Pulmonary Artery Diameter Predicts Lung Injury After Balloon Pulmonary Angioplasty in Patients With Chronic Thromboembolic Pulmonary Hypertension

• Published in: International Heart Journal Vol. 58; no. 4; pp. 584 - 588
• Main Authors: Kunii, Hiroyuki, Takeishi, Yasuchika, Nakazato, Kazuhiko, Yoshihisa, Akiomi, Saitoh, Shu-ichi, Suzuki, Hitoshi, Yamaki, Takayoshi, Sugimoto, Koichi, Sakamoto, Nobuo
• Format: Journal Article
• Language: English
• Published: Japan International Heart Journal Association 01.01.2017; Japan Science and Technology Agency
• Subjects: Acute Lung Injury - diagnosis; Acute Lung Injury - epidemiology; Acute Lung Injury - etiology; Angioplasty; Angioplasty, Balloon - adverse effects; Balloon treatment; Chronic Disease; Complication; Computed tomography; Female; Follow-Up Studies; Hemoptysis; Humans; Hypertension; Hypertension, Pulmonary - diagnosis; Hypertension, Pulmonary - etiology; Hypertension, Pulmonary - surgery; Incidence; Japan - epidemiology; Lungs; Male; Middle Aged; Nitric oxide; Perfusion Imaging - methods; Postoperative Complications - diagnosis; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Predictive Value of Tests; Predictor; Pulmonary arteries; Pulmonary artery; Pulmonary Artery - diagnostic imaging; Pulmonary Artery - surgery; Pulmonary Embolism - complications; Pulmonary Embolism - diagnosis; Pulmonary Embolism - surgery; Pulmonary hypertension; Retrospective Studies; Risk Factors; Thromboembolism; Tomography, X-Ray Computed; Predictor; Complication
• ISSN: 1349-2365; 1349-3299
• DOI: 10.1536/ihj.16-365

Balloon pulmonary angioplasty (BPA) has been an attractive strategy for chronic thromboembolic pulmonary hypertension (CTEPH), even though it occasionally causes lung injury. However, predictive factors of lung injury after BPA have not been established. Pulmonary artery (PA) dilatation is often observed in patients with pulmonary hypertension. We investigated the association between PA diameter and complications after BPA.The subjects were 19 CTEPH patients who underwent BPA. Patients were divided into two groups: patients with lung injury including asymptomatic lung infiltration on computed tomography (CT) images or mild hemoptysis (group L, n = 9) and no complications (group N, n = 10). PA diameter was measured on CT and corrected by the body surface area (PA diameter index).There were no significant differences in hemodynamic indices or the number of treated vessels between the two groups. Right, left, and main PA diameter indices were higher in group L than in group N. Among the clinical variables, the right, left, and main PA diameter indices were significant predictors for lung injury caused by BPA (right PA: OR 1.819, 95%CI 1.056-3.135, P < 0.05; left PA: OR 1.857, 95%CI 1.091-3.159, P < 0.05; main PA: OR 1.399, 95%CI 1.001-1.956, P < 0.05).The PA diameter index can be used to effectively predict the risk of lung injury after BPA.