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

Abstract

Aims: To evaluate the evolution of pulmonary embolism (PE) in the first year of follow-up as it concerns the efficacy and complications of therapy. Methods: In the last 4 years, 522 patients had the diagnosis of PE by spiral CT scan (382, 73.2 %), pulmonary angiography (4, 0.76 %), or highly compatible perfusion lung scan (PLS) and clinical probability (136, 26 %). Then, they were followed for 1 year through clinical assesment, blood gas analysis, PLS (7, 30, 365 days after PE). PLS was quantified by the number of unperfused lung segments (Perfusion Damage Score, PDS). Moreover, in a subset of 53 patients, with EKG signs of right ventricle overload, echocardiogram was also performed at the embolization and 365 days later. Results: Seven clinical and scintigraphic relapses of PE were observed; of them 1 died during the first week, 2 during the first month. One case of major and 14 of minor bleedings were recorded. After 1 year, dyspnoea significantly decreased and PaO₂ significantly improved (p<0.001). The PDS decreased significantly after 7 and between 7 and 30 days (p<0.001), not significantly between 30 and 365 days. sPAP measured on echo was normal in 8 cases, it decreased significantly in 13 cases (p<0.05) and remained almost unchanged in 32 cases after 365 days. In these latter patients the PDS was significantly higher (p<0.05) than in the remaining patients at the end of follow-up. Conclusions: A complete recovery of pulmonary perfusion was not obtained in several patients after the acute episode of PE. Patients who do not improve pulmonary hypertension at the end of follow-up recover less than the remainders.

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C. Ribas, G. Bardi, G. Palmiero, M. Gherardi, L. Marconi, N. Carpenè, C. Manta, M. Digiorgio, A. Palla (Pisa, Italy). Evolution of pulmonary embolism: 1 year of follow-up. Eur Respir J 2006; 28: Suppl. 50, 2365

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