Chronic thromboembolic pulmonary hypertension after the first episode of pulmonary embolism? How often?

Abstract

Background. Surviving pulmonary embolism (PE) brings a risk of thromboembolic disease chronicity. Chronic thromboembolic pulmonary hypertension (CTEPH) develops as a result of one or multiple pulmonary embolic events. It is an incapacitating long-term complication of thromboembolic disease with a negative impact on the patient’s quality of life and prognosis. Contemporary pharmacological and especially surgical treatment possibilities offer hope for the patient’s full recovery, but an early diagnosis is crucial for success. Methods. In a prospective study cohort of 97 consecutive patients with a proven diagnosis of PE as the first documented thromboembolic event we tried to estimate the incidence of CTEPH during a 2-year follow-up. Results. Four individuals from our study population developed CTEPH, which represents an incidence of 4.2%. Conclusion. Chronic thromboembolic pulmonary hypertension in pulmonary embolism survivors is a not uncommon complication deserving the attention of clinicians. Patients at risk of CTEPH can be identified for effective follow-up according to echocardiographic finding of elevated pulmonary artery systolic pressure and NT-proBNP levels at the time of hospital discharge.