CORRELATION OF RVD AFTER ACUTE PULMONARY EMBOLISM AND THROMBOEMBOLIC EVENTS RECURRENCE: FOLLOW UP STUDY
Main Article Content
Keywords
acute pulmonary embolism, right ventricular dysfunction, recurrent thromboembolic episodes.
Abstract
Background : Acute pulmonary embolism may lead to a serious consequence known as right ventricular dysfunction, which has a substantial influence on patient outcomes and requires meticulous treatment. An acute pulmonary embolism occurs when a blood clot becomes lodged in the pulmonary arteries, blocking blood flow to the lungs. This blockage may result in elevated pressure in the pulmonary circulation, putting stress on the right ventricle of the heart.
Aim: This study aims to investigate the relationship between persistent right ventricular dysfunction (RVD) after hospital discharge following acute pulmonary embolism (PE) and the occurrence of recurrent thromboembolic events during a one-year follow-up period.
Method: The study included a group of 79 persons who were admitted to Banha teaching hospital and Zhraa hospital, Faculty of Medicine for girls with acute pulmonary embolism from May 2021 to May 2022. Acute pulmonary embolism (PE) was confirmed using computed tomography (CT) pulmonary angiography. Exclusion criteria included patients having a proven medical history of recurrent pulmonary embolism, chronic obstructive lung disease, congestive heart failure, and evidence of right ventricular hypertrophy on echocardiography. Patients with a history of deep vein thrombosis (DVT) were included. A thorough evaluation, which including Duplex ultrasonography, was conducted at the first hospitalization to differentiate between new deep vein thrombosis (DVT) and previous occurrences.
Results Age was found to be a factor influencing RVD persistence, with younger individuals showing higher rates. The study also compared concurrent illnesses and risk factors for venous thromboembolism. The results revealed the presence of statistically significant differences between study groups regarding recurrent thromboembolic event. The RVD Regression group had a higher incidence of both DVT and acute pulmonary embolism, while the Persistence group had a higher percentage of patients receiving thrombolysis. As nearly half of those with RVD persistence (48.15%) developed recurrent DVT, while recurrent DVT was observed in only 10.34% among those who had no RVD.
Conclusion: The results may provide valuable insights for developing risk stratification models, making therapy choices, and establishing long-term care plans for persons with persistent RVD. Acquiring this information has the capacity to enhance the quality of treatment and results for individuals who previously had acute pulmonary embolism.
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Amr Ibrahim EL Sayed Shehata
Department of Cardiology, Benha teaching hospital, General organization for teaching hospitals and institutes, Cairo, Egypt.
Shimaa Mohamed Mohamed Ahmed
Department of Radio-diagnosis, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
Doaa Lotfy Ali
Department of Radio-diagnosis, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
Lobna Kh. Sakr
Department of Radio-diagnosis, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
Elsayed Mohamed Abd El-Hamid Hassan
Department of Radiology, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
Zeinab Adawy
Department of chest diseases, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
Sawsan Bakr Elsawy
Department of chest diseases, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
Heba Anwar Shoman
Department of Internal medicine, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
Eman Roshdey Mohamed Mostafa
Department of Internal medicine, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt.
Ahmed Mohammed Hassan Mostafa
Consultant of intensive care medicine national heart institute
Khalid Omar Hassan
Senior specialist Medical intensive care unit Rashid hospital, Dubai, UAE
Mohamed Gamil Mehanna
Central laboratories of the egyptian ministry of health, Alexandria Governorate, Egypt.