Effects of right ventricular remodeling in chronic thromboembolic pulmonary hypertension on the outcomes of balloon pulmonary angioplasty: a 2D-speckle tracking echocardiography study

Figures

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  Fig. 1. Study population selection. BPA, Balloon pulmonary angioplasty

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  Fig. 2. Right ventricular longitudinal strain measured by 2D-speckle tracking echocardiography (2D-STE) before and after balloon pulmonary angioplasty (BPA) in a patient. RVFWLS, RV free wall longitudinal strain; RVGLS, RV global longitudinal strain

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  Fig. 3. Pulmonary angiography before and after BPA in a patient. A Pulmonary angiography before BPA. The yellow arrow indicateed the pulmonary artery stenosis; B Pulmonary angiography after 2.5 mm balloon dilation; C Pulmonary angiography after 4 mm balloon dilation

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  Fig. 4. Receiver operating characteristic curve analysis demonstrating the ability of right ventricular free wall longitudinal strain (RVFWLS) to predict BPA responders. AUC, area under the curve

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  Fig. 5. Hemodynamics, 6-min walking distance (6MWD) and right ventricular free wall longitudinal strain (RVFWLS) at baseline and follow-up in chronic thromboembolic pulmonary hypertension (CTEPH) patients with RVFWLS ≥ 12% and < 12% mPAP (A), PVR (B), 6MWD (C), and RVFWLS(D) at baseline and follow-up in CTEPH patients with RVFWLS ≥ 12% and < 12%. At baseline, RVFWLS < 12% vs RVFWLS ≥ 12% (mPAP: 51.4 ± 6.4 mmHg vs 50.3 ± 10.4 mmHg, p = 0.669; PVR: 1008.5 ± 326.1 dyn·s·cm-5 vs 845.8 ± 333.8 dyn·s·cm-5, p = 0.088; 6MWD: 275.3 ± 110.4 m vs 394.7 ± 121.4 m, p = 0.001; RVFWLS: 9.5 ± 1.6% vs 18.2 ± 4.3%, p < 0.001). mPAP, mean pulmonary artery pressure; PVR, pulmonary vascular resistance

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  Fig. 6. Bland–Altman plots for intra-observer and inter-observer agreement of 2D-STE findings. The horizontal dots represent the mean difference, and the yellow lines represent the mean difference ± 1.96 standard deviations