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Symptom-related telephone monitoring and cardiopulmonary exercise testing in the pulmonary embolism follow-up for early detection of chronic thromboembolic pulmonary hypertension (CTEPH)

Matthias Held, Alexander Hesse, Regina Holl, Tobias Romen, Franziska Walter, Gudrun Huebner, Berthold Jany
European Respiratory Journal 2013 42: P2602; DOI:
Matthias Held
1Internal Medicine, Respiratory Medicine and Cardiology, Mission Medical Hospital, Wuerzburg, Bavaria, Germany
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Alexander Hesse
1Internal Medicine, Respiratory Medicine and Cardiology, Mission Medical Hospital, Wuerzburg, Bavaria, Germany
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Regina Holl
1Internal Medicine, Respiratory Medicine and Cardiology, Mission Medical Hospital, Wuerzburg, Bavaria, Germany
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Tobias Romen
1Internal Medicine, Respiratory Medicine and Cardiology, Mission Medical Hospital, Wuerzburg, Bavaria, Germany
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Franziska Walter
1Internal Medicine, Respiratory Medicine and Cardiology, Mission Medical Hospital, Wuerzburg, Bavaria, Germany
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Gudrun Huebner
1Internal Medicine, Respiratory Medicine and Cardiology, Mission Medical Hospital, Wuerzburg, Bavaria, Germany
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Berthold Jany
1Internal Medicine, Respiratory Medicine and Cardiology, Mission Medical Hospital, Wuerzburg, Bavaria, Germany
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Abstract

The incidence of CTEPH as a serious complication of pulmonary embolism (PE) varies between 0.5 -8%. There are currently no established structured follow-up programs for early detection of CTEPH.

We prospectively studied the follow-up of patients with newly diagnosed PE to evaluate a symptom-related approach which is based on a telephone monitoring program. Patients were contacted after three, six, 12, 24 and 36 months. Patients were further studied if one item of a five item-questionnaire was positive. further imaging studies and right heart catheterization were performed in case that echocardiography or/and cardiopulmonary exercise testing (CPET) revealed abnormalities suggestive of pulmonary hypertension.

We report the results from our 3 months- follow-up and 18- months interim analysis.

3-months follow-up: n=104. Telephone interview suggesting abnormalities: n=32 (29,8 %). Pathological echocardiography: n=7, normal n= 25: CPET n=20: pathological CPET n =7, normal n =13. Further diagnostic work-up: n=15. Diagnosis CTEPH: n=7.

Interim analysis after18 months: n =123:Diagnosis CTEPH: n=10 .3 out of 10 patients had shown a pathological CPET despite normal echocardiographic findings.

The symptom-related follow-up program which is based on a telephone-monitoring and a 5 item-questionnaire detects patients with chronic-thromboembolic pulmonary hypertension. Cardiopulmonary exercise testing may serve as a complementary diagnostic tool. Telephone monitoring and cardiopulmonary exercise testing should be included in a pulmonary embolism follow-up program for early detection of CTEPH.

  • Pulmonary hypertension
  • Embolism
  • Telemedicine
  • © 2013 ERS
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Symptom-related telephone monitoring and cardiopulmonary exercise testing in the pulmonary embolism follow-up for early detection of chronic thromboembolic pulmonary hypertension (CTEPH)
Matthias Held, Alexander Hesse, Regina Holl, Tobias Romen, Franziska Walter, Gudrun Huebner, Berthold Jany
European Respiratory Journal Sep 2013, 42 (Suppl 57) P2602;

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Symptom-related telephone monitoring and cardiopulmonary exercise testing in the pulmonary embolism follow-up for early detection of chronic thromboembolic pulmonary hypertension (CTEPH)
Matthias Held, Alexander Hesse, Regina Holl, Tobias Romen, Franziska Walter, Gudrun Huebner, Berthold Jany
European Respiratory Journal Sep 2013, 42 (Suppl 57) P2602;
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