Prevalence and clinical predictors of persistent perfusion defects after acute pulmonary embolism

Amato, Rossella D; Martín, M. Purificación Ramírez

doi:10.1183/1393003.congress-2017.pa566

Cited by 1 publication

(3 citation statements)

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“…Three types of functional tests were reported: CPET in two studies [ 21 , 25 , 26 ], ISWT in one study [ 23 ] and 6MWT in three studies [ 17 , 27 , 28 ]. For CPET outcomes, the percentage of predicted V ′ O 2 at maximal exercise ( V ′ O 2 peak ) reported was higher in patients with pulmonary perfusion defects or residual vascular obstruction in one study, but the difference was not significant, while another study reported significantly lower V ′ O 2 peak ( table 2 ) [ 21 , 25 , 26 ].…”

Section: Resultsmentioning

confidence: 99%

“…Three types of functional tests were reported: CPET in two studies 22,26,27 , ISWT in one study 24 , and 6-MWT reported in three studies. 18,28,29 For CPET outcomes, the percentage of predicted oxygen consumption at maximal exercise (V'O 2 -peak) reported was higher in patients with pulmonary perfusion defects or residual vascular obstruction in one study, but the difference was not significant, while another study reported significantly lower V'O 2 -peak (Table 2). 22,26,27 Patients with pulmonary perfusion defects or residual vascular obstruction had a higher V'E/V'CO 2 ratio compared to patients with a normal VQ-scan/CTPA, reflecting decreased ventilatory efficiency due to increased dead space ventilation (Table 2).…”

Section: Quality Of Life and Functional Testsmentioning

confidence: 96%

“…Overall, 12 studies provided data on presence of pulmonary perfusion defects or residual vascular obstruction during acute PE follow-up as well as functional outcomes and were included in this systematic review. [17][18][19][20][21][22][23][24][25][26][27][28][29]…”

Section: Study Selectionmentioning

confidence: 99%

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Pulmonary perfusion defects or residual vascular obstruction and persistent symptoms after pulmonary embolism: a systematic review and meta-analysis

Cimini,

Luijten,

Barco

et al. 2024

ERJ Open Res

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IntroductionUp to 50% of pulmonary embolism (PE) patients has perfusion defects or residual vascular obstruction during follow-up despite adequate anticoagulant treatment and a similar percentage experience chronic functional limitations and/or dyspnea post-PE. We aimed to evaluate the association between pulmonary perfusion defects or residual vascular obstruction and functional recovery after PE.MethodsWe performed a systematic review and meta-analysis including studies assessing both the presence of perfusion defects or residual vascular obstruction and functional recovery (i.e.persistent symptoms, quality of life, exercise endurance). An odds-ratio (OR) was pooled for perfusion defects or residual vascular obstruction and persistent symptoms using a random-effect model.Results12 studies were included totaling 1888 PE patients; at a median of 6 months after PE (range 2–72), 34% had perfusion defects or residual vascular obstruction and 37% reported persistent symptoms. Among patients with perfusion defects or residual vascular obstruction, 48% (95%CI 37–60, I2=82%) remained symptomatic during follow-up, compared to 34% (95%CI 20–51, I2=96%) of patients without such defects. Presence of perfusion defects or residual vascular obstruction was associated with persistent symptoms (OR 2.15, 95%CI 1.66–2.78; I2=0%, τ=0). Notably, there was no association between these defects and quality of life or cardiopulmonary exercise test parameters.ConclusionWhile the odds of having persistent symptoms was higher in patients with perfusion defects or residual vascular obstruction after acute PE, a significant proportion of these patients reported no limitations. A possible causality between perfusion defects or residual vascular obstruction and residual functional limitation therefore remains to be proven.

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