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Minerva Cardiology and Angiology 2022 October;70(5):545-54

DOI: 10.23736/S2724-5683.21.05575-7

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Chronic thromboembolic pulmonary hypertension risk score evaluation and validation (CTEPH SOLUTION): proposal of a study protocol aimed to realize a validated risk score for early diagnosis

Cristiano MIOTTI 1, Andrea M. D’ARMINI 2, Beatrice SCARDOVI 3, Stefano GHIO 4, Gianfranco SINAGRA 5, Walter SERRA 6, Antonella ROMANIELLO 7, Giuseppe GALGANO 8, Loris RONCON 9, Michele D’ALTO 10, Daniela GIANNAZZO 11, Patrizio VITULO 12, Amedeo BONGARZONI 13, Matteo RUZZOLINI 14, Carlo ALBERA 15, Gavino CASU 16, Martina PERAZZOLO MARRA 17, Sante D. PIERDOMENICO 18, Federico LUONGO 1, Giovanna MANZI 1, Silvia PAPA 1, Gianmarco SCOCCIA 1, Nadia CEDRONE 1, Roberto BADAGLIACCA 1, Carmine D. VIZZA 1

1 Department of Cardiovascular and Respiratory Sciences, Sapienza University, Rome, Italy; 2 Section of Cardiac Surgery, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, San Matteo Polyclinic Hospital, Pavia, Italy; 3 Unit of Cardiology, Santo Spirito in Saxia Hospital, Rome, Italy; 4 S. Matteo Plyclinic Hospital, Pavia, Italy; 5 Department of Cardiovascular Surgery, Ospedali Riuniti Hospital, Trieste, Italy; 6 Unit of Cardiology, Maggiore Hospital, AOU Parma, Parma, Italy; 7 Unit of Cardiology, Sant’Andrea Hospital, Rome, Italy; 8 Unit of Cardiology and Intensive Care, Francesco Miulli Regional Hospital, Acquaviva delle Fonti, Bari, Italy; 9 Division of Cardiology, ULSS 18 Rovigo, Santa Maria della Misericordia Hospital, Rovigo, Italy; 10 Department of Cardiology, Monaldi Hospital, L. Vanvitelli University, Naples, Italy; 11 Division of Cardiology, Ferrarotto Hospital, AOU Policlinico Vittorio Emanuele, Catania, Italy; 12 Department of Pneumology, Mediterranean Institute of Trasplantation and Highly-Specialized Therapetics (ISMETT), Palermo, Italy; 13 Department of Cardiology, San Carlo Borromeo Hospital, Milan, Italy; 14 Unit of Cardiology and Intensiva Care, San Giovanni Calibita Fatebenefratelli Hospital, Rome, Italy; 15 Service of Pneumology, Molinette Hospital, Turin, Italy; 16 Unit of Cardiology, San Francesco Hospital, Nuoro, Italy; 17 Department of Cardiologic, Thoracic, and Vascular Sciences, AOU Padua, Padua, Italy; 18 Unit of Cardiovascular Diseases, Department of Medical and Oral Sciences and Biotechnologies, G. d’Annunzio University, Chieti, Italy



BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) is the most serious long-term complication of acute pulmonary embolism (PE) though it is the only potentially reversible form of pulmonary hypertension (PH). Its incidence is mainly limited to the first 2 years following the embolic event, however it is often underdiagnosed or misdiagnosed.
METHODS: This is a multicenter observational cross-sectional and prospective study. Patients with a prior diagnosis of PE will be enrolled and undergo baseline evaluation for prevalent PH detection through a clinical examination and an echocardiogram as first screening exam. All cases of intermediate-high echocardiographic probability of PH will be confirmed by right heart catheterization and then identified as CTEPH through appropriate imaging and functional examinations in order to exclude other causes of PH. A CTEPH Risk Score will be created using retrospective data from this prevalent cohort of patients and will be then validated on an incident cohort of patients with acute PE.
RESULTS: One thousand retrospective and 218 prospective patients are expected to be enrolled and the study is expected to be completed by the end of 2021. Up to now 841 patients (620 retrospective and 221 prospective) have been enrolled.
CONCLUSIONS: This study is the first large prospective study for the prediction of CTEPH development in patients with PE. It aims to create a comprehensive scoring tool that includes echocardiographic data which may allow early detection of CTEPH and the application of targeted follow-up screening programs in patients with PE.


KEY WORDS: Thromboembolism; Pulmonary hypertension; Risk factors; Echocardiography; Incidence

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