Balloon pulmonary angioplasty reverse right ventricular remodelling and dysfunction in patients with inoperable chronic thromboembolic pulmonary hypertension: a systematic review and meta-analysis.

Objectives: Right ventricular (RV) function is considered the major determinant of prognosis in patients with chronic thromboembolic pulmonary hypertension (CTEPH). The aim of this meta-analysis was to evaluate RV remodelling and function following balloon pulmonary angioplasty (BPA) in patients wit...

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Publicado en:European Radiology Vol. 31; no. 6; pp. 3898 - 3909
Autores principales: Li, Wen, Yang, Tao, Quan, Rui-lin, Chen, Xiao-xi, An, Jing, Zhao, Zhi-hui, Liu, Zhi-hong, Xiong, Chang-ming, He, Jian-guo, Gu, Qing
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Springer Nature Jun2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2021
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      pub: Springer Nature
      place: New York, New York
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        atl: Balloon pulmonary angioplasty reverse right ventricular remodelling and dysfunction in patients with inoperable chronic thromboembolic pulmonary hypertension: a systematic review and meta-analysis.
      aug:
        au:
          Li, Wen
          Yang, Tao
          Quan, Rui-lin
          Chen, Xiao-xi
          An, Jing
          Zhao, Zhi-hui
          Liu, Zhi-hong
          Xiong, Chang-ming
          He, Jian-guo
          Gu, Qing
        affil: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
      sug:
        subj:
          Pulmonary Embolism Therapy
          Hypertension, Pulmonary
          Angioplasty, Balloon
          Hypertension, Pulmonary Therapy
          Pulmonary Embolism
          Pulmonary Embolism Complications
          Hypertension, Pulmonary Complications
          Ventricular Dysfunction, Right
          Ventricular Function, Right
          Ventricular Remodeling
          Human
          Comparative Studies
          Multicenter Studies
          Evaluation Research
          Validation Studies
          Funding Source
          Systematic Review
          Meta Analysis
      ab: Objectives: Right ventricular (RV) function is considered the major determinant of prognosis in patients with chronic thromboembolic pulmonary hypertension (CTEPH). The aim of this meta-analysis was to evaluate RV remodelling and function following balloon pulmonary angioplasty (BPA) in patients with inoperable CTEPH or persistent/recurrent pulmonary hypertension (PH) after pulmonary endarterectomy (PEA).Methods: We reviewed all studies evaluating RV function by cardiac magnetic resonance (CMR) and/or echocardiography pre- and post-BPA from PubMed/Medline prior to 15 December 2019. Ten (299 patients) of the 29 studies retrieved met the inclusion criteria: 5 CMR and 5 echocardiography studies. The systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines.Results: Pooled data from CMR studies revealed BPA resulted in a significantly decreased RV end-diastolic volume index (weighted mean difference (WMD) - 28.33 ml/m2, p < 0.00001) and RV end-systolic volume index (WMD - 29.06 ml/m2, p < 0.00001) accompanied by an increased RV ejection fraction (RVEF, WMD 8.97%, p < 0.00001). Data from the echocardiography studies showed BPA resulted in decreased RV basal diameter (WMD - 0.37 cm, p = 0.0009) and an increase of RV fractional area change (WMD 5.97 %, p = 0.003), but improvements of tricuspid annular plane systolic excursion (TAPSE) and S' were not significant.Conclusions: BPA improves RVEF and decreases RV volumes in patients with inoperable CTEPH or persistent/recurrent PH after PEA.Key Points: • Balloon pulmonary angioplasty improves RVEF and decreases RV volumes in patients with inoperable CTEPH or persistent/recurrent PH after PEA.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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