title: Echocardiographic evolution of pulmonary artery pressure after acute pulmonary embolism. Results from IPER registry.
abstract: OBJECTIVE
  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%.
  
  
  CONCLUSIONS
  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.
authors.affiliation: UO Cardiologia, Ospedale S. Carlo Borromeo, Milano, Italy. Electronic address: franco.casazza@fastwebnet.it.
authors.forename: Franco
authors.initials: F
authors.lastname: Casazza
authors.affiliation: UO Cardiologia, Ospedale S. Carlo Borromeo, Milano, Italy.
authors.forename: Amedeo
authors.initials: A
authors.lastname: Bongarzoni
authors.affiliation: UO Cardiologia Fondazione Poliambulanza, Brescia, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Forgione
authors.affiliation: UO Cardiologia Fondazione Poliambulanza, Brescia, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Cuccia
authors.affiliation: UO Cardiologia, Ospedale S. Maria del Carmine, Rovereto, TN, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Imperadore
authors.affiliation: UO Nefrologia, Ospedale S. Carlo Borromeo, Milano, Italy.
authors.forename: Girolamo
authors.initials: G
authors.lastname: Arrigo
authors.affiliation: IRCCS Istituto di Ricerche Farmacologiche "Mario Negri", Milano, Italy.
authors.forename: Irene
authors.initials: I
authors.lastname: Floriani
authors.affiliation: UO Cardiologia, Ospedale S. Carlo Borromeo, Milano, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Pignataro
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D001795:Blood Pressure Determination / Q000706:statistics & numerical data; D015984:Causality; D015897:Comorbidity; D018450:Disease Progression; D015150:Echocardiography, Doppler / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000503:physiopathology; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000503:physiopathology; D012008:Recurrence; D012042:Registries; D012307:Risk Factors; D055815:Young Adult
keywords: Acute pulmonary embolism; Chronic thromboembolic pulmonary hypertension; Echocardiographic follow-up