Cor Vasa 2018, 60(6):e603-e606 | DOI: 10.1016/j.crvasa.2017.12.014

Development of early reperfusion after the first episode of acute pulmonary embolism

Jana Václavková^a,*, Jan Mrózek^b,c, Vladimír Janovský^a, Pavol Bindas^a, Jana Petrová^c, Luboš Kraus^d, Michal Svoboda^e, Pavel Jansa^f

^a Interní oddělení, Slezská nemocnice v Opavě, Opava, Česká republika

^b Kardiovaskulární oddělení, Fakultní nemocnice Ostrava, Ostrava, Česká republika

^c Kardiologické oddělení, Městská nemocnice Ostrava, Ostrava, Česká republika

^d Interní ambulance, Nemocnice Nový Jičín, Nový Jičín, Česká republika

^e Institut biostatistiky a analýz, Lékařská fakulta Masarykovy univerzity, Brno, Česká republika

^f Centrum pro plicní hypertenzi, II. interní klinika kardiologie a angiologie, 1. lékařská fakulta Univerzity Karlovy a Všeobecná fakultní nemocnice v Praze, Praha, Česká republika

Introduction: Factors influencing the early reperfusion after pulmonary embolism (PE), with possible impact on development of chronic thromboembolic disease and chronic thromboembolic pulmonary hypertension (CTEPH), have not been completely identified yet.
Study population and methods: The total of 85 patients hospitalized with the first episode of acute PE underwent a ventilation-perfusion lung scan before hospital discharge. The reperfusion was evaluated based on clinical, echocardiographic and laboratory parameters.

Results: The study population consisted of 37 men and 48 women, mean age 60 years. A high-risk PE was present in 9.4% of patients, medium-risk PE in 49.4% and low-risk PE in 41.2% of patients. 26 (30.5%) of patients were diagnosed with provoked pulmonary embolism. Prior to discharge, the residual perfusion defects were detectable in 66 patients, in 18 patients the perfusion was normal. The two groups did not significantly differ in clinical, echocardiographic or laboratory parameters.

Conclusion: The analysis did not identify risk factors significantly associated with the absence of early reperfusion of the PE. This points towards the need of further follow-up of patients after a PE with the aim of identifying the patients with the high risk of developing the chronic thromboembolic disease and CTEPH.

Keywords: Chronic thromboembolic disease; Chronic thromboembolic pulmonary hypertension; Pulmonary embolism; Reperfusion

Received: December 5, 2017; Accepted: December 30, 2017; Published: December 1, 2018  Show citation