Clinical application of transthoracic echocardiography in assessing hemodynamics in patients with chronic thromboembolic pulmonary hypertension after pulmonary balloon angioplasty

Authors: Badoian A.G., Sharafutdinov U.Sh., Mankuian S.N., Baranov A.A., Khelimskiy D.A., Krestyaninov O.V.

Company: National Medical Research Center named after Academician E.N. Meshalkin, Novosibirsk, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2023-17-3-415-423

For citation: Badoian A.G., Sharafutdinov U.Sh., Manukian S.N., Baranov A.A., Khelimskiy D.A., Krestyaninov O.V. Clinical application of transthoracic echocardiography in assessing hemodynamics in patients with chronic thromboembolic pulmonary hypertension after pulmonary balloon angioplasty. Creative Cardiology. 2023; 17 (3): 415–23 (in Russ.). DOI: 10.24022/1997-3187-2023-17-3-415-423

Received / Accepted:  22.08.2023 / 14.09.2023

Keywords: echocardiography pulmonary emblosim cardiac catheterization balloon pulmonary angioplasty

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Abstract

Objective. To assess the consistency of echocardiographic measurements of dynamic changes in pulmonary artery pressure with catheterization data in patients after balloon angioplasty for chronic thromboembolic pulmonary hypertension (CTEPH).

Material and methods. Retrospectively a total of 128 patients were included. All patients underwent right heart catheterization (RHC) and transthoracic echocardiography to assess pulmonary hemodynamics before the first and after the last session of pulmonary artery balloon angioplasty (BLA). Then, correlations between values of mean (mPAP) and systolic pressure in the pulmonary artery (sPAP), measured by two methods, were assessed. The agreement of two methods in assessing the changes of mPAP in dynamic was evaluated using Bland–Altman plot.

Results. Of 128 patients, 45 (45.9%) were male, and the mean age was 56.31±13.5 years. According to the RHC, SPAP was 69.01±27.2 mmHg and decreased to 58.5±25.6 mmHg., and mPAP – from 40.6±15.7 mmHg up to 33.8±14.4 mmHg Art. The correlation between RHC and echocardiography measures for sPAP was 0.802 and 0.680 at baseline and after the BLA sessions, and for the mPAP – 0.72 and 0.63, respectively. According to the Bland–Altman analysis, the average difference between the measurements of mPAP was 0.9 mmHg with limits of agreement from –14.3 to 16.2 mmHg.

Conclusion: our results indicate a poor agreement between echocardiography and RHC in assessing the mPAP in patients with CTEPH.

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About Authors

  • Aram G. Badoian, Researcher, Endovascular Surgeon; ORCID
  • Ulmas Sh. Sharafutdinov, Resident Physician; ORCID
  • Serezha N. Manukian, Postgraduate; ORCID
  • Aleksey A. Baranov, Postgraduate; ORCID
  • Dmitriy A. Khelimskiy, Researcher, Endovascular Surgeon; ORCID
  • Oleg V. Krestyaninov, Dr. Med. Sci., Endovascular Surgeon, Head of Department; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery