The Role of Transthoracic Echocardiography in Predicting Mortality in Patients with Chronic Thromboembolic Pulmonary Hypertension

Jola Klosi, Aneida Hodo Vevecka, Prof. Elizana Petrela, Prof. Mihal Tase

Abstract: Aim: To identify echocardiographic parameters who predict mortality of patients with chronic thromboembolic pulmonary hypertension (CTEPH) who did not performed surgical treatment or specific pulmonary vasodilator therapy. Methods: Prospective study, conducted at Department of Internal Medicine, University Hospital Center ?Mother Theresa? in Tirana, Albania. During 2012 ? 2015, 43 patient, survivors of an acute pulmonary embolism (PE) were included in the study and were followed periodically, after 3, 9, 15 and 24 months. Mean age of patients was 64.23?10.70 years old (31 females). Diagnosis of PE has been determined through pulmonary computer tomography and scintigraphy. CTEPH was diagnosed in 12 (28%) of 43 patients (pulmonary artery systolic pressure (PAsP) >45 mmHg, at least 3 months after PE und effective anticoagulation) among which 5 patients (41%) died during follow up period. We have determined through a detailed statistical analysis the echocardiographic parameters predictors of mortality in this study. Results: It was seen a strong statistical correlation between mortality and TAPSE (13.34?1.42; p=0.008). Moreover there is a relation between mortality and right ventricle ejection fraction (RVEF) (36.74?1.43; p=0.01) also between mortality and pulmonary velocity acceleration time (PVAT) (74.3?11.45; p=0.001). There is no correlation between mortality and PAsP (p=0.14); Conclusion: The most important echocardiographic parameters which are found statistically significant as predictive factors of mortality, in our group of patients, reflect mainly the systolic function of the right ventricle (RVEF, TAPSE and TAP). In the present study, PAsP was not a predictive factor of mortality.

Keywords: CTEPH, mortality, predictive factors, echocardiography