Population characteristics at baseline.

IntroductionPulmonary endarterectomy (PEA) is the first-line treatment for chronic thromboembolic pulmonary hypertension (CTEPH), while balloon pulmonary angioplasty (BPA) is an established alternative for inoperable patients. Although both interventions improve resting pulmonary hemodynamics, the extent of long-term physiological recovery during exercise and the persistence of functional limitations remain incompletely characterized.MethodsProspective single-center registry (2017–2023) including 14 patients completing BPA (71 sessions) and 15 undergoing PEA, with median follow-up of 50 months (IQR 36–61). Clinical assessment included resting hemodynamics, invasive exercise right heart catheterization to derive the exercise slope of the mean pulmonary arterial pressure to cardiac output relashionship (mPAP/CO slope), and health-related quality of life (HRQOL) evaluated using the SF-36 questionnaire. Analyses were descriptive and focused on within-pathway changes over time.ResultsBoth BPA and PEA significantly reduced mPAP (44.8 ± 12.4 → 26.1 ± 9.3 mmHg; 42.1 ± 12.9 → 22.6 ± 5.4 mmHg, both p ConclusionBPA and PEA provide durable improvements in resting pulmonary hemodynamics; however, incomplete physiological recovery is common, with persistent exercise abnormalities and reduced physical quality of life at long-term follow-up.引言 肺动脉内膜剥脱术（Pulmonary endarterectomy, PEA）是慢性血栓栓塞性肺动脉高压（chronic thromboembolic pulmonary hypertension, CTEPH）的一线治疗方案，而球囊肺动脉成形术（balloon pulmonary angioplasty, BPA）则是无法手术患者的公认替代疗法。尽管两种干预手段均可改善静息状态下的肺血流动力学，但运动过程中的长期生理恢复程度以及功能受限的持续情况仍未得到充分阐明。 方法 本研究为2017—2023年开展的单中心前瞻性注册研究，共纳入14例完成球囊肺动脉成形术治疗（共计71次手术操作）的患者与15例接受肺动脉内膜剥脱术治疗的患者，中位随访时间为50个月（四分位间距36~61个月）。临床评估内容涵盖静息血流动力学指标、通过有创运动右心导管检查推导平均肺动脉压与心输出量的运动斜率（mPAP/CO slope），以及采用SF-36量表评估的健康相关生活质量（health-related quality of life, HRQOL）。本研究采用描述性分析方法，重点关注同一治疗组内随时间推移的变化。 结果 两种治疗手段均显著降低了平均肺动脉压（BPA组：44.8 ± 12.4 → 26.1 ± 9.3 mmHg；PEA组：42.1 ± 12.9 → 22.6 ± 5.4 mmHg，两组均P<[原文未完整标注]）。 结论 球囊肺动脉成形术与肺动脉内膜剥脱术均可使静息肺血流动力学得到持久改善；然而，生理恢复不完全的情况较为常见，长期随访中仍存在运动功能异常与躯体生活质量降低的问题。