| Echocardiographic assessment of pulmonary arterial pressure in the follow-up of patients with pulmonary embolism. | |
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MedLine Citation:
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PMID: 21247617 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Echocardiography remains a clinically useful screening test for chronic thromboembolic pulmonary hypertension (CTEPH) in patients with a history of pulmonary embolism (PE). To devise an effective screening strategy, the definition of a high-risk group is necessary. METHODS: We examined a total of 744 patients with acute symptomatic pulmonary embolism (PE) who were enrolled in a Spanish multicenter study. Patients were monitored every 6months during the first two years, and then once a year thereafter. Transthoracic echocardiography was used to screen patients with a clinical suspicion of CTEPH during follow-up. Pulmonary arterial hypertension was defined as an estimated pulmonary artery systolic pressure (PAP)>50mm Hg. The index thromboembolic episode was considered severe if: (a) the patient was immobilized for medical reasons; or (b) systolic blood pressure was less than 90mm Hg; or (c) troponin T values were above the reference range. RESULTS: The incidence of PAP>50mm Hg at 36months was 8.3% (95% confidence interval=4.6%-14.5%). Statistical analysis showed a highly significant association between a severe index thromboembolic episode and the subsequent detection of PAP>50mm Hg on echocardiography, with high positive likelihood ratio (2.40) and negative predictive value (>0.97). CONCLUSIONS: Patients with a severe index thromboembolic episode would constitute a high-risk group for the development of CTEPH. This group of patients should be subjected to a strict follow-up protocol. |
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Authors:
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Remedios Otero; Mikel Oribe; Aitor Ballaz; David Jimenez; Fernando Uresandi; Dolores Nauffal; Francisco Conget; Consolación Rodriguez; Teresa Elias; Luis Jara; Aurelio Cayuela; Isabel Blanco; Joan Barberá |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-1-17 |
Journal Detail:
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Title: Thrombosis research Volume: - ISSN: 1879-2472 ISO Abbreviation: - Publication Date: 2011 Jan |
Date Detail:
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Created Date: 2011-1-20 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0326377 Medline TA: Thromb Res Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2010 Elsevier Ltd. All rights reserved. |
Affiliation:
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Service of Pneumology, Hospital Universitario Virgen del Rocío, Avda Manuel Siurot s/n, 41013 Seville, Spain. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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