Key result
In patients with chronic thromboembolic pulmonary hypertension undergoing balloon pulmonary angioplasty, a higher glomerular filtration rate was independently associated with a lower risk of major adverse events (OR 0.693).
Why the study?
Renal function markedly influences the prognosis of CTEPH, but the prognostic value of GFR in patients undergoing BPA required evaluation.
Does decreased GFR (≤53) predict major adverse events in patients with CTEPH who have undergone balloon pulmonary angioplasty?
Cohort (n=47)
No
Does decreased GFR (≤53) predict major adverse events in patients with CTEPH who have undergone balloon pulmonary angioplasty?
Odds Ratio: 0.693 (95% CI 0.529–0.908)
Absolute Event Rate: 46.15% vs 90.48%
p-value: p=0.008
Decreased GFR is an independent prognostic marker for major adverse events and is associated with right ventricular function in patients with CTEPH treated with balloon pulmonary angioplasty.
Chronic thromboembolic pulmonary hypertension (CTEPH) plays a key role in the deterioration of lung hemodynamics and contributes to secondary dysfunction of the right heart, which is consistently accompanied by systemic malperfusion and a reduced glomerular filtration rate (GFR). The prognosis of CTEPH is markedly influenced by renal function. The aim of the present study was to evaluate the prognostic value of GFR in patients with CTEPH who have undergone balloon pulmonary angioplasty (BPA). From December 2012 to September 2020, a total of 47 patients diagnosed with CTEPH who received BPA were retrospectively studied. Patients were categorized according to their renal function on admission into two groups: GFR >53 and ≤53. Biological, clinical and demographic data of the patients were collected. Data for the two groups in hospital and during follow-up were systematically analyzed and compared. All-cause mortality, death from right heart failure (RHF) and rehospitalization associated with RHF were considered major adverse events (MAEs). The results revealed that the 6-min walk distance, N-terminal pro-B type natriuretic peptide (NT-proBNP), Troponin I and right ventricle diameter were significantly lower, and tricuspid annular plane systolic excursion was significantly higher in the GFR >53 group compared with the GFR ≤53 group at final follow-up. In addition, GFR levels were significantly correlated with NT-proBNP at baseline and final follow-up. Furthermore, based on a multivariate analysis, it was determined that the decreased GFR was an independent predictor of MAEs during follow-up. Therefore, it may be concluded that in addition to being associated with right ventricular function, decreased GFR is also a prognostic marker in CTEPH treated with BPA.
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Zhang et al. (2023) conducted a cohort in Chronic thromboembolic pulmonary hypertension (CTEPH) (n=47). Glomerular filtration rate >53 ml/min/1.73 m2 vs. Glomerular filtration rate ≤53 ml/min/1.73 m2 was evaluated on Major adverse events (all-cause mortality, death from right heart failure, and rehospitalization associated with right heart failure) (OR 0.693, 95% CI 0.529-0.908, p=0.008). In patients with chronic thromboembolic pulmonary hypertension undergoing balloon pulmonary angioplasty, a higher glomerular filtration rate was independently associated with a lower risk of major adverse events (OR 0.693).
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