A simple non-invasive diagnostic algorithm for ruling out chronic thromboembolic pulmonary hypertension in patients after acute pulmonary embolism.

摘要: Abstract Background Our aim was to construct a diagnostic model for ruling out chronic thromboembolic pulmonary hypertension (CTEPH) in symptomatic patients after acute embolism (PE) that is based on simple, non-invasive tests. Methods Plasma levels of various CTEPH associated biomarkers and conventional ECG criteria right ventricular pressure overload were assessed 82 consecutive with confirmed 160 history PE who suspected have CTEPH, but whom this disease ruled out. Results hypertrophy detected more frequently (77%) than the without (11%, Odds ratio 26, 95% confidence interval [CI] 13–53). Also, clotting factor FVIII activity N-terminal-pro-brain-type natriuretic peptide (NT-pro-BNP), Growth Differentiation Factor-15, C-reactive protein urate, not D-dimer level, higher CTEPH. A including NT-pro-BNP had sensitivity 94% (95% CI 86-98%) specificity 65% 56-72%). The area under receiver-operator-characteristic curve 0.80 0.74-0.85) diagnosis Even high prevalences up 10%, negative predictive value proved be very (99%, 97-100%). Conclusions Ruling seems safe additional testing absence indicative normal level.