Echocardiographic evolution of pulmonary artery pressure after acute pulmonary embolism. Results from IPER registry

Franco Casazza, Amedeo Bongarzoni, Chiara Forgione, Claudio Cuccia, Ferdinando Imperadore, Girolamo Arrigo, Irene Floriani, Luigi Pignataro

Research output: Contribution to journalArticle

Abstract

Aims The aim of the study is to describe the course of the echocardiographically measured pulmonary artery systolic pressure (PAsP) in a series of patients included in the Italian Pulmonary Embolism Registry (IPER).

Methods Patients with confirmed PE received an echo-Doppler evaluation within 24 hours from hospital admission and after one year. Pulmonary hypertension (PH) was considered "likely", "possible" or "unlikely" with a right ventricular-right atrial (RV-RA) pressure gradient > 45 mm Hg, between 32 and 45 mm Hg and ≤ 31 mm Hg and no additional echocardiographic variables suggestive of PH, respectively.

Results We studied 286 patients (169 females and 117 males, mean age 67 ± 15; mean follow-up 387 ± 45 days): 240 had a baseline tricuspid regurgitation (TR) and a RV-RA gradient of variable degree. PH was considered likely, unlikely and possible in 97, 93 and 50 patients respectively. At FU echocardiography, 6 patients (2.1%) had a likely PH and all of them were part of the group of 97 patients with a baseline likely PH; 24 patients (8.4%) had a possible PH, and 67% of them had an initial likely PH. No patients with a baseline unlikely PH or without TR developed a follow-up PH (both likely or possible). The probability to show a likely PH at FU echocardiography for patients with a baseline RV-RA gradient > 45 mm Hg was 6.2%, while the probability not to have a likely PH for patients with a baseline RV-RA gradient ≤ 45 mm Hg was 100%.

Conclusion In our study population of patients with acute PE, we observed that those presenting with a baseline echocardiographic RV-RA pressure gradient ≤ 45 mm Hg were completely free from a likely PH after 1-year.

Original languageEnglish
Pages (from-to)1224-1228
Number of pages5
JournalThrombosis Research
Volume134
Issue number6
DOIs
Publication statusPublished - Dec 1 2014

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Pulmonary Embolism
Pulmonary Hypertension
Pulmonary Artery
Registries
Pressure
Tricuspid Valve Insufficiency
Atrial Pressure
Echocardiography
Blood Pressure

Keywords

  • Acute pulmonary embolism
  • Chronic thromboembolic pulmonary hypertension
  • Echocardiographic follow-up

ASJC Scopus subject areas

  • Hematology
  • Medicine(all)

Cite this

Casazza, F., Bongarzoni, A., Forgione, C., Cuccia, C., Imperadore, F., Arrigo, G., ... Pignataro, L. (2014). Echocardiographic evolution of pulmonary artery pressure after acute pulmonary embolism. Results from IPER registry. Thrombosis Research, 134(6), 1224-1228. https://doi.org/10.1016/j.thromres.2014.09.026

Echocardiographic evolution of pulmonary artery pressure after acute pulmonary embolism. Results from IPER registry. / Casazza, Franco; Bongarzoni, Amedeo; Forgione, Chiara; Cuccia, Claudio; Imperadore, Ferdinando; Arrigo, Girolamo; Floriani, Irene; Pignataro, Luigi.

In: Thrombosis Research, Vol. 134, No. 6, 01.12.2014, p. 1224-1228.

