Pulmonary flow profile and distensibility following acute pulmonary embolismReport as inadecuate




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Journal of Cardiovascular Magnetic Resonance

, 13:14

First Online: 18 February 2011Received: 18 May 2010Accepted: 18 February 2011

Abstract

ObjectiveProof of concept study evaluating CMR as screening tool for chronic thromboembolic pulmonary hypertension CTEPH in patients treated for acute pulmonary embolism PE.

Materials and methodsRight and left ventricular function of 15 consecutive patients treated for PE and 10 consecutive patients in whom PE was excluded was estimated at baseline by cardiac CT and at 6 months follow-up by CMR. Additionally, during the follow-up visit, pulmonary artery PA hemodynamics were studied by CMR and the presence of pulmonary hypertension by echocardiography.

ResultsCT measured right ventricular ejection fraction RVEF was lower in patients with PE compared to patients without PE at time of diagnosis median 47%, interquartile range 39-53 vs. 55%, 52-58; p = 0.014. After 6 months follow up, the RVEF between patients treated for PE and patients without PE were not statistically significant different 55%, 52-60 versus 54%, 51-57; p = 0.57, as were distensibility index 0.18 ± 0.18 versus 0.25 ± 0.18, p = 0.20, mean velocity 14.1 ± 3.9 cm-s versus 14.0 ± 2.5 cm-s, p = 0.81, peak velocity 86.5 ± 22 cm-s versus 89.6 ± 13 cm-s, p = 0.43 and time to peak PA blood flow velocity 142 ± 49 ms versus 161 ± 29 ms, p = 0.14. One patient was diagnosed with CTEPH and CMR revealed poor right systolic function, decreased PA distensibility and flow velocity, and a systolic notch in the PA flow profile consistent with persistent PA obstruction.

ConclusionIn this small series, right ventricular performance and PA flow profiles of patients treated for 6 months after PE are equivalent to those parameters in normal patients.

Electronic supplementary materialThe online version of this article doi:10.1186-1532-429X-13-14 contains supplementary material, which is available to authorized users.

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Author: Frederikus A Klok - Soha Romeih - Jos JM Westenberg - Lucia JM Kroft - Menno V Huisman - Albert de Roos

Source: https://link.springer.com/article/10.1186/1532-429X-13-14







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