Three-Dimensional Echocardiography-Derived Right Atrioventricular Coupling Index as a Predictor of Response to Balloon Pulmonary Angioplasty
Abstract
Abstract Background Balloon pulmonary angioplasty (BPA) improves hemodynamic status and clinical outcomes in patients with chronic thromboembolic pulmonary hypertension (CTEPH). However, reliable preprocedural predictors of treatment response remain lacking. The right atrioventricular coupling index (RACI) reflects the structural remodeling relationship between the right atrium and right ventricle. This study aimed to evaluate the efficacy of BPA in patients with CTEPH and to investigate the value of three-dimensional echocardiography-derived RACI in predicting treatment response. Methods A total of 68 consecutive patients with CTEPH who underwent at least four BPA sessions at Beijing Chaoyang Hospital, Capital Medical University, between January 2017 and June 2023 were retrospectively enrolled. BPA responders were defined as patients who achieved a mean pulmonary arterial pressure (mPAP) ≤ 30 mmHg or a ≥ 30% reduction in pulmonary vascular resistance (PVR) after the final BPA session. Logistic regression analysis was performed to identify independent predictors of BPA response. Results Following BPA, hemodynamic status improved significantly. mPAP decreased from 50.96 ± 10.15 mmHg to 33.72 ± 10.18 mmHg (P Conclusions BPA effectively reduces pulmonary artery pressure, promotes reverse right heart remodeling, and improves exercise capacity in patients with CTEPH. The three-dimensional echocardiography-derived RACI is an independent predictor of treatment response to BPA and…
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