The incidence of chronic thromboembolic pulmonary hypertension in asympthomatic pulmonary embolism patients

More than half of patients with chronic thromboembolic pulmonary hypertension (CTEPH) have no acute pulmonary embolism history with clinical signs, so determining of actual incidence and prevalence of CTEPH is difficult. At this study, we aimed to search especially asympthomatic CTEPH incidence and the risk factors those may be associated with CTEPH in patients who had acute PTE. One hundred twelve patients with acute pulmonary embolism diagnosed by thorax CT or ventilation/perfussion scintigraphy in our clinic included into the study. Patients that have risk factors for pulmoner hypertension other than thromboembolic disease were excluded. The results arterial blood gas (ABG) analysis, levels of D-Dimer, troponin, doppler ultrasonography of lower extremities on admission were recorded. Thorax CT, and echocardiography studies, both on admission and at 6 th month, were also recorded. Presence of pulmonary hypertension (PHT) (systolic PAB>35 mmHg) was determined on 6 th month in 45 of 112 patients (37 of them were asympthomatic) and asympthomatic CTEPH incidence was identified as 33.03%. We determined that CTEPH risk was increased 4.59 times by being male sex (95% CI 1.071-19.683, p=0.040), 218 times by previous history of deep vein thrombosis (DVT) (95% CI 1.235-38543.073, p=0.041), and 56.903 times by PaO 2 In conclusion, asympthomatic CTEPH development after PTE may be frequently seen. If probable risk factors is known, patients can be closely monitorize for CTEPH development.