Multicentre observational screening survey for the detection of CTEPH following pulmonary embolism

@inproceedings{Coquoz2018MulticentreOS,
  title={Multicentre observational screening survey for the detection of CTEPH following pulmonary embolism},
  author={Nicolas Coquoz and Daniel Weilenmann and Daiana Stolz and Vladimir Popov and Andrea Azzola and J. M. Fellrath and Hans Stricker and A. Pagnamenta and Sebastian R. Ott and Silvia Ulrich and S{\'a}ndor Gy{\"o}rik and J{\'e}r{\^o}me Pasquier and John-David Aubert},
  booktitle={European Respiratory Journal},
  year={2018}
}
Chronic thromboembolic pulmonary hypertension (CTEPH) is a severe complication of pulmonary embolism. [] Key MethodThis prospective, multicentre, observational study (Multicentre Observational Screening Survey for the Detection of Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Following Pulmonary Embolism (INPUT on PE); ISRCTN61417303) included patients with acute pulmonary embolism from 11 centres in Switzerland from March 2009 to November 2016. Screening for possible CTEPH was performed at 6, 12 and…
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Chronic thromboembolic pulmonary hypertension after acute pulmonary embolism: to screen or not to screen?
  • M. Hoeper
  • Medicine
    European Respiratory Journal
  • 2018
TLDR
As the risk of CTEPH in survivors of acute pulmonary embolism is probably in the range of 0.5–1.0%, screening is unlikely to be efficacious and the ongoing debate reflects a lack of robust data.
Chronic thromboembolic pulmonary hypertension
TLDR
Each patient with CTEPH should receive treatment assessment starting with evaluation for pulmonary endarterectomy, which is the guideline recommended treatment, and balloon pulmonary angioplasty should be considered at a centre experienced with this challenging but potentially effective and complementary intervention.
CT-Based Biomarkers for Prediction of Chronic Thromboembolic Pulmonary Hypertension After an Acute Pulmonary Embolic Event.
TLDR
Assessment of CT-based markers predictive of the development of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism found the presence of an occlusive clot on initial imaging is associated with an increased probability of CTEPH development.
Incidence and predictors of chronic thromboembolic pulmonary hypertension following first episode of acute pulmonary embolism.
TLDR
RV diameter, baseline PAP and RV dysfunction were independent predictors of CTEPH, and Multivariate logistic regression demonstrated significant association of RV diameter, and PAP in baseline echocardiography as well as RV strain in CTA with development ofCTEPH.
Diagnosis of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism
TLDR
This review will focus on the clinical presentation of and risk factors for CTEPH, and provide best practices for PE follow-up programmes from expert centres, based on a clinical case.
Diagnosis of chronic thromboembolic pulmonary hypertension: A Canadian Thoracic Society clinical practice guideline update
TLDR
Routine screening for CTEPH following acute PE has not yet been demonstrated in prospective controlled trials to improve patient outcomes, and an approach which follows the recommendations and sequence of testing outlined in this guideline may improve the rate of diagnosis and potentially the outcomes in these patients.
Higher Incidence of Chronic Thromboembolic Pulmonary Hypertension After Acute Pulmonary Embolism in Asians Than in Europeans: A Meta-Analysis
TLDR
The incidence of CTEPH after acute PE is ~3% and the incidence is higher in Asians than Europeans and in retrospective cohorts than prospective cohorts, and in studies with smaller sample size than those with larger sample size.
Clinical and imaging outcomes after intermediate- or high-risk pulmonary embolus
TLDR
It is suggested that follow-up in a dedicated pulmonary hypertension clinic 2–4 months after acute intermediate- or high-risk pulmonary embolism may add value to patient care.
ERS statement on chronic thromboembolic pulmonary hypertension
TLDR
This statement outlines a review of the literature and current practice concerning diagnosis and management of chronic thromboembolic pulmonary hypertension and represents the first collaboration of the European Respiratory Society, the International CTEPH Association and the European Reference Network-Lung in the pulmonary hypertension domain.
A Novel Doppler TRPG/AcT Index Improves Echocardiographic Diagnosis of Pulmonary Hypertension after Pulmonary Embolism
TLDR
A Doppler index TRPG/AcT improves the assessment of symptomatic PE survivors and is a significant predictor of CTEPH + CTED after considering echocardiographic probability.
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References

SHOWING 1-10 OF 44 REFERENCES
Prevalence of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism. Prevalence of CTEPH after pulmonary embolism.
TLDR
Initial echocardiography and CT data at the time of the index PE suggest that a majority of patients with CTEPH had previously unknown pulmonary hypertension, indicating that a first clinical presentation ofCTEPH may mimic acute PE.
Prospective cardiopulmonary screening program to detect chronic thromboembolic pulmonary hypertension in patients after acute pulmonary embolism
TLDR
Wide scale implementation of prolonged follow-up including echocardiography of all patients with pulmonary embolism to detect chronic thromboembolic pulmonary hypertension does not seem to be warranted.
Incidence and risk factors of chronic thromboembolic pulmonary hypertension in patients after acute pulmonary embolism.
TLDR
CTEPH was not rare after acute PE in this Chinese population, especially within 3 years of diagnosis, but lower-limb varicose veins, intermediate-risk PE with elevated SPAP in the acute phase, and residual emboli during follow-up might increase the risk of CTEPH.
To screen or not to screen for chronic thromboembolic pulmonary hypertension after acute pulmonary embolism.
A symptom-related monitoring program following pulmonary embolism for the early detection of CTEPH: a prospective observational registry study
TLDR
A follow-up program based on telephone monitoring of symptoms and further structured evaluation of symptomatic subjects can detect patients with chronic thromboembolic pulmonary hypertension.
Active search for chronic thromboembolic pulmonary hypertension does not appear indicated after acute pulmonary embolism.
Incidence of chronic thromboembolic pulmonary hypertension after a first episode of pulmonary embolism.
TLDR
The incidence of chronic thromboembolic pulmonary hypertension after the first episode of objectively confirmed pulmonary embolism was about 1%, and a diagnosis of CTPH was confirmed in two patients with idiopathic PE.
Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism.
TLDR
D diagnostic and therapeutic strategies for the early identification and prevention of CTPH are needed and a relatively common, serious complication of pulmonary embolism.
Incidence of Symptomatic and Asymptomatic Chronic Thromboembolic Pulmonary Hypertension
Chronic Thromboembolic Pulmonary Hypertension. Epidemiology and Risk Factors.
TLDR
Risk factors most consistently associated with CTEPH are circulating anti-phospholipid antibodies or lupus anticoagulant, increased factor VIII, non-O blood groups, and chronic inflammatory diseases.
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