, ユウ所属機関名医学部附属病院
著者名 Miwa, Keisuke
著者名 Sumimoto, Keiko
著者名 Tsuboi, Yasunori
著者名 Onishi, Hiroyuki
著者名 Yanaka, Kenichi
著者名 Emoto, Noriaki
著者ID A0883 研究者ID 1000020283880 KUID https://kuid-rm-web.ofc.kobe-u.ac.jp/search/detail?systemId=383af6bc2b817735520e17560c007669 著者名 Hirata, Kenichi 平田, 健一ヒラタ, ケンイチ所属機関名医学研究科
言語	English (英語)
収録物名	International Journal of Cardiology
巻(号)	333
ページ	188-194
出版者	Elsevier B.V.
刊行日	2021-06-15
公開日	2021-12-24
抄録	Background: The efficacy of balloon pulmonary angioplasty (BPA) in patients with inoperable chronic thromboembolic pulmonary hypertension would be promising. However, some patients showed residual dyspnea or symptoms, despite normalized hemodynamics. We aimed to clarify the clinical impact of oxygenation parameters on BPA outcome. Method: Ninety-nine consecutive patients who underwent BPA from September 2011 to December 2019 were enrolled. We evaluated hemodynamics with right heart catheterization, arterial blood gas examination, New York Heart Association functional class (NYHA-FC), respiratory function tests, nocturnal oximetry, and exercise capacity (6-min walk test and cardiopulmonary exercise testing) at baseline and after BPA. Result: Nearly normal hemodynamics was achieved after BPA (mean pulmonary artery pressure (PAP): 37.5 ± 10.0 to 20.6 ± 4.9 mmHg, p < 0.01). Oxygenation slightly improved (partial pressure of arterial oxygen; 61.5 ± 12.3 to 67.7 ± 12.7 mmHg, p < 0.01). Exertional desaturation remained unchanged (−8.1 ± 4.8 to −7.8 ± 5.1, p = 0.59), and this was associated with residual symptom (NYHA-FC ≥ 2) after BPA (OR 0.591, 95% CI 0.416–0.840, p = 0.003) in multivariate regression analyses. Lower vital capacity (r2 = 0.03, p = 0.01), higher mean PAP (r2 = 0.08, p = 0.02), and higher minute ventilation/carbon dioxide production (VE/VCO2) slope (r2 = 0.18, p < 0.01), the marker of ventilatory inefficiency, were correlated with exertional desaturation after BPA in multivariate linear analyses. Conclusion: Although hemodynamics nearly normalized, oxygenation did not. Moreover, exertional desaturation remained unchanged. This might cause residual symptom after BPA. Residual pulmonary hypertension suggesting incurable arteriopathy, and higher VE/VCO2 slope suggesting ventilation-perfusion mismatch might be related to exertional desaturation. Domiciliary oxygen therapy should be continued, if necessary.
キーワード	Chronic thromboembolic pulmonary hypertension
	Balloon pulmonary angioplasty
	Hypoxia
	Desaturation
	Exercise tolerance
カテゴリ	医学研究科
	医学部附属病院
	学術雑誌論文
権利	© 2021 The Author(s). Published by Elsevier B.V.
権利	This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
関連情報	DOI https://doi.org/10.1016/j.ijcard.2021.03.002

資源タイプ	journal article
ISSN	0167-5273　OPACで所蔵を検索　 CiNiiで学外所蔵を検索
NCID	AA10623832　OPACで所蔵を検索　 CiNiiで表示

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