Echocardiographic evaluation for pulmonary hypertension after recurrent pulmonary embolism

Introduction: Although recurrent venous thromboembolism is a known risk factor for chronic thromboembolic pulmonary hypertension (CTEPH), the prevalence of CTEPH after recurrent pulmonary embolism (PE) is not clear.

Materials and methods: A cohort screening study was performed to clarify the prevalence of echocardiographic variables indicating pulmonary hypertension (PH) in patients after recurrent PE.

Results: 43 survivors of recurrent PE could be enrolled. Echocardiography indicated likely PH in 7 patients. In 5 out of these 7 patients PH was likely and the left ventricular function was normal. Right heart catheterization and ventilation/perfusion lung scan were performed in these patients. CTEPH could be diagnosed in all 5 patients (11.6% of the total study population). No World Health Organisation functional class (WHO-FC) I patient was suspected to have CTEPH. CTEPH was significantly more often diagnosed in WHO-FC III than in WHO-FC II (33.3% versus 9.5%; p=0.024).

Conclusions: CTEPH was found to be a frequent sequela in patients with recurrent PE. The prevalence of CTEPH is dependent on the patient's functional class. Evaluation for PH might be useful in symptomatic patients after recurrent PE.