title: Long-term clinical outcome of patients with persistent right ventricle dysfunction or pulmonary hypertension after acute pulmonary embolism.
abstract: OBJECTIVE
  Persistent, echocardiography-assessed right ventricle dysfunction (RVD) and/or pulmonary hypertension (PHT) are relatively frequent findings after an acute pulmonary embolism (PE). It has been suggested that echocardiography might predict long-term adverse events. Our objectives were to evaluate the prognostic value of RVD or isolated PHT 6 months after an acute PE with regard to all-cause mortality or venous thromboembolism (VTE) recurrence.
  
  
  RESULTS
  In a previous study, echocardiography was used to assess RVD or PHT on admission and 6 months after an acute PE in 101 consecutive, haemodynamically stable pulmonary patients. We assessed the subsequent vital status and incidence of recurrent VTE in these patients. Six patients were lost for follow-up. The other 95 patients were categorized as those (i) with RVD or PHT 6 months after PE (17 cases, 17.8%) and (ii) patients with neither RVD nor PHT (78 cases, 82.1%). After a mean±SD of 2.8±1.06 years, there were 9 (9.4%) deaths and 12 (12.6%) VTE recurrences. At multivariate analysis, only age predicted all-cause mortality [hazard ratio (HR): 1.081, 95% confidence interval (CI): 1.003-1.166, P=0.004]. RVD or PHT persistence did not appear to increase the risk of mortality or recurrent VTE.
  
  
  CONCLUSIONS
  Persistent echocardiographic signs of right ventricular pressure overload 6 months after an acute PE did not predict long-term adverse outcome events in this study.
authors.affiliation: Respiratory Division, Servicio de Neumología, Hospital Lucus Augusti, C/ San Cibrao s/n, 27004 Lugo, Spain. rgolpe@separ.es
authors.forename: Rafael
authors.initials: R
authors.lastname: Golpe
authors.forename: Ana
authors.initials: A
authors.lastname: Testa-Fernández
authors.forename: Luis A
authors.initials: LA
authors.lastname: Pérez-de-Llano
authors.forename: Olalla
authors.initials: O
authors.lastname: Castro-Añón
authors.forename: Carlos
authors.initials: C
authors.lastname: González-Juanatey
authors.forename: Ruth
authors.initials: R
authors.lastname: Pérez-Fernández
authors.forename: María Carmen
authors.initials: MC
authors.lastname: Fariñas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011655:Pulmonary Embolism / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality*; D054060:Pulmonary Infarction / Q000000981:diagnostic imaging* / Q000209:etiology; D012008:Recurrence; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography; D054556:Venous Thromboembolism / Q000209:etiology; D018497:Ventricular Dysfunction, Right / Q000000981:diagnostic imaging* / Q000209:etiology