Evaluation of balloon pulmonary angioplasty using lung perfusion SPECT in patients with chronic thromboembolic pulmonary hypertension

• Published in: Journal of nuclear cardiology Vol. 29; no. 6; pp. 3392 - 3400
• Main Authors: Hashimoto, Hidenobu, Oka, Takashi, Nakanishi, Rine, Mizumura, Sunao, Dobashi, Shintaro, Hashimoto, Yukiko, Okamura, Yuriko, Ota, Kyoko, Ikeda, Takanori
• Format: Journal Article
• Language: English
• Published: Cham Elsevier Inc 01.12.2022; Springer International Publishing; Springer Nature B.V
• Subjects: Angioplasty; Angioplasty, Balloon - methods; Cardiology; Chronic Disease; Humans; hybrid imaging; Hypertension, Pulmonary - diagnostic imaging; Hypertension, Pulmonary - therapy; Imaging; Lung; Medicine; Medicine & Public Health; Nuclear Medicine; Original; Original Article; Perfusion; perfusion agents; Pulmonary arteries; Pulmonary Embolism - complications; Pulmonary Embolism - diagnostic imaging; Pulmonary Embolism - therapy; Pulmonary hypertension; Radiology; Regression analysis; SPECT; Thromboembolism; Tomography, Emission-Computed, Single-Photon; vascular imaging; mPAP; hybrid imaging; FVL-LPSPECT; PVR; SPECT; WHO FC; CT; perfusion agents; BPA; vascular imaging; 99mTc-MAA; CTEPH; 6MWD
• ISSN: 1071-3581; 1532-6551
• DOI: 10.1007/s12350-022-02971-0

The aim of this study was to evaluate the effect of balloon pulmonary angioplasty (BPA) using lung perfusion single-photon emission computed tomography (SPECT) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). 20 consecutive patients (64 ± 15 years) who were diagnosed with CTEPH and underwent BPA were included in this study. All patients underwent lung perfusion SPECT before and after BPA. The relationship between functional %volume of the lung calculated from the lung perfusion SPECT (FVL-LPSPECT), and other clinical parameters before and after BPA was assessed using the Wilcoxon signed-rank test. The correlation between each parameter and mean pulmonary artery pressure (mPAP) using the Spearman’s correlation was performed. To determine predictors of mPAP for evaluating treatment effectiveness, significant parameters were included in multiple regression analysis. After BPA, world health organization functional classification, six-minute walk distance (6MWD), mPAP, and FVL-LPSPECT significantly improved. FVL-LPSPECT (r = − 0.728, P < 0.001) and 6MWD (r = − 0.571, P = 0.009) were significant correlation of mPAP. In the multiple regression analysis, FVL-LPSPECT was the most significant predictor of improvement in mPAP after BPA (P < 0.001). This study demonstrated that the lung perfusion SPECT could be a potential measurement of the effectiveness of BPA in patients with CTEPH.