Research output: Contribution to journalArticle

Casazza, F, Bongarzoni, A, Forgione, C, Cuccia, C, Imperadore, F, Arrigo, G, Floriani, I & Pignataro, L 2014, 'Echocardiographic evolution of pulmonary artery pressure after acute pulmonary embolism. Results from IPER registry', Thrombosis Research, vol. 134, no. 6, pp. 1224-1228. https://doi.org/10.1016/j.thromres.2014.09.026
Casazza, Franco ; Bongarzoni, Amedeo ; Forgione, Chiara ; Cuccia, Claudio ; Imperadore, Ferdinando ; Arrigo, Girolamo ; Floriani, Irene ; Pignataro, Luigi. / Echocardiographic evolution of pulmonary artery pressure after acute pulmonary embolism. Results from IPER registry. In: Thrombosis Research. 2014 ; Vol. 134, No. 6. pp. 1224-1228.
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AU - Casazza, Franco

AU - Bongarzoni, Amedeo

AU - Forgione, Chiara

AU - Cuccia, Claudio

AU - Imperadore, Ferdinando

AU - Arrigo, Girolamo

AU - Floriani, Irene

AU - Pignataro, Luigi

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N2 - Aims The aim of the study is to describe the course of the echocardiographically measured pulmonary artery systolic pressure (PAsP) in a series of patients included in the Italian Pulmonary Embolism Registry (IPER).Methods Patients with confirmed PE received an echo-Doppler evaluation within 24 hours from hospital admission and after one year. Pulmonary hypertension (PH) was considered "likely", "possible" or "unlikely" with a right ventricular-right atrial (RV-RA) pressure gradient > 45 mm Hg, between 32 and 45 mm Hg and ≤ 31 mm Hg and no additional echocardiographic variables suggestive of PH, respectively.Results We studied 286 patients (169 females and 117 males, mean age 67 ± 15; mean follow-up 387 ± 45 days): 240 had a baseline tricuspid regurgitation (TR) and a RV-RA gradient of variable degree. PH was considered likely, unlikely and possible in 97, 93 and 50 patients respectively. At FU echocardiography, 6 patients (2.1%) had a likely PH and all of them were part of the group of 97 patients with a baseline likely PH; 24 patients (8.4%) had a possible PH, and 67% of them had an initial likely PH. No patients with a baseline unlikely PH or without TR developed a follow-up PH (both likely or possible). The probability to show a likely PH at FU echocardiography for patients with a baseline RV-RA gradient > 45 mm Hg was 6.2%, while the probability not to have a likely PH for patients with a baseline RV-RA gradient ≤ 45 mm Hg was 100%.Conclusion In our study population of patients with acute PE, we observed that those presenting with a baseline echocardiographic RV-RA pressure gradient ≤ 45 mm Hg were completely free from a likely PH after 1-year.

AB - Aims The aim of the study is to describe the course of the echocardiographically measured pulmonary artery systolic pressure (PAsP) in a series of patients included in the Italian Pulmonary Embolism Registry (IPER).Methods Patients with confirmed PE received an echo-Doppler evaluation within 24 hours from hospital admission and after one year. Pulmonary hypertension (PH) was considered "likely", "possible" or "unlikely" with a right ventricular-right atrial (RV-RA) pressure gradient > 45 mm Hg, between 32 and 45 mm Hg and ≤ 31 mm Hg and no additional echocardiographic variables suggestive of PH, respectively.Results We studied 286 patients (169 females and 117 males, mean age 67 ± 15; mean follow-up 387 ± 45 days): 240 had a baseline tricuspid regurgitation (TR) and a RV-RA gradient of variable degree. PH was considered likely, unlikely and possible in 97, 93 and 50 patients respectively. At FU echocardiography, 6 patients (2.1%) had a likely PH and all of them were part of the group of 97 patients with a baseline likely PH; 24 patients (8.4%) had a possible PH, and 67% of them had an initial likely PH. No patients with a baseline unlikely PH or without TR developed a follow-up PH (both likely or possible). The probability to show a likely PH at FU echocardiography for patients with a baseline RV-RA gradient > 45 mm Hg was 6.2%, while the probability not to have a likely PH for patients with a baseline RV-RA gradient ≤ 45 mm Hg was 100%.Conclusion In our study population of patients with acute PE, we observed that those presenting with a baseline echocardiographic RV-RA pressure gradient ≤ 45 mm Hg were completely free from a likely PH after 1-year.

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KW - Chronic thromboembolic pulmonary hypertension

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