ISSN 2149-2263 | E-ISSN 2149-2271
Volume : 25 Issue : 1 Year : 2021
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The Anatolian Journal of Cardiology Chronic thromboembolic pulmonary hypertension in patients with persistent chest symptoms after acute pulmonary embolism [Anatol J Cardiol]
Anatol J Cardiol. 2021; 25(1): 24-29 | DOI: 10.14744/AnatolJCardiol.2020.69057

Chronic thromboembolic pulmonary hypertension in patients with persistent chest symptoms after acute pulmonary embolism

Elif Sahutoglu1, Esin Tuncay1, Gülfidan Aras1, Esin Yentürk1, Dilek Kanmaz1, Hurrem Gul Ongen2, Zeki Ongen3
1Department of Pulmonology, Yedikule Hospital for Chest Disease and Thoracic Surgery; İstanbul-Turkey
2Department of Pulmonology, Cerrahpaşa Faculty of Medicine, İstanbul University; İstanbul-Turkey
3Department of Cardiology, Cerrahpaşa Faculty of Medicine, İstanbul University; İstanbul-Turkey

Objective: This study aimed to analyze the role of chronic thromboembolic pulmonary hypertension (CTEPH) in patients with persistent chest symptoms after acute PE.
Methods: Patients aged between 18 and 80 years who were followed up for acute PE were screened for chest symptoms which persisted after the anticoagulation treatment. Patients suffering other types of pulmonary hypertension (PH) or metastatic malignancies were excluded in this study. Demographic and functional data of patients included this study were collected. The patients underwent transthoracic echocardiography and ventilation/perfusion (VQ) scans. Also, invasive hemodynamic studies were done to patients with intermediate/high probability of VQ scans.
Results: Of the 140 patients screen for this study, 29 patients (Female/Male=16/13) with mean age of 56.1±11.2 years and follow-up time of 35.1±17.7 months met the inclusion criteria. The mean systolic pulmonary artery blood pressure (sPAP) on transthoracic echocardiography was 28.9±4.9 mm Hg (range=20–40 mm Hg). Furthermore, intermediate or high probability of VQ scans was detected in 2 patients, who were subsequently diagnosed with CTEPH (6.9%) via right heart catheterization.
Conclusion: CTEPH was diagnosed at a low rate in patients with persistent chest symptoms after the anticoagulation treatment for PE. CTEPH is still an elusive entity, which requires a multidisciplinary and invasive approach.

Keywords: pulmonary embolism, chronic thromboembolic pulmonary hypertension; ventilation-perfusion scan; right heart catheterization

Elif Sahutoglu, Esin Tuncay, Gülfidan Aras, Esin Yentürk, Dilek Kanmaz, Hurrem Gul Ongen, Zeki Ongen. Chronic thromboembolic pulmonary hypertension in patients with persistent chest symptoms after acute pulmonary embolism. Anatol J Cardiol. 2021; 25(1): 24-29

Corresponding Author: Elif Sahutoglu, Türkiye