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Percutaneous Pulmonary Angioplasty for Patients With Takayasu Arteritis and Pulmonary Hypertension Attenuated Mitral Leaflet Enlargement Contributes to Functional Mitral Regurgitation After Myocardial Infarction High Coronary Shear Stress in Patients With Coronary Artery Disease Predicts Myocardial Infarction Functional Mitral Regurgitation Outcome and Grading in Heart Failure With Reduced Ejection Fraction Potential Candidates for Transcatheter Tricuspid Valve Intervention After Transcatheter Aortic Valve Replacement: Predictors and Prognosis Surgery Does Not Improve Survival in Patients With Isolated Severe Tricuspid Regurgitation Impact of Transcatheter Mitral Valve Repair on Preprocedural and Postprocedural Hospitalization Rates 5-Year Outcomes of PCI Guided by Measurement of Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve
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Original Research2022 Apr, 79 (15) 1477–1488

JOURNAL：J Am Coll Cardiol. Article Link

Percutaneous Pulmonary Angioplasty for Patients With Takayasu Arteritis and Pulmonary Hypertension

Y-P Zhou , Y-P Wei , Y-J Yang et al.

ABSTRACT

BACKGROUND - Percutaneous transluminal pulmonary angioplasty (PTPA) is a treatment modality for chronic thromboembolic pulmonary hypertension, but whether it can be applied to Takayasu arteritis–associated pulmonary hypertension (TA-PH), another chronic obstructive pulmonary vascular disease, remains unclear.

 

OBJECTIVES - This study sought to investigate the efficacy and safety of PTPA for TA-PH.

 

METHODS - Between January 1, 2016, and December 31, 2019, a total of 50 patients with TA-PH who completed the PTPA procedure (the PTPA group) and 21 patients who refused the PTPA procedure (the non-PTPA group) were prospectively enrolled in this cohort study. The primary outcome was all-cause mortality. The safety outcomes included PTPA procedure-related complications.

 

RESULTS - Baseline characteristics and medical therapies were similar between the PTPA group and the non-PTPA group. During a mean follow-up time of 37 ± 14 months, deaths occurred in 3 patients (6.0%) in the PTPA group and 6 patients (28.6%) in the non-PTPA group, contributing to the 3-year survival rate of 93.7% in the PTPA group and 76.2% in the non-PTPA group (P = 0.0096 for log-rank test). The Cox regression model showed that PTPA was associated with a significantly reduced hazard of all-cause mortality in TA-PH patients (HR: 0.18; 95% CI: 0.05-0.73; P = 0.017). No periprocedural death occurred. Severe complications requiring noninvasive positive pressure ventilation occurred in only 1 of 150 total sessions (0.7%).

 

CONCLUSIONS - PTPA tended to be associated with a reduced risk of all-cause mortality with acceptable safety profiles and seemed to be a promising therapeutic option for TA-PH patients.

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