Evaluation of incidence of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism in patients admitted to Imam Reza Hospital, Tabriz, Iran (primary results)

Abstract

Introduction: Chronic thromboembolic pulmonary hypertension (CTEPH) is a late complication of pulmonary thromboembolism, which is associated with high morbidity and mortality. Although the pathogenesis is not fully understood, the damage and frequency of this complication have a wide range. The aim of this study was to evaluate the incidence of CTEPH following the first episode of acute pulmonary embolism (PE). Methods: In a cohort study, 101 patients with acute embolism who had undergone anticoagulant therapy were followed up for at least one year. Patients that presented symptoms of dyspnea were selected. Echocardiography was performed on these patients, and they were evaluated for symptoms of right heart failure and increased pulmonary artery pressure of more than 35 mmHg. Results: 101 patients with a mean age of 85.2 ± 17.7 years, including 57 men (56.4%) and 44 females (43.6%), were treated for a diagnosis of acute PE and were followed up for one year. 77.2% of patients had an idiopathic PE and 22.8% had it as the underlying cause. During follow-up, 23 patients (22.8%) experienced dyspnea. Echocardiography was normal in 13 cases and 10 cases had signs of right heart failure and pulmonary artery pressure. The overall incidence of CTEPH was 9.9%. Demographic data and computed tomography (CT) angiography findings were not associated with higher incidence of CTEPH. Conclusion: CTEPH is a serious complication of acute PE, and the incidence of pulmonary hypertension after pulmonary emboli is relatively high. Age and gender did not influence its occurrence. Moreover, there was no relationship between the findings of CT angiography in the initial PE and chronic pulmonary hypertension rate of incidence.

Keywords: Deep Venous Thrombosis, Pulmonary Embolism, Echocardiography