Balloon pulmonary artery angioplasty (BPA) is a treatment option for chronic thromboembolic pulmonary hypertension (CTEPH). The aim of this study was to evaluate the mechanism of BPA, changes in vascular elastic properties, inflammation and endothelial function. Patients with CTEPH treated with BPA between 2015 and 2017 were included. Global compliance (CPa) was assessed by cardiac catheterization. Intravascular ultrasound assessed local elastic properties (DC and CC) and thrombus structure. Twenty patients with CTEPH were included. During 103 BPA procedures, the composition of 159 thrombi and the elastic properties of 102 vascular segments were assessed. Compared to healthy subjects, patients with CTEPH showed lower CPa, DC, CC and higher levels of interleukin 6 (IL-6), interleukin 8 (IL-8) and endothelin 1 (ET-1). Two mechanisms of BPA were distinguished - type A related to increase in the outer vessel area and type B related to thrombus compression. Immediately after BPA and 6 months after treatment, there was an increase in CPa, in the absence of changes in DC and CC, and a decrease in IL-6, IL-8 and ET-1. 24 hours after BPA, there was an increase in pro-inflammatory cytokines. Conclusions: BPA improves global capacitance, in the absence of changes in local elastic properties. Smaller vessels mainly exhibit compression of the thrombus, while larger demonstrate stretching o ; f the external vessel area. BPA treatment induces a non-specific inflammatory response with reduced inflammation and improved endothelial function after treatment.
Rada Dyscypliny Nauki medyczne
16 sie 2024
6 lut 2024
12
0
http://dl.cm-uj.krakow.pl:8080/publication/5031
Nazwa wydania | Data |
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ZB-137693 | 16 sie 2024 |
Magoń, Wojciech
Urbański, Karol
Wilk, Grzegorz
Chyrchel, Michał
Mrevlje, Blaž
Baran, Jakub
Kaczmarczyk, Paweł
Gosiewski, Tomasz