title: Pulmonary thromboembolism in 102 consecutive patients with chronic atrial fibrillation. Diagnostic value of echocardiography.
abstract: BACKGROUND
  Little is known about the incidence and diagnosis of pulmonary thromboembolism (PE) in patients with chronic permanent atrial fibrillation (CAF). Also it has not been established if echocardiography, a diagnostic tool useful in clinical evaluation of both diseases, is of value in diagnosis of PE in CAF patients.
  
  
  OBJECTIVE
  To establish the prevalence of PE among patients suffering from CAF without or with poorly controlled anticoagulation as well as to evaluate the possibility to detect PE and to assess the diagnostic role of echocardiography.
  
  
  METHODS
  Prevalence of PE in a population of 102 patients (52 males and 50 females at the mean age of 68 years, range 32-88 years) admitted to hospital between January and December 2004 with diagnosis of CAF was studied retrospectively. Echocardiography-based original algorithm of PE diagnosis in such patients was analysed.
  
  
  RESULTS
  Among 102 patients with CAF, 20 (19%) cases of PE were diagnosed, including 12 with acute PE (APE) and 8 suffering from chronic thromboembolic pulmonary hypertension (CTEPH). Patients with CAF and APE as well as with CAF and CTEPH had increased right ventricular dimension (p=0.0002 and p=0.001, respectively), higher tricuspid pressure gradient (p=0.005 and p=0.001, respectively) and shorter pulmonary artery acceleration time (p=0.00006 and p=0.0004, respectively) estimated in echocardiography as compared to patients with CAF but without PE. Subjects with CAF and PE had also significantly decreased left ventricular dimension and better left ventricular performance.
  
  
  CONCLUSIONS
  A relatively high incidence of PE among patients with CAF not treated with anticoagulants or with poorly controlled anticoagulation therapy was noted. The important value of a diagnostic algorithm employing echocardiography in a diagnosis of clinically significant APE and CTEPH in this group of patients was also shown.
authors: Division of Cardiology, Research-Developmental Centre, Regional Specialistic Hospital, Wroclaw, Poland.
authors: Piotr
authors: P
authors: Piszko
authors: Jerzy
authors: J
authors: Lewczuk
authors: Lucyna
authors: L
authors: Lenartowska
authors: Jacek
authors: J
authors: Jagas
authors: Renata
authors: R
authors: Romaszkiewicz
authors: Daniel
authors: D
authors: Błaszczyk
authors: Andrzej
authors: A
authors: Konieczny
authors: Karol
authors: K
authors: Turkiewicz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications*; D002908:Chronic Disease; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies