Hamostaseologie 2018; 38(01): 22-32
DOI: 10.5482/HAMO-17-06-0020
Review
Schattauer GmbH

Follow-up after acute Pulmonary Embolism

Predicting chronic thromboembolic pulmonary hypertension and post-pulmonary embolism syndromeNachsorge bei akuter Lungenembolie: Vorhersage einer chronisch thromboembolischen pulmonalen Hypertonie und eines chronischen Lungenembolie-Syndroms
Frederikus A. Klok
1   Center for Thrombosis and Hemostasis, University Hospital of the Johannes Gutenberg University Mainz, Mainz, Germany
2   Department of Thrombosis and Hemostasis, Leiden University Medical Center, Leiden, the Netherlands
,
Stefano Barco
1   Center for Thrombosis and Hemostasis, University Hospital of the Johannes Gutenberg University Mainz, Mainz, Germany
› Author Affiliations

Frederikus Klok reports research grants from Bayer, research grants from Bristol-Myers Squibb, research grants from Boehringer-Ingelheim, research grants from MSD and non-financial research support from Daiichi-Sankyo. Stefano Barco has received congress and travel payments from Daiichi-Sankyo and Bayer HealthCare. The work of Frederikus Klok and Stefano Barco is supported by the German Federal Ministry of Education and Research (BMBF 01EO1003 and 01EO1503).
Further Information

Correspondence to:

F.A. Klok
Department of Thrombosis and Hemostasis
LUMC
Albinusdreef 2
2300 RC Leiden

Publication History

received: 20 June 2017

accepted in revised form: 11 December 2017

Publication Date:
26 February 2018 (online)

 

Summary

In addition to among others major bleeding from anticoagulant therapy and recurrent venous thromboembolism (VTE), patients who survived acute pulmonary embolism (PE) face an increased risk of chronic functional limitations and decreased quality of life. In recent years, this latter complications have been better framed within the evolving definition of “post-PE syndrome” of which chronic thromboembolic pulmonary hypertension (CTEPH) represents the most extreme presentation. The post-PE syndrome in all its aspects is a frequent and clinically relevant long-term complication of PE but -except for CTEPH- has been largely understudied. There is great need to better define and understand the natural course of acute PE, to predict the development of the post-PE syndrome and to evaluate the potential benefits evolving treatments such as cardiopulmonary rehabilitation.


Zusammenfassung

Über Komplikationen wie größere Blutungen infolge der Antikoagulation oder rezidivie-rende venöse Thrombembolien (VTE) hinaus, haben Patienten, die eine akute Lungenem-bolie (LE) überlebt haben, ein erhöhtes Risiko für chronische funktionelle Einschränkungen und eine reduzierte Lebensqualität. Letztere werden neuerdings in dem aufkommenden Begriff des chronischen LE-Syndroms (“Post-LE-Syndrom”) zusammengefasst, das seine extremste Ausprägung in der chronisch thromboembolischen pulmonalen Hypertonie (CTEPH) findet. Das chronische LE-Syndrom in all seinen Aspekten ist eine häufige und klinisch relevante Langzeitkomplikation der LE, wurde jedoch – mit Ausnahme der CTEPH – nur unzureichend untersucht. Es ist drin-gend erforderlich, den natürlichen Verlauf ei-ner akuten LE besser zu definieren und zu verstehen, um die Entwicklung eines chroni-schen LE-Syndroms vorherzusagen und den potenziellen Nutzen neuer Behandlungsfor-men, wie der kardiopulmonalen Rehabilitation, zu evaluieren.


 


Authorship statement Both authors have contributed significantly to and approve of this manuscript.



Correspondence to:

F.A. Klok
Department of Thrombosis and Hemostasis
LUMC
Albinusdreef 2
2300 RC Leiden