Echocardiographic evaluation for pulmonary hypertension after recurrent pulmonary embolism

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.

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

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).

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.