Predictive Capability of Cardiopulmonary and Exercise Parameters From Day 1 to 6 Months After Acute Pulmonary Embolism. Issue 12 (August 2018)

• Record Type: Journal Article
• Authors: Habedank, Dirk; Opitz, Christian; Karhausen, Tim; Kung, Thomas; Steinke, Ingo; Ewert, Ralf
• Is Part Of: Clinical medicine insights. Issue 12(2018)
• Publication Date: 2018-08
• Subjects: Acute pulmonary embolism -- VE/VCO2-slope -- pulmonary hypertension -- cardiopulmonary exercise testing -- follow-up; Cardiovascular system -- Diseases -- Periodicals; Respiratory organs -- Diseases -- Periodicals; Blood Circulation; Respiration; Lung Diseases; Cardiovascular system -- Diseases; Respiratory organs -- Diseases; Electronic journals; Periodicals; Periodicals; 616.1005
• DOI: 10.1177/1179548418794155
• Languages: English
• ISSNs: 1179-5484

Abstract

We hypothesized that the slope of relation ventilation to carbon dioxide output ( V' E/ V' CO2-slope) could be predictive already during the very first days after submassive pulmonary embolism (PE) to right ventricular systolic pressure (RVsys by echocardiography) after 6 months. We evaluated 21 hemodynamically stable patients at admittance, at days 3, 7, 90, and 180 by cardiopulmonary exercise testing and echocardiography. V' E/ V' CO2-slope (48.4 ± 10.8) decreased within the first week (43.0 ± 9.8 at day 7) and normalized until follow-up at 6 months (35.0 ± 11.3; P < 10 -4 ), p(a-ET)CO2 remained abnormal between days 1 and 3 (5.0 ± 3.9 to 6.7 ± 5.3 mmHg). RVsys declined from 41.7 ± 14.3 to 26.3±13.1 mmHg ( P < 10 –4 ) at 6 months. V' E/ V' CO2-slope ( r ²= 0.27; P < .02) and RVsys ( r ² = 0.28; P = .03) at day 7 correlated with RVsys at 6 months. p(a-ET) CO2, p(a-ET) O2, V' D/ V' T were not related to RVsys after 6 months. RVsys 6 months after acute PE is positively correlated with the V' E/ V' CO2-slope at day 7.