Correspondence Balloon pulmonary angioplasty attenuates ongoing myocardial damage in patients with chronic thromboembolic pulmonary hypertension Mai Kimura, Takashi Kohno ⁎, Takashi Kawakami, Masaharu Kataoka, Taku Inohara, Makoto Takei, Toshimitsu Tsugu, Mitsushige Murata, Yuichiro Maekawa, Keiichi Fukuda Department of Cardiology, Keio University School of Medicine, Tokyo, Japan article info Article history: Received 1 October 2015 Received in revised form 31 October 2015 Accepted 4 November 2015 Available online 18 November 2015 Keywords: Balloon pulmonary angioplasty Chronic thromboembolic pulmonary hypertension High-sensitivity troponin T Chronic thromboembolic pulmonary hypertension (CTEPH) has a poor prognosis because it is associated with progressive right heart failure (HF). Balloon pulmonary angioplasty (BPA) improves hemodynamics and functional capacity in CTEPH patients [1–3]. Cardiac troponin T is the preferred marker of ongoing myocardial damage, which is one of the central pathophysiological processes in HF [4]. Although it is difficult to detect elevated cardiac troponin levels using traditional assays, elevat- ed serum troponin levels have been found to be associated with increased mortality in patients with pulmonary hypertension (PH) [5]. High- sensitivity troponin T (hs-TnT) levels, which are measured by newer assays with a 10-fold lower detection range than traditional assays, are now available for clinical use and research. Although hs-TnT levels are International Journal of Cardiology 207 (2016) 387–389 ⁎ Corresponding author at: Department of Cardiology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582, Japan. E-mail address: kohno.a2@keio.jp (T. Kohno). Table 1 Baseline characteristics of patients. High hs-TnT group (n = 33) Low hs-TnT group (n = 33) Total (n = 66) P value Age, y 68.1 ± 11.6 56.7 ± 15.0 63.2 ± 13.2 0.001 Female sex, n (%) 24 (72) 20 (61) 44 (67) 0.300 WHO functional class, n (%) II 2 (6) 11 (33) 13 (20) 0.001 III 27 (82) 22 (67) 49 (74) IV 4 (12) 0 (0) 4 (6) Number of patients previously treated with PEA 3 (9) 2 (6) 5 (8) 0.595 eGFR, mL/min/1.73 m 2 54.0 ± 18.2 70.5 ± 17.5 61.0 ± 18.6 b0.001 BNP, pg/mL 392.5 ± 622.5 82.9 ± 150.9 247.8 ± 524.9 b0.001 Six-minute walk distance, m 272 ± 96 351 ± 95 313 ± 99 0.002 Drugs, n (%) Phosphodiesterase type-5 inhibitor 22 (66) 14 (42) 36 (55) 0.050 Endothelin-receptor antagonist 16 (49) 11 (33) 27 (41) 0.214 Prostacyclin analogue 10 (30) 9 (27) 19 (29) 0.787 Soluble guanylate cyclase stimulator 3 (9) 4 (12) 7 (11) 0.692 Warfarin 32 (97) 33 (100) 65 (99) 0.317 Diuretics 22 (67) 11 (30) 33 (50) 0.007 Mean RAP, mm Hg 7.5 ± 3.7 5.8 ± 2.3 6.3 ± 3.2 0.033 Mean PAP, mm Hg 42.5 ± 11.2 35.8 ± 8.8 38.1 ± 10.6 0.006 CO, L/min 3.4 ± 1.3 4.2 ± 1.6 3.7 ± 1.5 0.042 PCWP, mm Hg 8.3 ± 2.8 9.5 ± 3.0 8.6 ± 3.0 0.086 PVR, dynes·sec·cm -5 975 ± 668 543 ± 249 760 ± 588 0.004 SvO 2 ,% 60.1 ± 10.6 66.4 ± 6.6 62.6 ± 9.8 0.004 Data are mean ± standard deviation. WHO, World Health Organization; PEA, pulmonary endarterectomy; eGFR, estimated glomerular filtration rate; BNP, B-type natriuretic peptide; RAP, right atrial pressure; PAP, pulmonary artery pressure; CO, cardiac output; PCWP, pulmonary capillary wedge pressure; PVR, pulmonary vascular resistance; SvO 2 , mixed venous oxygen saturation. http://dx.doi.org/10.1016/j.ijcard.2015.11.026 0167-5273/© 2015 Elsevier Ireland Ltd. All rights reserved. Contents lists available at ScienceDirect International Journal of Cardiology journal homepage: www.elsevier.com/locate/ijcard