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Residual pulmonary hypertension is associated with clinical outcomes in patients with acute pulmonary thromboembolism

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Abstract

In patients with acute pulmonary thromboembolism (PTE), the influence of residual pulmonary hypertension (PH) has not been well investigated. The aim of this study was to compare clinical characteristics between patients with and without residual PH, and to investigate the association between residual PH and clinical outcomes after acute phase in acute PTE. We included acute PTE patients who underwent echocardiogram after acute phase between January 2009 and December 2016. These patients were divided into residual PH and non-residual PH groups according to the value of estimated right ventricular systolic pressure (eRVSP) by echocardiogram after acute phase (the residual PH group: eRVSP ≥ 40 mmHg, the non-residual PH group: eRVSP < 40 mmHg). Kaplan–Meier survival curves were applied to investigate whether the residual PH were associated with PTE-related death or recurrent PTE in patients with acute PTE. A total of 49 patients with acute PTE were allocated into the residual PH group (n = 10) and non-residual PH group (n = 39). Median follow-up period for 49 patients was 7 months. The event-free survival rate was significantly lower in the residual PH group as compared with the non-residual PH group (p = 0.003), whereas there was no statistical significance between two groups stratified by initial PH or not (p = 0.97). Residual PH after acute phase was significantly associated with mid-term PTE-related death or recurrent PTE in patients with acute PTE.

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References

  1. Goldhaber SZ, Bounameaux H (2012) Pulmonary embolism and deep vein thrombosis. Lancet 379:1835–1846

    Article  Google Scholar 

  2. Konstantinides SV, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galie N, Gibbs JS, Huisman MV, Humbert M, Kucher N, Lang I, Lankeit M, Lekakis J, Maack C, Mayer E, Meneveau N, Perrier A, Pruszczyk P, Rasmussen LH, Schindler TH, Svitil P, Vonk Noordegraaf A, Zamorano JL, Zompatori M, Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (2014) 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 35(3033–3069):3069a–3069k

  3. Haddad F, Doyle R, Murphy DJ, Hunt SA (2008) Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance, and management of right ventricular failure. Circulation 117:1717–1731

    Article  Google Scholar 

  4. Grifoni S, Olivotto I, Cecchini P, Pieralli F, Camaiti A, Santoro G, Conti A, Agnelli G, Berni G (2000) Short-term clinical outcome of patients with acute pulmonary embolism, normal blood pressure, and echocardiographic right ventricular dysfunction. Circulation 101:2817–2822

    Article  CAS  Google Scholar 

  5. Goldhaber SZ, Visani L, De Rosa M (1999) Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 353:1386–1389

    Article  CAS  Google Scholar 

  6. Pesavento R, Filippi L, Palla A, Visona A, Bova C, Marzolo M, Porro F, Villalta S, Ciammaichella M, Bucherini E, Nante G, Battistelli S, Muiesan ML, Beltramello G, Prisco D, Casazza F, Ageno W, Palareti G, Quintavalla R, Monti S, Mumoli N, Zanatta N, Cappelli R, Cattaneo M, Moretti V, Cora F, Bazzan M, Ghirarduzzi A, Frigo AC, Miniati M, Prandoni P, Investigators S (2017) Impact of residual pulmonary obstruction on the long-term outcome of patients with pulmonary embolism. Eur Respir J 49:1601980

    Article  Google Scholar 

  7. Yokoi K, Hara M, Ueda Y, Yamamoto K, Ota K, Kabata D, Kitamura T, Sakata Y, Shintani A (2017) Epidemiological and outcome data in Japanese patients with deep vein thrombosis with and without malignancy. Heart Vessels 32:1469–1477

    Article  Google Scholar 

  8. Grifoni S, Vanni S, Magazzini S, Olivotto I, Conti A, Zanobetti M, Polidori G, Pieralli F, Peiman N, Becattini C, Agnelli G (2006) Association of persistent right ventricular dysfunction at hospital discharge after acute pulmonary embolism with recurrent thromboembolic events. Arch Intern Med 166:2151–2156

