Serial balloon pulmonary angioplasty significantly improved right ventricular reverse remodeling, including a reduction in right atrial area from 20.8 to 14.0 cm2, which was closely associated with reductions in pulmonary vascular resistance.
Observational (n=46)
No
Does serial balloon pulmonary angioplasty improve right ventricular reverse remodeling and hemodynamics in patients with chronic thromboembolic pulmonary hypertension?
Serial balloon pulmonary angioplasty in CTEPH patients induces significant early right ventricular reverse remodeling that is driven by reductions in pulmonary vascular resistance.
Absolute Event Rate: 14% vs 20.8%
p-value: p=<0.001
Background Balloon pulmonary angioplasty (BPA) effectively treats chronic thromboembolic pulmonary hypertension (CTEPH); however, its effects on right ventricular (RV) remodeling remains unclear. This study investigates RV reverse remodeling patterns and key hemodynamic determinants in patients undergoing sequential BPA therapy. Methods In this retrospective study, 46 patients who underwent BPA at monthly intervals were included. Serial echocardiography was used to monitor cardiac structure and function, while right heart catheterization assessed hemodynamic parameters before and after treatment. Longitudinal changes were analyzed using mixed-effects models with piecewise assessment of early and late treatment phases. Results Significant improvements in right ventricular structure and function were observed across BPA sessions. Notably, right atrial transverse diameter and tricuspid annular systolic velocity demonstrated early responses to BPA, with significant changes evident during the initial treatment phase. In longitudinal analyses, early treatment phases (baseline to BPA 3 ) were characterized by marked reverse remodeling, including reductions in right atrial area (RAA), RV end-diastolic transverse diameter, and wall thickness, accompanied by improvements in tricuspid annular plane systolic excursion, enhanced RV function. Greater reductions in pulmonary vascular resistance (PVR) were associated with more pronounced RV reverse remodeling, particularly in RAA. Conclusion A temporal pattern of RV reverse remodeling is observed during serial BPA, characterized by substantial early improvements followed by a plateau in later sessions. These changes are closely associated with reductions in PVR, supporting a central role of afterload reduction in driving RV recovery. This pattern may help inform the optimization of BPA treatment strategies.
Wang et al. (2026) conducted an observational in Chronic thromboembolic pulmonary hypertension (CTEPH) (n=46). Serial balloon pulmonary angioplasty (BPA) vs. Baseline (pre-BPA) was evaluated on Right atrial area (RAA) in cm2 (p=<0.001). Serial balloon pulmonary angioplasty significantly improved right ventricular reverse remodeling, including a reduction in right atrial area from 20.8 to 14.0 cm2, which was closely associated with reductions in pulmonary vascular resistance.