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Circulation. 1999 Mar 16;99(10):1325-30.

Pulmonary embolism: one-year follow-up with echocardiography doppler and five-year survival analysis.

Author information

1
Departments of Clinical Physiology, Haematology and Cardiovascular Medicine, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden. ari@thfys.ks.se

Abstract

BACKGROUND:

The long-term prognosis for patients with pulmonary embolism (PE) is dependent on the underlying disease, degree of pulmonary hypertension (PH), and degree of right ventricular (RV) dysfunction. A precise description of the time course of pulmonary artery pressure (PAsP)/RV function is therefore of importance for the early identification of persistent PH/RV dysfunction in patients treated for acute PE. Other objectives were to identify variables associated with persistent PH/RV dysfunction and to analyze the 5-year survival rate for patients alive 1 month after inclusion.

METHODS AND RESULTS:

Echocardiography Doppler was performed in 78 patients with acute PE at the time of diagnosis and repeatedly during the next year. A 5-year survival analysis was made. The PAsP decreased exponentially until the beginning of a stable phase, which was </=38 days. The recovery of RV function occurred during the same time period. Risk factors for persistent PH/RV dysfunction and the 5-year mortality rate were analyzed using multiple logistic regression models. A PAsP of >50 mm Hg at the time of diagnosis of acute PE was associated with persistent PH after 1 year. The 5-year mortality rate was associated with underlying disease. Only patients with persistent PH in the stable phase required pulmonary thromboendarterectomy within 5 years.

CONCLUSIONS:

An echocardiography Doppler investigation performed 6 weeks after diagnosis of acute PE can identify patients with persistent PH/RV dysfunction and may be of value in planning the follow-up and care of these patients.

PMID:
10077516
DOI:
10.1161/01.cir.99.10.1325
[Indexed for MEDLINE]

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