Source: Annual Congress 2006 - Pulmonary hypertension: thromo-embolic processes
Disease area: Pulmonary vascular diseases

Abstract

Pulmonary embolism is a frequent disorder, leading to chronic thromboembolic pulmonary hypertension in about 4% of patients with persistent symptoms.
However, long term consequences with asymptomatic impairment of pulmonary circulation are currently not known.
We noninvasively assessed 93 patients (31 male, 62 female, mean age 48 +/- 13 years) after acute idiopathic pulmonary embolism without significant co-morbidities using echocardiography at rest and during exercise, Measurements were performed mean 105 (9-505) months after first acute event. 17% of patients suffered from recurrent pulmonary embolism. Echocardiographically sPAP at rest was normal in all patients (mean sPAP 19 +/- 5 mm Hg). Echocardiography during spiroergometry increased to a sPAP of mean 34 +/- 10 mm Hg and an exercise capacity of VO2 max.70 (+/- 21) % pred.
An abnormal pulmonary vascular response has been regarded when sPAP was higher than 40 mm Hg and Vo2< 80% pred. at maximum exercise, consistent with exercise induced pulmonary hypertension. This condition has been found in 15 patients (16%) with an increase in sPAP to 46 +/- 4 mm Hg during ergometry and exercise capacity of 63 (+/- 8) % VO2max predicted.
Conclusion: In 16% of patients after acute idiopathic PE, exercise induced pulmonary hypertension can be detected using echocardiography at rest and during cardiopulmonary exercise test.

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F. Reichenberger, R. Vosswinckel, B. Enke, P. Kohler, B. Kemkes-Matthes, H. Olschewski, H. A. Ghofrani, W. Seeger (Giessen, Germany; Graz, Austria). Frequency of exercise induced pulmonary hypertension after pulmonary embolism. Eur Respir J 2006; 28: Suppl. 50, 2364

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