Prolonged QRS duration as a predictor of right ventricular dysfunction after balloon pulmonary angioplasty.
Int J Cardiol
; 280: 176-181, 2019 04 01.
Article
em En
| MEDLINE
| ID: mdl-30448112
ABSTRACT
BACKGROUND:
Balloon pulmonary angioplasty (BPA) has shown beneficial effects for chronic thromboembolic pulmonary hypertension (CTEPH). However, previous studies have shown less cardiac output improvement and symptoms remaining after BPA, implying poor right ventricular (RV) function recovery. Therefore, we investigated the residual RV dysfunction after BPA to reveal risk factors, clinical effects, and possible underlying histopathological mechanisms. METHODS ANDRESULTS:
We investigated 61 consecutive CTEPH patients who underwent cardiovascular magnetic resonance before and 3 and 12â¯months after BPA series. Residual dysfunction (RD) of RV was defined as RV end-diastolic volume index >100â¯ml/m2 or RV ejection fraction (EF) <45% at 12-month follow-up. Patients were divided into RD (44%) and normalized dysfunction (ND) (56%) groups. Compared with the ND group, the RD group had significantly worse World Health Organization (WHO) functional class at follow-up. No significant hemodynamic differences were observed between the groups. On multivariable logistic regression analysis, male sex (odds ratio [OR] 12.5, pâ¯=â¯0.004) and prolonged QRS duration (OR 1.08, pâ¯=â¯0.029) were independently associated with residual RV dysfunction. Additionally, RV histopathology in 11 CTEPH autopsy cases showed that QRS duration was correlated with RV fibrosis area.CONCLUSIONS:
Relatively high percentage (44%) of residual RV dysfunction with worse WHO functional class was observed in CTEPH patients even after BPA. Prolonged QRS duration may predict poor recovery in RV function after BPA.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
11_ODS3_cobertura_universal
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2_ODS3
Base de dados:
MEDLINE
Assunto principal:
Arritmias Cardíacas
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Embolia Pulmonar
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Angioplastia com Balão
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Disfunção Ventricular Direita
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Hipertensão Pulmonar
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Int J Cardiol
Ano de publicação:
2019
Tipo de documento:
Article