• 作者：David Martí ; ^a ; Vicente Gó ; mez^b ; Carlos Escobar^a ; Carolin Wagner^b ; Celia Zamarro^b ; Diana Sá ; nchez^b ; Allan Sam^b ; Sem Briongos^a ; Javier Gaudó ; ^b ; Antonio Sueiro^b ; David Jimé ; nez^b ; ^{djc_69_98@yahoo.com}
• 关键词：Tromboembolia de pulmó ; n ; Hipertensió ; n pulmonar ; Ecocardiografí ; a ; Cateterismo cardiaco
• 刊名：Archivos de Bronconeumolog铆a
• 出版年：2010
• 期刊代码：pca65_03002896
• 类别：med
• 出版时间：December 2010
• 卷：46
• 期：12
• 页码：628-633
• 文件大小：223 K

Introduction and objectives

To assess the incidence of long-term symptomatic and asymptomatic chronic thromboembolic pulmonary hypertension (CTEPH) in a cohort of patients with acute symptomatic pulmonary embolism (PE), and the potential risk factors for its diagnosis.

Methods

We conducted a prospective, long-term, follow-up study in 110 consecutive patients with an acute episode of pulmonary embolism (PE). All patients underwent transthoracic echocardiography (TTE) two years after the diagnosis of PE was made. If systolic pulmonary artery pressure exceeded 40 mmHg and there was evidence of residual PE either by ventilation-perfusion or CT scan, patients underwent right heart catheterisation to confirm the diagnosis. In asymptomatic patients, right heart catheterisation was performed if a repeated TTE still demonstrated persistent pulmonary hypertension six months after the first.

Results

CTEPH was diagnosed in 10 (6 patients during follow-up, and 4 at the end of the study) of the 110 patients (9.1%; 95%confidence interval [CI], 3.7 to 14.5%). All patients showed symptoms related to the disease according to a structured questionnaire. In the multivariate regression analysis, only concomitant age (relative risk [RR] 1.2 per age; 95%CI, 1.0 to 1.3; P=0.03) and previous PE (RR 5.7; IC 95%, 1.5 a 22.0; P=0.01) were independent predictors of CTEPH.

Conclusions

CTEPH cumulative incidence appears to be higher than previously reported. All patients had symptoms related to the disease.