• Mazdak Tavoly, Hilde S Wik, Per-Anton Sirnes, Lars-Petter Jelsness-Jørgensen, Josef P Ghanima, Frederikus A Klok, Per-Morten Sandset, and Waleed Ghanima.
• Department of Medicine, Østfold 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.
• Thromb. Res. 2018 Nov 1; 171: 84-91.

IntroductionRecent 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.AimsTo 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 MethodsIn this cross-sectional study, consecutive patients diagnosed with PE between 2002 and 2011 at Østfold 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).Results203 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.ConclusionsPE-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.Copyright © 2018 Elsevier Ltd. All rights reserved.

20 keywords...

hide…