Abstract
Chronic thromboembolic pulmonary hypertension(CTEPH) is a curable and preventable complication with a substantial incidence leading to severe morbidity and mortality.The aim of the study was to find out the incidence of CTEPH secondary to acute pulmonary thromboembolism(PTE) using non-invasive procedures such as ventilation/perfusion(V/Q) scintigraphy and pulmonary multidetector CT(MDCT)angiography.The study included a total of 99 patients diagnosed with initial PTE between January 2010 and December 2012.The patients who received anticoagulant therapy at least for 3 months underwent transthoracic echocardiography(TTE)(N=85).Thirtyone patients with a SPAP value>30mmHg and/or an evidence of right ventricular dysfunction in TTE underwent pulmonaryangiography and V/Q scintigraphy.The patients with an evidence of residual chronic thromboembolic signs in MDCTpulmonary angiography and/or segmental perfusion defect(s) in V/Q scintigraphy underwent rightheart catheterization(RHC)(N=7).During diagnosis,24 subjects were considered having massive,61 submassive and 14 non-massive PTE. Nineteen patients(19,1%) received thrombolythic therapy.Other 80 patients(80.8%) received standard anticoagulant therapy.In 79.8% of patients,thromboembolism was bilateral and it was unilateral in 21.8%.After a minimum of 1 year,and maximum of 2 years follow up five subjects(5.5%) were diagnosed with CTEPH.The univariate analysis showed no association between the development of CTEPH and factors like;age,etiologic risk factors for PTE,receiving thrombolytic treatment,prevalence and type of PTE.Potentially preventabl complication of PE;CTEPH had a substantial incidence during follow-up.
- © 2014 ERS
