Abstract：
UNASSIGNED: Electrocardiogram (ECG) and measurement of plasma brain natriuretic peptides (BNP) are established markers of right ventricular dysfunction (RVD) in the setting of acute pulmonary embolism (PE) but their value at long-term follow-up is largely unknown. The purpose of this prospective study was to determine the prevalence of ECG abnormalities, describe levels of N-terminal proBNP (NT-proBNP), and establish their association with dyspnea at long-term follow-up after PE.
UNASSIGNED: All Swedish patients diagnosed with acute PE in 2005 (n = 5793) were identified through the Swedish National Patient Registry. Surviving patients in 2007 (n = 3510) were invited to participate. Of these, 2105 subjects responded to a questionnaire about dyspnea and comorbidities. Subjects with dyspnea or risk factors for development of chronic thromboembolic pulmonary hypertension were included in the study in a secondary step, which involved collection of blood samples and ECG registration.
UNASSIGNED: Altogether 49.3% had a completely normal ECG. The remaining participants had a variety of abnormalities, 7.2% had atrial fibrillation/flutter (AF). ECG with any sign of RVD was found in 7.2% of subjects. Right bundle branch block was the most common RVD sign with a prevalence of 6.4%. An abnormal ECG was associated with dyspnea. AF was associated with dyspnea, whereas ECG signs of RVD were not. 61.2% of subjects had NT-proBNP levels above clinical cut-off (>125 ng/L). The degree of dyspnea did not associate independently with NT-proBNP levels.
UNASSIGNED: We conclude that the value of ECG and NT-proBNP in long term follow-up after PE lies mostly in differential diagnostics.
UNASSIGNED: All Swedish patients diagnosed with acute PE in 2005 (n = 5793) were identified through the Swedish National Patient Registry. Surviving patients in 2007 (n = 3510) were invited to participate. Of these, 2105 subjects responded to a questionnaire about dyspnea and comorbidities. Subjects with dyspnea or risk factors for development of chronic thromboembolic pulmonary hypertension were included in the study in a secondary step, which involved collection of blood samples and ECG registration.
UNASSIGNED: Altogether 49.3% had a completely normal ECG. The remaining participants had a variety of abnormalities, 7.2% had atrial fibrillation/flutter (AF). ECG with any sign of RVD was found in 7.2% of subjects. Right bundle branch block was the most common RVD sign with a prevalence of 6.4%. An abnormal ECG was associated with dyspnea. AF was associated with dyspnea, whereas ECG signs of RVD were not. 61.2% of subjects had NT-proBNP levels above clinical cut-off (>125 ng/L). The degree of dyspnea did not associate independently with NT-proBNP levels.
UNASSIGNED: We conclude that the value of ECG and NT-proBNP in long term follow-up after PE lies mostly in differential diagnostics.
摘要：
■心电图（ECG）和血浆脑钠肽（BNP）的测量是急性肺栓塞（PE）情况下右心室功能障碍（RVD）的确定标志，但它们在长期随访中的价值尚不清楚。这项前瞻性研究的目的是确定心电图异常的患病率，描述N末端proBNP（NT-proBNP）的水平，并确定其与PE后长期随访中呼吸困难的关系。
■所有在2005年诊断为急性PE的瑞典患者（n=5793）均通过瑞典国家患者登记处进行鉴定。2007年存活的患者（n=3510）被邀请参加。其中,2105名受试者回答了关于呼吸困难和合并症的问卷。有呼吸困难或发展为慢性血栓栓塞性肺动脉高压的危险因素的受试者被纳入研究的次要步骤。其中涉及血液样本的收集和心电图登记。
■总共49.3％的心电图完全正常。其余参与者有各种异常，7.2%有心房颤动/扑动(AF)。在7.2%的受试者中发现具有任何RVD征象的ECG。右束支传导阻滞是最常见的RVD征象，患病率为6.4%。心电图异常与呼吸困难有关。房颤与呼吸困难有关，而RVD的ECG征象没有。61.2%的受试者的NT-proBNP水平高于临床临界值(>125ng/L)。呼吸困难程度与NT-proBNP水平无关。
■我们得出的结论是，在PE后的长期随访中，ECG和NT-proBNP的价值主要在于鉴别诊断。
■所有在2005年诊断为急性PE的瑞典患者（n=5793）均通过瑞典国家患者登记处进行鉴定。2007年存活的患者（n=3510）被邀请参加。其中,2105名受试者回答了关于呼吸困难和合并症的问卷。有呼吸困难或发展为慢性血栓栓塞性肺动脉高压的危险因素的受试者被纳入研究的次要步骤。其中涉及血液样本的收集和心电图登记。
■总共49.3％的心电图完全正常。其余参与者有各种异常，7.2%有心房颤动/扑动(AF)。在7.2%的受试者中发现具有任何RVD征象的ECG。右束支传导阻滞是最常见的RVD征象，患病率为6.4%。心电图异常与呼吸困难有关。房颤与呼吸困难有关，而RVD的ECG征象没有。61.2%的受试者的NT-proBNP水平高于临床临界值(>125ng/L)。呼吸困难程度与NT-proBNP水平无关。
■我们得出的结论是，在PE后的长期随访中，ECG和NT-proBNP的价值主要在于鉴别诊断。
