Habedank D; Opitz C; Karhausen T; Kung T; Steinke I; Ewert R;

Clinical Medicine Insights. Circulatory, Respiratory And Pulmonary Medicine [Clin Med Insights Circ Respir Pulm Med] 2018 Aug 16; Vol. 12, pp. 1179548418794155. Date of Electronic Publication: 20180816 (Print Publication: 2018).

We hypothesized that the slope of relation ventilation to carbon dioxide output (V’E/V’CO2-slope) could be predictive already during the very first days after submassive pulmonary embolism (PE) to right ventricular systolic pressure (RVsys by echocardiography) after 6 months. We evaluated 21 hemodynamically stable patients at admittance, at days 3, 7, 90, and 180 by cardiopulmonary exercise testing and echocardiography. V’E/V’CO2-slope (48.4 ± 10.8) decreased within the first week (43.0 ± 9.8 at day 7) and normalized until follow-up at 6 months (35.0 ± 11.3; P < 10-4), p(a-ET)CO2 remained abnormal between days 1 and 3 (5.0 ± 3.9 to 6.7 ± 5.3 mmHg). RVsys declined from 41.7 ± 14.3 to 26.3±13.1 mmHg (P < 10-4) at 6 months. V’E/V’CO2-slope (r²= 0.27; P < .02) and RVsys (r² = 0.28; P = .03) at day 7 correlated with RVsys at 6 months. p(a-ET)CO2, p(a-ET)O2, V’D/V’T were not related to RVsys after 6 months. RVsys 6 months after acute PE is positively correlated with the V’E/V’CO2-slope at day 7.