ArticleFrontiers in medicine2026
Patterns of right ventricular reverse remodeling and hemodynamic drivers in serial balloon pulmonary angioplasty.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Balloon pulmonary angioplasty (BPA) effectively treats chronic thromboembolic pulmonary hypertension (CTEPH); however, its effects on right ventricular (RV) remodeling remains unclear. This study investigates RV reverse remodeling patterns and key hemodynamic determinants in patients undergoing sequential BPA therapy. Methods: In this retrospective study, 46 patients who underwent BPA at monthly intervals were included. Serial echocardiography was used to monitor cardiac structure and function, while right heart catheterization assessed hemodynamic parameters before and after treatment. Longitudinal changes were analyzed using mixed-effects models with piecewise assessment of early and late treatment phases. Results: Significant improvements in right ventricular structure and function were observed across BPA sessions. Notably, right atrial transverse diameter and tricuspid annular systolic velocity demonstrated early responses to BPA, with significant changes evident during the initial treatment phase. In longitudinal analyses, early treatment phases (baseline to BPA Conclusion: A temporal pattern of RV reverse remodeling is observed during serial BPA, characterized by substantial early improvements followed by a plateau in later sessions. These changes are closely associated with reductions in PVR, supporting a central role of afterload reduction in driving RV recovery. This pattern may help inform the optimization of BPA treatment strategies.
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