Incidence of chronic thromboembolic pulmonary hypertension after a first episode of pulmonary embolism
| Autor: | Giancarlo Agnelli, Maria Rita Taliani, Walter Ageno, Cecilia Becattini, Raffaele Pesavento, Mauro Silingardi, Renzo Poggio |
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| Rok vydání: | 2006 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Hypertension Pulmonary Chronic thromboembolic pulmonary hypertension Critical Care and Intensive Care Medicine Internal medicine medicine Pulmonary angiography Confidence Intervals Humans Risk factor Prospective cohort study Aged Ultrasonography First episode Deep venous thrombosis Pulmonary embolism Venous thromboembolism business.industry Incidence Respiratory disease Anticoagulants medicine.disease Pulmonary hypertension Surgery Venous thrombosis Dyspnea Italy Cardiology Female Cardiology and Cardiovascular Medicine business Pulmonary Embolism Follow-Up Studies |
| Zdroj: | Chest. 130(1) |
| ISSN: | 0012-3692 |
| Popis: | Study objective To assess the incidence of chronic thromboembolic pulmonary hypertension (CTPH) after the first episode of objectively confirmed pulmonary embolism (PE). Design Prospective cohort study in 12 Italian medical centers. Patients Consecutive patients treated with oral anticoagulants for the first episode of PE, either idiopathic or associated with temporary risk factors, were followed up for at least 3 years. Patients were excluded from the study if they had a known persistent risk factor for venous thromboembolism (VTE). Interventions At the follow-up visits, patients were evaluated for persistent dyspnea, either at rest or on exertion. All patients who were referred with dyspnea were assessed by transthoracic echocardiography, with evaluation of the systolic and mean pulmonary artery pressures. Patients with evidence of pulmonary hypertension on echocardiography underwent perfusion lung scans and pulmonary angiography to confirm the diagnosis of CTPH. Results Overall, 259 patients were included in the study. PE was idiopathic in 135 patients, while it was associated with at least a temporary risk factor for VTE in 124 patients. After an average follow-up period of 46 months, 37 patients were found to have persistent dyspnea that was unexplained in 5 patients. Among these patients, a diagnosis of CTPH was confirmed in two patients with idiopathic PE (0.8% of the overall study population [95% confidence interval (CI), 0.0 to 1.9]; 1.5% of patients with idiopathic PE [95% CI, 0.0 to 3.6]). The diagnosis was made 14 and 22 months, respectively, after the acute PE. Conclusions The incidence of CTPH observed in this study was about 1%. CTPH was observed in two patients with idiopathic PE. |
| Databáze: | OpenAIRE |
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