Fig 1.
Flowchart of CTEPH patients from initial evaluation to long-term follow-up, including clinical assessment, HRQOL, and resting and exercise right heart catheterization.
* One patient who died during follow-up was not available for long-term HRQOL assessment (SF-36).
Table 1.
Population characteristics at baseline.
Table 2.
Long-term changes in clinical, echocardiographic and resting hemodynamic parameters.
Fig 2.
Sankey diagram illustrating changes in WHO Functional Class (WHO FC) from baseline to follow-up in the BPA and PEA groups.
Each vertical node represents a WHO FC category at baseline (left) and follow-up (right). The width of each flow is proportional to the number of patients transitioning between classes.
Fig 3.
Changes over time in mean pulmonary arterial pressure, pulmonary vascular resistance and cardiac index in both groups.
1st RHC: first right heart catheterization; BPA: balloon pulmonary angioplasty; CI: cardiac index; PAP: pulmonary arterial pressure; PEA: pulmonary endarterectomy; PVR: pulmonary vascular resistance.
Fig 4.
Proportion of patients at follow-up exceeding predefined hemodynamic thresholds.
Bars show the percentage of patients in the BPA and PEA groups with mPAP > 20 mmHg, mPAP > 30 mmHg, and PVR > 3.75 Wood units at follow-up. For the PEA group, four patients with mPAP > 30 mmHg and PVR > 3.75 WU at 6 months who subsequently crossed over to BPA were excluded from the main analysis and are represented as the hatched upper segment of the green bars.
Fig 5.
Individual mPAP/CO slopes in patients treated with BPA (left) and PEA (right).
Each line represents one patient, connecting resting and peak exercise measurements of mean pulmonary arterial pressure (mPAP) versus cardiac output (CO). The red dashed line represents the upper limit of normal for the mPAP/CO slope (3 mmHg/L/min).
Fig 6.
Exercise hemodynamics in both BPA and PEA pathways.
Left: Mean mPAP/CO slope; Right: proportion of patients with an abnormal slope (>3.0 mmHg/L/min).
Table 3.
Long-term HRQOL scores.