PMID- 30267974
OWN - NLM
STAT- MEDLINE
DCOM- 20190114
LR  - 20190114
IS  - 1879-2472 (Electronic)
IS  - 0049-3848 (Linking)
VI  - 171
DP  - 2018 Nov
TI  - The impact of post-pulmonary embolism syndrome and its possible determinants.
PG  - 84-91
LID - S0049-3848(18)30532-2 [pii]
LID - 10.1016/j.thromres.2018.09.048 [doi]
AB  - INTRODUCTION: Recent studies suggest that up to 50% of patients surviving 
      pulmonary embolism (PE) may suffer from post-PE syndrome, which is defined by 
      persistent dyspnea, impaired exercise capacity and/or decreased health-related 
      quality of life (HRQoL). The possible determinants of post-PE syndrome are 
      however not fully established. AIMS: To describe the differences between dyspneic 
      and non-dyspneic PE-patients and to explore determinants of dyspnea, 6-min 
      walking test (6MWT) and HRQoL. MATERIAL AND METHODS: In this cross-sectional 
      study, consecutive patients diagnosed with PE between 2002 and 2011 at Ostfold 
      Hospital, Norway were identified from hospital registries. Patients were 
      scheduled for clinical examination and a 6MWT. Dyspnea was assessed by the New 
      York Heart Association (NYHA) classification. HRQoL was assessed with PEmb-QoL 
      questionnaire. PE severity was assessed with PESI score, mean bilateral proximal 
      extent of the clot and right-/left ventricle-ratio (RV/LV-ratio). RESULTS: 203 
      patients participated in this study, of which 96 patients reported dyspnea (47%). 
      Median time from diagnosis was 3.6 years (IQR 1.9-6.5). Patients without dyspnea 
      performed better on 6MWT (488 m vs 413 m, p < 0.005) and had better HRQoL results 
      (p < 0.005). None of the variables we examined, including Charlson comorbidity 
      index, was independently associated with dyspnea. However, higher RV/LV ratio at 
      diagnosis was significantly associated with reduced 6MWT at follow-up. Further, 
      ongoing anticoagulation and unemployment were independently associated with 
      impaired HRQoL. CONCLUSIONS: PE-survivors complaining of dyspnea suffer from 
      impaired HRQoL and reduced exercise capacity. Although PE-severity factors were 
      associated with reduced exercise capacity, none of the examined factors were 
      found to be independent determinants of dyspnea.
CI  - Copyright (c) 2018 Elsevier Ltd. All rights reserved.
FAU - Tavoly, Mazdak
AU  - Tavoly M
AD  - Department of Medicine, Ostfold Hospital Trust, Sarpsborg, Norway; Institute of 
      Clinical Medicine, University of Oslo, Oslo, Norway; Department of Medicine, 
      Sahlgrenska University Hospital, Gothenburg, Sweden. Electronic address: 
      mazdak.tavoly@vgregion.se.
FAU - Wik, Hilde S
AU  - Wik HS
AD  - Department of Haematology, Oslo University Hospital Rikshospitalet, Oslo, Norway.
FAU - Sirnes, Per-Anton
AU  - Sirnes PA
AD  - Cardiology Practice, Ostlandske Hjertesenter, Moss, Norway.
FAU - Jelsness-Jorgensen, Lars-Petter
AU  - Jelsness-Jorgensen LP
AD  - Department of Medicine, Ostfold Hospital Trust, Sarpsborg, Norway; Department of 
      Health Science, Ostfold University College, Fredrikstad, Norway.
FAU - Ghanima, Josef P
AU  - Ghanima JP
AD  - Department of Medicine, Ostfold Hospital Trust, Sarpsborg, Norway.
FAU - Klok, Frederikus A
AU  - Klok FA
AD  - Department of Thrombosis and Hemostasis, Leiden University Medical Center, 
      Leiden, the Netherlands.
FAU - Sandset, Per-Morten
AU  - Sandset PM
AD  - Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of 
      Haematology, Oslo University Hospital Rikshospitalet, Oslo, Norway.
FAU - Ghanima, Waleed
AU  - Ghanima W
AD  - Department of Medicine, Ostfold Hospital Trust, Sarpsborg, Norway; Department of 
      Haematology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
LA  - eng
PT  - Journal Article
DEP - 20180915
PL  - United States
TA  - Thromb Res
JT  - Thrombosis research
JID - 0326377
SB  - IM
MH  - Adult
MH  - Aged
MH  - Dyspnea/*etiology/physiopathology
MH  - Echocardiography
MH  - Exercise Test
MH  - Exercise Tolerance
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Embolism/*complications/physiopathology
MH  - Quality of Life
OTO - NOTNLM
OT  - Dyspnea
OT  - Exercise capacity
OT  - Post-PE syndrome
OT  - Pulmonary embolism
OT  - Quality of life
EDAT- 2018/09/30 06:00
MHDA- 2019/01/15 06:00
CRDT- 2018/09/30 06:00
PHST- 2018/05/21 00:00 [received]
PHST- 2018/08/21 00:00 [revised]
PHST- 2018/09/15 00:00 [accepted]
PHST- 2018/09/30 06:00 [pubmed]
PHST- 2019/01/15 06:00 [medline]
PHST- 2018/09/30 06:00 [entrez]
AID - S0049-3848(18)30532-2 [pii]
AID - 10.1016/j.thromres.2018.09.048 [doi]
PST - ppublish
SO  - Thromb Res. 2018 Nov;171:84-91. doi: 10.1016/j.thromres.2018.09.048. Epub 2018 
      Sep 15.