AUTHOR=Huang Zhiwei , Wang Man , Hu Fenghuan , Liu Xiaoning 

TITLE=Long-Term Outcomes After Percutaneous Transluminal Pulmonary Angioplasty in Patients With Takayasu Arteritis and Pulmonary Hypertension

JOURNAL=Frontiers in Immunology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.828863

DOI=10.3389/fimmu.2022.828863

ISSN=1664-3224

ABSTRACT=Objective: This  study  aimed  to investigate  the  long-term efficacy  of  percutaneous
transluminal pulmonary  angioplasty (PTPA)  for treatment  in Takayasu arteritis  (TA)
patients with pulmonary artery stenosis and pulmonary hypertension (PH).
Methods: We included 183 lesions of 79 operations in 32 TA patients with PH. Clinical
symptoms, laboratory tests, World Health Organization (WHO) functional class, 6-min
walk  distance (6MWD),  hemodynamic parameters,  and  prognosis were  analyzed at
baseline and follow-up.
Results: Among the enrolled patients, comprising 28 women and 4 men. The mean age
was 42.8 ±  11.9 years. The median follow-up  time was 49.5  months (26-71 months).
Compared with the baseline, Changes in total bilirubin, NT-proBNP, 6MWD, and WHO
function class had  a significant difference  (all P<0.001). Echocardiography indicated
that right ventricular diameter, left ventricular diameter, tricuspid annular plane systolic
excursion,  and estimated  pulmonary artery  systolic  pressure were  all improved  (all
P<0.05). Importantly, repeated right heart catheterization showed that mean pulmonary
artery pressure, pulmonary  vascular resistance and  cardiac index were also  improved
significantly at follow-up  (all P<0.05). Among those received stent implantation,  one
patient had  restenosis.  Unfortunately, two  patients died  during follow-up.  One  died
from the aggravation of right heart failure after lung infection, the other died for traffic
accident.
Conclusions:  This  study  indicated  that  PTPA treatment  significantly  improve  the
clinical symptoms, exercise tolerance and hemodynamic parameters in TA patients with
pulmonary artery  stenosis and  PH. More  importantly, reperfusion  pulmonary edema
had a significant decrease and no patient died for PTPA-related complications with the
guidance of the pressure wire.