Abstract
Background: Endarterectomy and pulmonary vasodilators including riociguat have been shown to have beneficial effects in the treatment of chronic thromboembolic pulmonary hypertension (CTEPH). Exercise capacity and pulmonary vascular resistance can be significantly improved. Little is known about changes in right ventricular (RV) function after therapy.
Aim: Identification of change in RV function studied by echocardiography
Methods: All patients prospectively underwent a right heart catheterization (RHC), VQ Scan. And 2D Speckle tracking echocardiography within an hour. We measured right atrium (RA) area, TAPSE, RV fractional area change (FAC), global and regional longitudinal strain. All measurements were performed at baseline and after 3 to 6 months.
Results: 20 patients (8 women; 12 mean) age 71 ± 13 were included. At baseline, mPAP was 42 ± 9 mmHg, cardiac output was 4.8 ± 1.56, pulmonary capillary wedge pressure was 10 ± 4, right atrial pressure was 9 ± 5, pulmonary vascular resistance was 7 ± 3 WU. Two patients were treated by surgery, one patient was treated with balloon pulmonary angioplasty and 13 received pulmonary vasodilators. During follow-up, WHO functional class was improved in all patients (p < 0.05). Right ventricular structure and systolic function improved: significant decrease in RA area (23 ± 6 vs 17 ± 5, p < 0.05) and increase in RVFAC (31 ± 11 vs 41 ± 9, p < 0.05). TAPSE increased from 17 ± 5 vs 19± 4. Change in intraventricular dyssynchrony was significant.
Conclusion: Right ventricular structure, systolic function and dyssynchrony are improved after surgical or medical therapy in chronic thromboembolic pulmonary hypertension.
- Copyright ©the authors 2016
