ArticleClinical research in cardiology : official journal of the German Cardiac Society2026
Post-pulmonary embolism cardiac impairment and chronic thromboembolic pulmonary hypertension after ultrasound-assisted catheter-directed thrombolysis for acute pulmonary embolism.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSparse data are available on the long-term course of acute pulmonary embolism (PE) after ultrasound-assisted catheter-directed thrombolysis (USAT).
methodsWe included consecutive patients with intermediate-high or high-risk acute PE treated with USAT (alteplase 20 mg over 15 h) and therapeutic anticoagulation at a tertiary center, who underwent a structured post-interventional follow-up. The following outcomes were analyzed for patients with at least 3 months of follow-up: all-cause death, persistent dyspnea, symptomatic post-PE cardiac impairment, chronic thromboembolic pulmonary hypertension (CTEPH) or chronic thromboembolic pulmonary disease (CTEPD). Symptomatic post-PE cardiac impairment was defined as residual respiratory symptoms with at least one echocardiographic parameter of right ventricular dysfunction.
resultsAmong 300 patients (41% women, median age 65 [52-74] years), 254 (85%) had intermediate-high and 46 (15%) had high-risk PE. Follow-up data beyond the first 3 months (median 6.1 [3.6-12] months) were available for 260 (88%) survivors. At follow-up, 45 (17%) patients reported persistent respiratory symptoms and 18 (6.9%) met the criteria for post-PE cardiac impairment. CTEPH was diagnosed in 7 (2.7%) patients, deemed pre-existing in all cases based on radiological reassessment of index imaging. CTEPD was confirmed in 2 (0.8%) patients. The 1-year death rate was 2.9% after intermediate-high risk and 21% after high-risk PE.
conclusionsAfter a median of 6 months after acute PE, almost one in five patients treated with USAT had persistent respiratory symptoms, although post-PE cardiac impairment was rare. CTEPH was diagnosed in 2.7% of patients and deemed pre-existing in all cases.
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