Predictors of pulmonary hypertension after intermediate-to-high risk pulmonary embolism

Abstract

Background: Pulmonary embolism (PE) is a common cardiovascular emergency that, when combined with chronic thromboembolic pulmonary hypertension (PH), is associated with high mortality and morbidity. We aimed to determine the incidence of and predisposing factors for the development of PH after a PE episode.

Methods: A retrospective study was conducted in 213 patients admitted to an intensive care unit with intermediate-to-high risk PE between 2000 and 2010. Clinical data at admission were collected and the incidence of PH as assessed by echocardiography (estimated pulmonary systolic artery pressure over 40 mmHg) was determined. Multivariate analysis was used to determine predictors of development of PH.

Results: PH was detected in 12.4% of patients after a mean follow-up of three years. Only age (hazard ratio [HR] 1.09, 95% confidence interval [CI] 1.02-1.20 per year; p=0.012) and body mass index (HR 1.19, 95% CI 1.04-1.36) per kg/m2, p=0.013) emerged as independent predictors of the development of this complication during follow-up.

Conclusions: PH after PE was a relatively common complication in our series. We identified advanced age and increased body mass index as predisposing factors.

Keywords: Age; Body mass index; Chronic thromboembolic pulmonary hypertension; Fatores de risco; Hipertensão pulmonar tromboembólica crónica; Idade; Obesidade; Obesity; Pulmonary embolism; Risk factors; Tromboembolia-pulmonar; Índice de massa corporal.