Exercise echocardiography predicts exercise-induced pulmonary hypertension post-BPA in CTEPH patients, with ΔMean TRPG/ΔCO correlating with resting mPAP (R=0.686, p=0.010).
Does exercise echocardiography predict exercise-induced pulmonary hypertension in CTEPH patients post-balloon pulmonary angioplasty?
Exercise echocardiography provides a non-invasive, accessible alternative to right heart catheterization for assessing exercise hemodynamics and predicting exercise-induced pulmonary hypertension in CTEPH patients after balloon pulmonary angioplasty.
Absolute Event Rate: 0% vs 0%
Abstract Background Multimodal CTEPH therapy, including balloon pulmonary angioplasty (BPA), significantly improves hemodynamics and prognosis. However, BPA endpoint determination varies, and exercise-induced pulmonary hypertension (exercise PH) frequently persists despite good resting hemodynamics. Exercise right heart catheterization, the gold standard for exercise PH assessment, is not widely available. Purpose To determine if exercise echocardiography predicts exercise PH post-BPA in CTEPH patients. Methods Thirteen CTEPH patients (9 male; mean age, 62 ± 10 years) underwent multiple BPA procedures (June-December 2024) followed by exercise echocardiography. Estimated mean pulmonary artery pressure (mPAP) was calculated using estimated right atrial pressure + mean tricuspid regurgitation pressure gradient (TRPG). Baseline catheterization data showed mean pulmonary vascular resistance (PVR) of 1.8 ± 0.9 WU and mPAP of 24 ± 8 mmHg. Results Patients achieved adequate exercise (mean peak workload, 97 ± 29 watts; mean double product, 22675 ± 4588). Exercise SpO2 significantly decreased (98% to 93%, p0.001), correlating negatively with resting mPAP (R=-0.647, p=0.017). Exercise mean TRPG and cardiac output (CO) increased significantly (p0.001). Importantly, ΔMean TRPG/ΔCO significantly correlated with resting mPAP (R=0.686, p=0.010). Conclusion Exercise echocardiography offers a readily accessible, non-invasive method for assessing post-BPA exercise hemodynamics in CTEPH, potentially replacing exercise right heart catheterization for predicting and diagnosing exercise PH.
Yokomori et al. (Sat,) reported a other. Exercise echocardiography predicts exercise-induced pulmonary hypertension post-BPA in CTEPH patients, with ΔMean TRPG/ΔCO correlating with resting mPAP (R=0.686, p=0.010).