title: The predictive value of echocardiography for chronic thromboembolic pulmonary hypertension after acute pulmonary embolism in Korea.
abstract: OBJECTIVE
  Chronic thromboembolic pulmonary hypertension (CTEPH) is a life-threatening complication after acute pulmonary embolism (APE) and is associated with substantial morbidity and mortality. This study aimed to investigate the incidence of CTEPH after APE in Korea and to determine echocardiographic predictors of CTEPH.
  
  
  METHODS
  Among 381 patients with APE confirmed by chest computed tomography (CT) between January 2007 and July 2013, 246 consecutive patients with available echocardiographic data were enrolled in this study. CTEPH was defined as a persistent right ventricular systolic pressure (RVSP) greater than 35 mmHg on echocardiography during follow-up and persistent pulmonary embolism on the follow-up CT.
  
  
  RESULTS
  Fifteen patients (6.1%) had CTEPH. The rate of right ventricular (RV) dilatation (66.7% vs. 28.1%,p= 0.002) and the RVSP (75.5 mmHg vs. 39.0 mmHg,p< 0.001) were significantly higher in the CTEPH group. D-dimers, RV dilatation, RV hypertrophy, RVSP, and intermediate-risk APE were associated with the risk of CTEPH after APE (odds ratio [OR] 0.59, 5.11, 7.82, 1.06, and 4.86, respectively) on univariate analysis. RVSP remained as a significant predictor of CTEPH on multivariate analysis (OR, 1.056; 95% confidence interval, 1.006 to 1.109;p= 0.029).
  
  
  CONCLUSIONS
  This study showed that the incidence of CTEPH after APE in Korea was 6.1% and that initial RVSP by echocardiography was a strong prognostic factor for CTEPH.
authors.affiliation: Division of Cardiology, Medical Research Institute, Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
authors.forename: Jin Sup
authors.initials: JS
authors.lastname: Park
authors.affiliation: Division of Cardiology, Medical Research Institute, Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
authors.forename: Jinhee
authors.initials: J
authors.lastname: Ahn
authors.affiliation: Division of Cardiology, Medical Research Institute, Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Division of Cardiology, Medical Research Institute, Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Medical Research Institute, Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
authors.forename: Jun-Hyok
authors.initials: JH
authors.lastname: Oh
authors.affiliation: Division of Cardiology, Medical Research Institute, Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
authors.forename: Han Cheol
authors.initials: HC
authors.lastname: Lee
authors.affiliation: Division of Cardiology, Medical Research Institute, Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
authors.forename: Kwang Soo
authors.initials: KS
authors.lastname: Cha
authors.affiliation: Division of Cardiology, Medical Research Institute, Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
authors.forename: Taek Jong
authors.initials: TJ
authors.lastname: Hong
mesh_terms: D000368:Aged; D019540:Area Under Curve; D016009:Chi-Square Distribution; D002908:Chronic Disease; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000503:physiopathology; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000453:epidemiology*; D012372:ROC Curve; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013599:Systole; D014057:Tomography, X-Ray Computed; D016278:Ventricular Function, Right; D017725:Ventricular Pressure
keywords: Echocardiography; Hypertension, pulmonary; Pulmonary embolism