Improvement in the electrocardiograms associated with right ventricular hypertrophy after balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension

Takahiko Nishiyama, Seiji Takatsuki, Takashi Kawakami, Yoshinori Katsumata, Takehiro Kimura, Masaharu Kataoka, Hikaru Tsuruta, Yuji Itabashi, Mitsushige Murata, Shinsuke Yuasa, Yoshiyasu Aizawa, Keiichi Fukuda

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Background: Balloon pulmonary angioplasty (BPA) is a treatment option for patients with chronic thromboembolic pulmonary hypertension (CTEPH). Methods and results: In 60 patients with CTEPH, we examined the hemodynamic data before and after BPA. In addition, the sequential ECG findings for right ventricular hypertrophy (RVH) were assessed. The mean pulmonary arterial pressure (mPAP) decreased from 38 ± 11 to 20 ± 4 mm Hg (p < 0.05). The ROC analysis showed that the S waves in V5, R waves in V1 + S waves in V5, S waves in I, and QRS axis were significant predictors of an mPAP ≧ 30 mm Hg (AUC > 0.75, p < 0.01). The predictive values for the mPAP before the BPA were the S and R waves in lead V6, and P waves in lead II (33.417 + 0.078 × P in II − 0.10 × R in V6 + 0.012 × S in V6). The change in the mPAP (ΔmPAP) correlated with the change in the amplitudes of the ECGs: ΔS wave in lead I (R = 0.544, p < 0.001), ΔR in V1 + S in V5 (R = 0.476, p < 0.001), and ΔP wave in II (R = 0.511, p < 0.001). At 6 months of follow-up, the improvement in an R in V1 + S in V5 of ≧10 mm implied a better functional status. Conclusion: BPA therapy reduced the pulmonary arterial pressure in patients with CTEPH and was associated with an improvement in the ECG findings related to RVH.

Original languageEnglish
Pages (from-to)75-82
Number of pages8
JournalIJC Heart and Vasculature
Publication statusPublished - 2018 Jun 1



  • Balloon pulmonary angioplasty
  • Chronic thromboembolic pulmonary hypertension
  • Electrocardiogram
  • Right ventricular hypertrophy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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