Prevalence and Risk Factors of Chronic Thrombo-embolic Disease After a Pulmonary Embolism Event

Centre Hospitalier Universitaire de Nice123 enrolled

Overview

Venous thromboembolic disease (VTE) is a common clinical entity whose two manifestations are deep vein thrombosis (DVT) and pulmonary embolism (PE). After an acute PE, almost half of the patients complain residual dyspnea, despite well-conducted curative anticoagulation. Some will present persistent defects on lung scan-scintigraphy, without pulmonary hypertension. This condition defines Chronic-Thrombo-Embolic Disease(CTED). The prevalence of CTED after PE is poorly known as are its risk factors. The primary objective is to determine the prevalence of CTED at 3 or 6 months, depending on the provoked or unprovoked character, after a PE. The secondary objectives are: * To determine the potential risk factors for the occurrence of CTED. * To look for an association between the persistence of DVT and the occurrence of CTED. * To look for an association between the diagnosis of CTED and PE recurrence during the 12-month follow-up. * To determine the diagnostic performance of the clinician alone compared to the lung scintigraphy (gold standard) for the diagnosis of CTED. * To compare the impact on the quality of life (QoL) with or without CTED. * To determine the correlation between impaired QoL and the degree of residual obstruction on lung scintigraphy.

Study Type

OBSERVATIONAL

Enrollment

123

Conditions

Chronic Emboilism

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 99 Years

Medical Language ↔ Plain English

Inclusion Criteria: * definite PE with expected life expectancy of more than 3 months - Age ≥ 18 years old. * Patients with a first episode of symptomatic pulmonary embolism, diagnosed by CT angiography or pulmonary scintigraphy and treated in a conventional manner. * Having received oral information about the study and having expressed a non-opposition to participate to the study * Benefiting from a social security scheme Exclusion Criteria: * Patients with pulmonary hypertension. * Patients who have already had a recurrence of pulmonary embolism or deep vein thrombosis of the lower limbs. * Patients with a contraindication to performing a lung ventilation-perfusion scintigraphy. * Patients at high risk of recurrence of venous thromboembolic disease (severe thrombophilia or active cancer). * Classical contraindications to anticoagulants. * Vulnerable patients: pregnant women, under guardianship or curatorship * Premature termination of participation * Recurrent pulmonary embolism diagnosed by CT angiography, or deep vein thrombosis diagnosed by venous Doppler ultrasound of the lower limbs within the first 3 or 6 months depending on the nature of the VTE. * Occurence of pulmonary hypertension detected by trans-thoracic ultrasound (systolic pulmonary arterial pressure more than 35 mmgh).

Outcomes

Primary Outcomes

Chronic thrombo-embolic disease (CTED) prevalence

CTED is determined by lung ventilation-perfusion scintigraphy witch detect a persistant obstruction more than 10% of the pulmonary arteries perfusion (defined by amputation of at least two pulmonary segments on V/ Q lung scan).