Incidence of chronic pulmonary hypertension in patients with previous pulmonary embolism
Incidence of chronic pulmonary hypertension in patients with previous pulmonary embolism
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DOI：
10.1016/j.thromres.2009.01.003
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发表时间：
2009-07-01
影响因子：
7.5
通讯作者：
Ageno, Walter
中科院分区：
文献类型：
--
作者：
Dentali, Francesco;Donadini, Marco;Ageno, Walter
简介：慢性血栓栓塞性肺动脉高压（CTPH）的真实发病率仍然存在争议。有症状的 CTPH 可能比以前报道的更常见，而无症状 CTPH 的发生尚未定义，因为目前可用超声心动图多普勒诊断无症状 CTPH 发生率的证据非常有限。因此，我们进行了一项前瞻性队列研究，以评估连续首次 PE 发作的患者中经超声心动图多普勒诊断 CTPH 的发生率。方法：在指标事件发生后 6 至 12 个月内，对连续首次 PE 发作的患者进行多普勒经胸超声心动图评估。肺动脉高压定义为静息时肺动脉收缩压>= 40 mmHg，且灌注闪烁扫描时存在残余灌注缺陷。通过标准化问卷评估是否存在与肺动脉高压相关的症状。结果：纳入了 91 名患者（平均年龄 61.9 +/- 15.7 岁；范围 22-89；39 名男性）。 8 名患者 (8.8%: 95% CI 4.5,16.4) 患有 CTPH：其中 4 名 (4.4%; 95% CI 2.0,9.3) 有症状。结论：PE 后无症状 CPTH 并不罕见。更大规模的前瞻性试验和更长的随访时间应该评估无症状 CPTH 的预后意义。 (c) 2009 Elsevier B.V. 保留所有权利。
Introduction: The true incidence of chronic thromboembolic pulmonary hypertension (CTPH) remains a matter of debate. Symptomatic CTPH is probably more common than previously reported, Whereas the occurrence of asymptomatic CTPH has not been defined since very limited evidence on the incidence of asymptomatic CTPH diagnosed with echocardiography Doppler are currently available. We therefore carried out a prospective cohort study to assess the incidence of CTPH diagnosed with echocardiography Doppler in consecutive patients with a first episode of PE.Methods: Consecutive patients with a first episode of PE were evaluated with Doppler transthoracic echocardiography within 6 to 12 months after the index event. Pulmonary hypertension was defined as a systolic pulmonary artery pressure >= 40 mmHg at rest in the presence of residual perfusion defects at perfusion scintigraphy. Presence of symptoms related to pulmonary hypertension was evaluated with a standardized questionnaire.Results: Ninety-one patients (mean age 61.9 +/- 15.7 years; range 22-89; 39 men) were enrolled. Eight patients (8.8%: 95% CI 4.5,16.4) had CTPH: of these, 4 (4.4%; 95% CI 2.0,9.3) were symptomatic.Conclusions: Asymptomatic CPTH is not an uncommon finding after PE. Larger prospective trials with a longer follow up should assess the prognostic significance of asymptomatic CPTH. (c) 2009 Elsevier B.V. All rights reserved.