INCIDENCE OF CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION AFTER ACUTE PULMONARY EMBOLISM – A SINGLE CENTER EXPERIENCE
O. Dzikowska-Diduch [1], M. Kostrubiec [1], M. Roik [1], B. Lichodziejewska [1], A. Wyzgał [1], A. Łabyk [1], Sz. Pacho [1], K. Kurnicka [1], P. Pruszczyk [1]
- Department of Internal Medicine and Cardiology, Medical University of Warsaw, Warsaw, Poland
Purpose: Although chronic thromboembolic pulmonary hypertension (CTEPH) is one of the most prevalent forms of pulmonary hypertension, it is still frequently underdiagnosed, and the true prevalence after acute pulmonary embolism (APE) is still undetermined. CTEPH is a potentially lethal condition and survivors of APE should be followed after the acute episode to detect signs or symptoms of CTEPH and determine the appropriate therapeutic strategy. The objective of this study was to analyze the association between CTEPH and APE with or without right ventricle dysfunction (RVD). Methods: We studied consecutive 729 patients (398F, age 64±10.6yrs) with objectively proven APE: 208 pts with RVD (ICD10:I26.0,RVD(+) group) and 521 pts without RVD (ICD10:I26.9,RVD(-) group). Pts with known precapillary pulmonary hypertension were excluded. APE survivors were referred to our out-patient clinic for follow up, which also included CTEPH screening. Results: All cause in-hospital mortality RVD(+) group reached 10%(21/208), while in RVD(-) it was 4,4%(23/521). From 685 survivors 314 pts completed at least 6 months follow-up (mean follow up 1.5±0.9yrs), while 361 others due to advanced age, severe comorbidities or distant residence were not controlled. Eventually, CTEPH was confirmed by right heart catheterization in 11(3,5%) of 314 pts. Importantly, 9(82%) CTEPH pts presented RVD during APE episode. Conclusion: Since the incidence of CTEPH after episode of APE reached 3.5% in pts with at least 6 months follow-up and most of them presented RVD during APE, we suggest that clinical screening with subsequent imaging diagnosis should be performed in APE survivors especially with RVD at presentation.
Purpose: Although chronic thromboembolic pulmonary hypertension (CTEPH) is one of the most prevalent forms of pulmonary hypertension, it is still frequently underdiagnosed, and the true prevalence after acute pulmonary embolism (APE) is still undetermined. CTEPH is a potentially lethal condition and survivors of APE should be followed after the acute episode to detect signs or symptoms of CTEPH and determine the appropriate therapeutic strategy. The objective of this study was to analyze the association between CTEPH and APE with or without right ventricle dysfunction (RVD).
Methods: We studied consecutive 729 patients (398F, age 64±10.6yrs) with objectively proven APE: 208 pts with RVD (ICD10:I26.0,RVD(+) group) and 521 pts without RVD (ICD10:I26.9,RVD(-) group). Pts with known precapillary pulmonary hypertension were excluded. APE survivors were referred to our out-patient clinic for follow up, which also included CTEPH screening.
Results: All cause in-hospital mortality RVD(+) group reached 10%(21/208), while in RVD(-) it was 4,4%(23/521). From 685 survivors 314 pts completed at least 6 months follow-up (mean follow up 1.5±0.9yrs), while 361 others due to advanced age, severe comorbidities or distant residence were not controlled. Eventually, CTEPH was confirmed by right heart catheterization in 11(3,5%) of 314 pts. Importantly, 9(82%) CTEPH pts presented RVD during APE episode.
Conclusion: Since the incidence of CTEPH after episode of APE reached 3.5% in pts with at least 6 months follow-up and most of them presented RVD during APE, we suggest that clinical screening with subsequent imaging diagnosis should be performed in APE survivors especially with RVD at presentation.
cteph
ustna