Chest
Original InvestigationsDeterminants of Right Ventricular Function and Hemodynamics after Pulmonary Embolism
Section snippets
MATERIALS AND METHODS
Hemodynamic measurements in this study were made at the time that PE was proved by selective pulmonary angiography in 36 consecutive, unselected patients. Only patients who showed intravascular filling defects or unequivocal vessel cutoffs by angiography were admitted to the study.4 All patients were men, ranging in age from 31 to 79 years (mean, 55.8) and all were studied in a stable, postabsorptive state. The population included 8 patients with normal cardiopulmonary status prior to embolism
RESULTS
Pulmonary embolic obstruction, estimated by angiography, ranged from 5 to 53 percent The greatest degrees of obstruction were observed in patients with no prior heart or lung disease (18 to 53 percent, mean 34.8 percent) and in patients with pre-embolic mitral valvular disease (22 to 50 percent, mean 31.5 percent). Lesser degrees were present among patients with AVD, CLD and CHD (Fig 1). Patients with aortic valvular disease, all of whom had previous CHF, had significantly less embolic
DISCUSSION
The consequences of varying degrees of pulmonary artery occlusion have been observed directly in the experimental animal for more than 80 years.5, 6, 7, 8 For most of this period, studies of the relationship between the magnitude of embolic obstruction and the cardiovascular response in man were impaired by the absence of a technique for defining the presence and extent of embolism during life. Shortly after selective pulmonary angiography was established as the definitive diagnostic tool,
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Manuscript received January 22, 1973; revision accepted December 3.