RT Journal Article
SR Electronic
T1 Long-term screening for pulmonary hypertension after pulmonary embolism
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2321
VO 44
IS Suppl 58
A1 Jonas Högele
A1 Henning Gall
A1 Robert Voswinckel
A1 Richard Schulz
A1 Beate Kemkes-Matthes
A1 Hossein A. Ghofani
A1 Werner Seeger
A1 Dagmar Steiner
A1 Frank Reichenberger
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P2321.abstract
AB After pulmonary embolisms (PE) up to 4% of patients develop pulmonary hypertension (PH). We examined patients after idiopathic, recurrent or familiar PE with stress echocadiography for non-invasive assessment of pulmonary circulation and pefusions scan. Afterwards patients remain in follow-up.After initial screening of 150 patients, we noninvasively investigated 93 patients (61 female, age 48 +/- 14 years), among them 85% with previous PE and 15% with multiple PE, and 37% of patients with thrombophilia. The age at first thromboembolic event was 39 +/- 14 years. The time between PE and the investigation was 9 +/- 8 years.A rest, 91 patients showed a normal systolic pulmonary artery pressure (sPAP) and normal right ventricular function (sPAP 36 +/- 1 mm Hg). In 2 patients the sPAP was > 40 mm Hg at rest. A hypertensive pulmonary vascular reaction was present in 26 patents with an increase of the sPAP to 48+/-4 mm Hg during exercise. In 55 patients perfusion defects were preset on V/Q scan. One patient had manifest precapillary pulmonary hypertension on right heart catheter.After 8 years, 24 of the 93 patients reported about exertional dyspnea and underwent a repeat investigation. All of them had a hypertensive pulmonary vascular reaction and at least one perfusion defect at initial assessment.In 4 patients pulmonary hypertension was detected on resting echocardiography, which has been confirmed by right heart catheterization (mPAP 31 +/- 5 mm Hg, PVR 478 +/- 133 dynes), consistent with 4.3% of the initial cohort.The presence of a hypertensive pulmonary vascular reaction in combination with a persistent perfusion defect after PE might be a risk constellation for development of PH.