title: Factors associated with elevated pulmonary arterial pressure levels on the echocardiographic assessment in patients with prior pulmonary embolism.
abstract: BACKGROUND
  Factors associated with the detection of raised systolic pulmonary artery pressure (sPAP) levels in patients with a prior episode of pulmonary embolism (PE) are not well known.
  
  
  METHODS
  We used the RIETE Registry database to identify factors associated with the finding of sPAP levels ≥50 mm Hg on trans-thoracic echocardiography, in 557 patients with a prior episode of acute, symptomatic PE.
  
  
  RESULTS
  Sixty-two patients (11.1%; 95% CI: 8.72-14.1) had sPAP levels ≥50 mm Hg. These patients were more likely women, older, and more likely had chronic lung disease, heart failure, renal insufficiency or leg varicosities than those with PAP levels <50mm Hg. During the index PE event, they more likely had recent immobility, and more likely presented with hypoxemia, increased sPAP levels, atrial fibrillation, or right bundle branch block. On multivariate analysis, women aged ≥70 years (hazard ratio [HR]: 2.0; 95% CI: 1.0-3.7), chronic heart or chronic lung disease (HR: 2.4; 95% CI: 1.3-4.4), atrial fibrillation at PE presentation (HR: 2.8; 95% CI: 1.3-6.1) or varicose veins (HR: 1.8; 95% CI: 1.0-3.3) were all associated with an increased risk to have raised sPAP levels. Chronic heart disease, varicose veins, and atrial fibrillation were independent predictors in women, while chronic heart disease, atrial fibrillation, a right bundle branch block or an S1Q3T3 pattern on the electrocardiogram were independent predictors in men.
  
  
  CONCLUSIONS
  Women aged ≥70 years more likely had raised sPAP levels than men after a PE episode. Additional variables influencing this risk seem to differ according to gender.
authors: Department of Pneumonology, Hospital Universitario Virgen del Rocío, HUVR-IBIS, CIBERES, Sevilla, Spain. rotero@separ.es
authors: Remedios
authors: R
authors: Otero
authors: Teresa
authors: T
authors: Elías
authors: Luis
authors: L
authors: Jara
authors: Javier
authors: J
authors: Trujillo-Santos
authors: Laurent
authors: L
authors: Bertoletti
authors: Dolores
authors: D
authors: Nauffal
authors: Justo
authors: J
authors: Ruiz-Ruiz
authors: Ángeles
authors: Á
authors: Blanco-Molina
authors: Manuel
authors: M
authors: Monreal
mesh_terms: D000368:Aged; D062186:Arterial Pressure / Q000502:physiology; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D011379:Prognosis; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D012307:Risk Factors