Pulmonary arterial compliance and exercise capacity after balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension

To determine whether changes in pulmonary vascular resistance (PVR) and changes in pulmonary artery compliance (PCa) are associated with changes in exercise capacity assessed either by changes in peak oxygen consumption (V̇O2) or by changes in 6-min walk distance (6MWD) in patients with chronic thromboembolic pulmonary hypertension (CTEPH) undergoing balloon pulmonary angioplasty (BPA).Invasive haemodynamic parameters, peak V̇O2and 6MWD were measured within 24 h, before and after BPA (interval, 3.1±2.4 months) in 34 CTEPH patients without significant cardiac and/or pulmonary comorbidities, of which 24 received at least one pulmonary hypertension-specific treatment. PCa was calculated according to the pulse pressure method: PCa=([SV/PP]/1.76+0.1), where SV is the stroke volume and PP is the pulse pressure. The resistance-compliance (RC)-time of the pulmonary circulation was calculated as the PVR and PCa product.After BPA, PVR decreased (562±234versus290±106 dyn.s.cm−5;p<0.001), PCa increased (0.90±0.36versus1.63±0.65 mL.mmHg−1; p<0.001) but RC-time did not change (0.325±0.069versus0.321±0.083 s; p=0.75). There were improvements in peak V̇O2(1.11±0.35versus1.30±0.33 L.min-1; p <0.001) and in 6MWD (393±119versus432±100 m; p <0.001). After adjustment for age, height, weight and gender, changes in exercise capacity, assessed either by peak V̇O2and 6MWD, were significantly associated with changes in PVR, but not with changes in PCa.Contrary to what has been reported in CTEPH patients undergoing pulmonary endarterectomy, in CTEPH patients undergoing BPA, changes in exercise capacity was not associated with changes in pulmonary artery compliance.