    Article  Google Scholar 

  9. Ribeiro A, Lindmarker P, Johnsson H, Juhlin-Dannfelt A, Jorfeldt L (1999) Pulmonary embolism: one-year follow-up with echocardiography Doppler and five-year survival analysis. Circulation 99:1325–1330

    Article  CAS  Google Scholar 

  10. Kircher BJ, Himelman RB, Schiller NB (1990) Noninvasive estimation of right atrial pressure from the inspiratory collapse of the inferior vena cava. Am J Cardiol 66:493–496

    Article  CAS  Google Scholar 

  11. Jaff MR, McMurtry MS, Archer SL, Cushman M, Goldenberg N, Goldhaber SZ, Jenkins JS, Kline JA, Michaels AD, Thistlethwaite P, Vedantham S, White RJ, Zierler BK, Council American Heart Association, on Cardiopulmonary CCP, Resuscitation, American Heart Association Council on Peripheral Vascular Disease, American Heart Association Council on Arteriosclerosis T, Vascular B (2011) Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association. Circulation 123:1788–1830

    Article  Google Scholar 

  12. McLaughlin VV, Archer SL, Badesch DB, Barst RJ, Farber HW, Lindner JR, Mathier MA, McGoon MD, Park MH, Rosenson RS, Rubin LJ, Tapson VF, Varga J, American College of Cardiology Foundation Task Force on Expert Consensus Documents, American Heart Association, American College of Chest Physicians, American Thoracic Society Inc, Pulmonary Hypertension Association (2009) ACCF/AHA 2009 expert consensus document on pulmonary hypertension a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association developed in collaboration with the American College of Chest Physicians; American Thoracic Society, Inc.; and the Pulmonary Hypertension Association. J Am Coll Cardiol 53:1573–1619

  13. Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, Schiller NB (2010) Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 23:685–713 (quiz 786–688)

    Article  Google Scholar 

  14. Pengo V, Lensing AW, Prins MH, Marchiori A, Davidson BL, Tiozzo F, Albanese P, Biasiolo A, Pegoraro C, Iliceto S, Prandoni P, Thromboembolic Pulmonary Hypertension Study G (2004) Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med 350:2257–2264

    Article  Google Scholar 

  15. Morris TA, Marsh JJ, Chiles PG, Magana MM, Liang NC, Soler X, Desantis DJ, Ngo D, Woods VL Jr (2009) High prevalence of dysfibrinogenemia among patients with chronic thromboembolic pulmonary hypertension. Blood 114:1929–1936

    Article  CAS  Google Scholar 

  16. Galie N, Kim NH (2006) Pulmonary microvascular disease in chronic thromboembolic pulmonary hypertension. Proc Am Thorac Soc 3:571–576

    Article  Google Scholar 

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitama, Saitama, 330-8503, Japan

    Tatsuro Ibe, Hiroshi Wada, Kenichi Sakakura, Seiichiro Yoshimura, Miyuki Ito, Yusuke Ugata, Kei Yamamoto, Masaru Seguchi, Yousuke Taniguchi, Shin-ichi Momomura & Hideo Fujita

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  1. Tatsuro Ibe
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  2. Hiroshi Wada
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  3. Kenichi Sakakura
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  4. Seiichiro Yoshimura
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  5. Miyuki Ito
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  6. Yusuke Ugata
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  7. Kei Yamamoto
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  9. Yousuke Taniguchi
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  10. Shin-ichi Momomura
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Correspondence to Hiroshi Wada.

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Ibe, T., Wada, H., Sakakura, K. et al. Residual pulmonary hypertension is associated with clinical outcomes in patients with acute pulmonary thromboembolism. Heart Vessels 34, 1866–1873 (2019). https://doi.org/10.1007/s00380-019-01420-2

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  • DOI: https://doi.org/10.1007/s00380-019-01420-2

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