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Right ventricular function changes after therapy in chronic thromboembolic pulmonary hypertension

Bouchra Lamia, Audrey Benguigui, Luis-Carlos Molano, Catherine Viacroze, Geraldine Menard, Jean Quieffin, Philippe Bonnet, Jean-Francois Muir, Antoine Cuvelier
European Respiratory Journal 2016 48: PA3609; DOI: 10.1183/13993003.congress-2016.PA3609
Bouchra Lamia
Pulmonary and Critical Care, Rouen University Hospital, Rouen, France
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Audrey Benguigui
Pulmonary and Critical Care, Rouen University Hospital, Rouen, France
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Luis-Carlos Molano
Pulmonary and Critical Care, Rouen University Hospital, Rouen, France
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Catherine Viacroze
Pulmonary and Critical Care, Rouen University Hospital, Rouen, France
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Geraldine Menard
Radiology, Hopsital Group Le Havre, Le Havre, France
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Jean Quieffin
Cardio-Pulmonary, Hospital Group Le Havre, Le Havre, France
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Philippe Bonnet
Cardio-Pulmonary, Hospital Group Le Havre, Le Havre, France
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Jean-Francois Muir
Pulmonary and Critical Care, Rouen University Hospital, Rouen, France
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Antoine Cuvelier
Pulmonary and Critical Care, Rouen University Hospital, Rouen, France
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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.

  • Pulmonary hypertension
  • Imaging
  • Circulation
  • Copyright ©the authors 2016
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Right ventricular function changes after therapy in chronic thromboembolic pulmonary hypertension
Bouchra Lamia, Audrey Benguigui, Luis-Carlos Molano, Catherine Viacroze, Geraldine Menard, Jean Quieffin, Philippe Bonnet, Jean-Francois Muir, Antoine Cuvelier
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3609; DOI: 10.1183/13993003.congress-2016.PA3609

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Right ventricular function changes after therapy in chronic thromboembolic pulmonary hypertension
Bouchra Lamia, Audrey Benguigui, Luis-Carlos Molano, Catherine Viacroze, Geraldine Menard, Jean Quieffin, Philippe Bonnet, Jean-Francois Muir, Antoine Cuvelier
European Respiratory Journal Sep 2016, 48 (suppl 60) PA3609; DOI: 10.1183/13993003.congress-2016.PA3609
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Show more 4.3 Pulmonary Circulation and Pulmonary Vascular Diseases

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