TY - JOUR
T1 - Improvement in the electrocardiograms associated with right ventricular hypertrophy after balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension
AU - Nishiyama, Takahiko
AU - Takatsuki, Seiji
AU - Kawakami, Takashi
AU - Katsumata, Yoshinori
AU - Kimura, Takehiro
AU - Kataoka, Masaharu
AU - Tsuruta, Hikaru
AU - Itabashi, Yuji
AU - Murata, Mitsushige
AU - Yuasa, Shinsuke
AU - Aizawa, Yoshiyasu
AU - Fukuda, Keiichi
N1 - Funding Information:
We thank Mr. John Martin for his linguistic advice. This work was supported by MEXT KAKENHI (grant number 17 K09585 and 15 K19396 ).
Publisher Copyright:
© 2017
PY - 2018/6
Y1 - 2018/6
N2 - 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.
AB - 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.
KW - Balloon pulmonary angioplasty
KW - Chronic thromboembolic pulmonary hypertension
KW - Electrocardiogram
KW - Right ventricular hypertrophy
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U2 - 10.1016/j.ijcha.2018.05.003
DO - 10.1016/j.ijcha.2018.05.003
M3 - Article
AN - SCOPUS:85047425877
VL - 19
SP - 75
EP - 82
JO - IJC Heart and Vasculature
JF - IJC Heart and Vasculature
SN - 2352-9067
ER -