Different response of the oxygen pathway in patients with chronic thromboembolic pulmonary hypertension treated with pulmonary endarterectomy versus balloon pulmonary angioplasty
单位：[1]Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China,[2]National Center for Respiratory Medicine, Beijing, China[3]Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China,[4]National Clinical Research Center for Respiratory Diseases, Beijing, China,[5]Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China,[6]Department of Pulmonary and Critical Care Medicine, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China,[7]State Key Laboratory of Medical Molecular Biology, Department of Physiology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
BackgroundOxygen pathway limitation exists in chronic thromboembolic pulmonary hypertension (CTEPH). Pulmonary endarterectomy (PEA) and balloon pulmonary angioplasty (BPA) are two effective interventions for CTEPH, but their effects and comparison of these two interventions on the oxygen pathway are not well demonstrated. MethodsCTEPH patients with available pulmonary function test, hemodynamics, and blood gas analysis before and after the interventions were included for comparison of oxygen pathway in terms of lung ventilation, lung gas exchange, oxygen delivery, and oxygen extraction between these two interventions. ResultsThe change in the percentage of the predicted forced expiratory volume in the 1 s (-3.4 +/- 12.7 vs. 3.8 +/- 8.7%, P = 0.006) and forced vital capacity (-5.5 +/- 13.0 vs. 4.2 +/- 9.9%, P = 0.001) among the PEA group (n = 24) and BPA group (n = 46) were significantly different. Patients in the PEA group had a significant increase in their arterial oxygen saturation (from 92.5 +/- 3.6 to 94.6 +/- 2.4%, P = 0.022), while those in the BPA group had no change, which could be explained by a significant improvement in ventilation/perfusion (-0.48 +/- 0.53 vs. -0.17 +/- 0.41, P = 0.016). Compared with patients post-BPA, patients post-PEA were characterized by higher oxygen delivery (756.3 +/- 229.1 vs. 628.8 +/- 188.5 ml/min, P = 0.016) and higher oxygen extraction (203.3 +/- 64.8 vs. 151.2 +/- 31.9 ml/min, P = 0.001). ConclusionPartial amelioration of the oxygen pathway limitations could be achieved in CTEPH patients treated with PEA and BPA. CTEPH patients post-PEA had better performance in lung gas exchange, oxygen delivery, and extraction, while those post-BPA had better lung ventilation. Cardiopulmonary rehabilitation may assist in improving the impairment of the oxygen pathway.
基金：
Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (CIFMS); National Natural Science Foundation of China; [2021-I2M-1-049]; [81970058]
第一作者单位：[1]Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China,[2]National Center for Respiratory Medicine, Beijing, China[3]Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China,[4]National Clinical Research Center for Respiratory Diseases, Beijing, China,[5]Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China,[6]Department of Pulmonary and Critical Care Medicine, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, China,
通讯作者：
通讯机构：[1]Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China,[2]National Center for Respiratory Medicine, Beijing, China[3]Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China,[4]National Clinical Research Center for Respiratory Diseases, Beijing, China,[5]Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China,
推荐引用方式(GB/T 7714)：
Fu Zhihui,Tao Xincao,Xie Wanmu,et al.Different response of the oxygen pathway in patients with chronic thromboembolic pulmonary hypertension treated with pulmonary endarterectomy versus balloon pulmonary angioplasty[J].FRONTIERS IN CARDIOVASCULAR MEDICINE.2022,9:doi:10.3389/fcvm.2022.990207.
APA：
Fu, Zhihui,Tao, Xincao,Xie, Wanmu,Yang, Peiran,Gao, Qian...&Zhai, Zhenguo.(2022).Different response of the oxygen pathway in patients with chronic thromboembolic pulmonary hypertension treated with pulmonary endarterectomy versus balloon pulmonary angioplasty.FRONTIERS IN CARDIOVASCULAR MEDICINE,9,
MLA：
Fu, Zhihui,et al."Different response of the oxygen pathway in patients with chronic thromboembolic pulmonary hypertension treated with pulmonary endarterectomy versus balloon pulmonary angioplasty".FRONTIERS IN CARDIOVASCULAR MEDICINE 9.(2022)
