Pulmonary vascular disease & thromboembolism
Long-Term Effects of Pulmonary Endarterectomy on Right Ventricular Stiffness and Fibrosis in Chronic Thromboembolic Pulmonary Hypertension
Main finding · RV massResult — go to the resultDifference −15.9 g/m² 95% CI −21.4 to −10.5Authors' conclusion
Although cellular hypertrophy regresses and diastolic stiffness normalizes after PEA, a relative increase in extracellular volume remains. Incomplete regression of diffuse RV interstitial fibrosis after PEA is accompanied by elevated levels of circulating collagen biomarkers, suggestive of active collagen turnover.
Study context
- Population
- Patients with chronic thromboembolic pulmonary hypertension treated with pulmonary endarterectomy (PEA)
- Participants
- 25 patients
- Exposure
- Before vs 6 and 18 months after PEA
- Outcome
- RV mass
- Follow-up
- 6 months after PEA
Main finding
As reported in the abstract
Difference
−15.9 g/m²
95% CI −21.4 to −10.5
P < 0.0001
By group
Post-PEAvs Baseline
difference −15.9 g/m² (95% CI −21.4 to −10.5); P < 0.0001
Observational data: associations, not effects.
Further findings
| Outcome | Baseline | Post-PEA | Difference (%) (95% CI) | P value | |
|---|---|---|---|---|---|
| Extracellular volume fraction, RV free wallPost-PEAvs Baseline | 31.0 ± 3.8 % | 33.6 ± 3.5 % | 3.6 (1.2–6.1) | P = 0.013 | |
| −50510Difference, % (linear scale) |
- Extracellular volume fraction, right ventricular (RV) free wall: larger reduction in cellular than matrix volume (Pinteraction=0.0013)
- Extracellular volume fraction, RV free wall: Pinteraction=0.0013
RV end-diastolic elastance (stiffness, Eed)
- Eed normalised after PEA
Circulating collagen biomarkers (MMP-1, TIMP-1, TGF-β)
- Elevated at baseline and remained elevated post-PEA
Original publication
Long-Term Effects of Pulmonary Endarterectomy on Right Ventricular Stiffness and Fibrosis in Chronic Thromboembolic Pulmonary Hypertension. Circ Heart Fail. Published 7 September 2023. doi:10.
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