Echocardiographic index for pulmonary hypertension discrimination in patients after pulmonary embolism - pilot study

Aims: Patients with residual perfusion defects and echocardiographic signs of pulmonary hypertension (PH) are referred for chronic thromboembolic pulmonary hypertension (CTEPH) evaluation. The first aim of this study was to test an echocardiographic index as a screening marker for pre-capillary PH....

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Main Authors: M. Peneva, G. Vladimirov, H. Mateev
Format: Article
Language:Bulgarian
Published: Pensoft Publishers 2024-12-01
Series:Българска кардиология
Subjects:
Online Access:https://journal.bgcardio.org/article/139492/download/pdf/
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author M. Peneva
G. Vladimirov
H. Mateev
author_facet M. Peneva
G. Vladimirov
H. Mateev
author_sort M. Peneva
collection DOAJ
description Aims: Patients with residual perfusion defects and echocardiographic signs of pulmonary hypertension (PH) are referred for chronic thromboembolic pulmonary hypertension (CTEPH) evaluation. The first aim of this study was to test an echocardiographic index as a screening marker for pre-capillary PH. The secondary aim was to assess its potential for PH type discrimination. Methods and results: The single-center’s retrospective cohort included 79 patients divided by gender, age, presence of chronic perfusion defects diagnosed by computer tomography (CT) or angiography, tricuspid annular plane systolic excursion/systolic pulmonary artery pressure (TAPSE/sPAP), right ventricle (RV) basal diameter, the ratio (TAPSE/sPAP)/RV x 100, PH groups – CTEPH/pre-capillary, combined pre- and post-capillary (CpcPH) and isolated post-capillary (IpcPH) and no PH. From a total of 79 patients – 43(54%) men and 36(46%) women at a mean age of 65, residual clots were detected in 42(53%). Analysis of invasive haemodynamic and echocardiographic data diagnosed no PH in 22 (28%), IpcPH – 25 (32%), CpcPH – 16 (20%) and CTEPH - 16(20%). There was a statistically significant difference in the mean index values between all PH subtypes groups (p < 0.001). Further analysis proved (TAPSE/sPAP)/RV x 100 to be statistically significant discriminator of PH subtypes and defined patients with a value above 1.79 as likely having no PH, leading post-capillary PH in the range of 0.83-1.79, pre-capillary PH < 0.52 (p < 0.001). Conclusion: The index might serve as a screening method for CTEPH and possible PH type discrimination. 
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spelling doaj-art-2ecb34d2e3224fa4b81c98d63df3d5432024-12-13T08:32:09ZbulPensoft PublishersБългарска кардиология2683-10152024-12-01303535810.3897/bgcardio.30.e139492139492Echocardiographic index for pulmonary hypertension discrimination in patients after pulmonary embolism - pilot studyM. Peneva0G. Vladimirov1H. Mateev2National Heart HospitalNational Heart HospitalNational Heart HospitalAims: Patients with residual perfusion defects and echocardiographic signs of pulmonary hypertension (PH) are referred for chronic thromboembolic pulmonary hypertension (CTEPH) evaluation. The first aim of this study was to test an echocardiographic index as a screening marker for pre-capillary PH. The secondary aim was to assess its potential for PH type discrimination. Methods and results: The single-center’s retrospective cohort included 79 patients divided by gender, age, presence of chronic perfusion defects diagnosed by computer tomography (CT) or angiography, tricuspid annular plane systolic excursion/systolic pulmonary artery pressure (TAPSE/sPAP), right ventricle (RV) basal diameter, the ratio (TAPSE/sPAP)/RV x 100, PH groups – CTEPH/pre-capillary, combined pre- and post-capillary (CpcPH) and isolated post-capillary (IpcPH) and no PH. From a total of 79 patients – 43(54%) men and 36(46%) women at a mean age of 65, residual clots were detected in 42(53%). Analysis of invasive haemodynamic and echocardiographic data diagnosed no PH in 22 (28%), IpcPH – 25 (32%), CpcPH – 16 (20%) and CTEPH - 16(20%). There was a statistically significant difference in the mean index values between all PH subtypes groups (p < 0.001). Further analysis proved (TAPSE/sPAP)/RV x 100 to be statistically significant discriminator of PH subtypes and defined patients with a value above 1.79 as likely having no PH, leading post-capillary PH in the range of 0.83-1.79, pre-capillary PH < 0.52 (p < 0.001). Conclusion: The index might serve as a screening method for CTEPH and possible PH type discrimination. https://journal.bgcardio.org/article/139492/download/pdf/pulmonary hypertensionpulmonary embolismchroni
spellingShingle M. Peneva
G. Vladimirov
H. Mateev
Echocardiographic index for pulmonary hypertension discrimination in patients after pulmonary embolism - pilot study
Българска кардиология
pulmonary hypertension
pulmonary embolism
chroni
title Echocardiographic index for pulmonary hypertension discrimination in patients after pulmonary embolism - pilot study
title_full Echocardiographic index for pulmonary hypertension discrimination in patients after pulmonary embolism - pilot study
title_fullStr Echocardiographic index for pulmonary hypertension discrimination in patients after pulmonary embolism - pilot study
title_full_unstemmed Echocardiographic index for pulmonary hypertension discrimination in patients after pulmonary embolism - pilot study
title_short Echocardiographic index for pulmonary hypertension discrimination in patients after pulmonary embolism - pilot study
title_sort echocardiographic index for pulmonary hypertension discrimination in patients after pulmonary embolism pilot study
topic pulmonary hypertension
pulmonary embolism
chroni
url https://journal.bgcardio.org/article/139492/download/pdf/
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AT gvladimirov echocardiographicindexforpulmonaryhypertensiondiscriminationinpatientsafterpulmonaryembolismpilotstudy
AT hmateev echocardiographicindexforpulmonaryhypertensiondiscriminationinpatientsafterpulmonaryembolismpilotstudy