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Chronic thromboembolic pulmonary hypertension risk score evaluation and validation (CTEPH SOLUTION): proposal of a
Cristiano Miotti1, Andrea M D'Armini2, Beatrice Scardovi3
1Department of Cardiovascular and Respiratory Sciences, Sapienza University, Rome, Italy.
Insights
This study aims to develop a risk score for early detection of chronic thromboembolic pulmonary hypertension (CTEPH) in patients with pulmonary embolism (PE). This tool will aid in identifying high-risk individuals for targeted screening and management.
Area of Science:
- Cardiology
- Pulmonary Medicine
- Medical Diagnostics
Background:
- Chronic thromboembolic pulmonary hypertension (CTEPH) is a severe complication of acute pulmonary embolism (PE), often underdiagnosed.
- CTEPH is the only potentially reversible form of pulmonary hypertension (PH).
Purpose of the Study:
- To develop a comprehensive scoring tool for predicting CTEPH development in PE patients.
- To enable early detection of CTEPH through echocardiographic data and targeted screening programs.
Main Methods:
- Multicenter observational study (cross-sectional and prospective).
- Enrolled patients with prior PE diagnosis undergo screening for PH via clinical exam and echocardiogram.
- Confirmed PH cases undergo right heart catheterization and further imaging to identify CTEPH.
Main Results:
- Study aims to enroll 1000 retrospective and 218 prospective patients.
- Enrollment is ongoing, with 841 patients (620 retrospective, 221 prospective) already included.
Conclusions:
- This is the first large prospective study to predict CTEPH development post-PE.
- The developed scoring tool aims to facilitate early CTEPH detection and targeted follow-up.
Background:
Chronic thromboembolic pulmonary hypertension (CTEPH) is the most serious long-term complication of acute pulmonary embolism (PE) though it is the only potentially reversible form of pulmonary hypertension (PH). Its incidence is mainly limited to the first 2 years following the embolic event, however it is often underdiagnosed or misdiagnosed.
Methods:
This is a multicenter observational cross-sectional and prospective study. Patients with a prior diagnosis of PE will be enrolled and undergo baseline evaluation for prevalent PH detection through a clinical examination and an echocardiogram as first screening exam. All cases of intermediate-high echocardiographic probability of PH will be confirmed by right heart catheterization and then identified as CTEPH through appropriate imaging and functional examinations in order to exclude other causes of PH. A CTEPH Risk Score will be created using retrospective data from this prevalent cohort of patients and will be then validated on an incident cohort of patients with acute PE.
Results:
One thousand retrospective and 218 prospective patients are expected to be enrolled and the study is expected to be completed by the end of 2021. Up to now 841 patients (620 retrospective and 221 prospective) have been enrolled.
Conclusions:
This study is the first large prospective study for the prediction of CTEPH development in patients with PE. It aims to create a comprehensive scoring tool that includes echocardiographic data which may allow early detection of CTEPH and the application of targeted follow-up screening programs in patients with PE.
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