Introduction: Acute PE is common and, since approximately 50% of patients report dyspnoea up to 40 months post PE1 and with wide-ranging potential causes, investigation of causation is potentially resource intensive.
Aims: Utility of full lung function tests (LFTs) in investigation of post-PE dyspnoea.
Methods: Retrospective analysis of 51 patients with persisting dyspnoea > 6 months post-PE. Comparison of LFTs in patients subsequently diagnosed with chronic thromboembolic disease/pulmonary hypertension (CTED/CTEPH) against those without, as assessed by ANOVA.
Results: Mean(SD) age was 55.6(12.5), smoking exposure 10.2(18.3) pack years, BMI 31.7(6.7) and male:female 27:24. LFTs in the 35 patients with CTED/CTEPH did not differ from other patients.
8 (35%) patients had abnormal lung function: 5 had airflow obstruction, 6 had restriction due to elevated BMI. 7 had isolated impairment of gas transfer, 6 of whom had CTED/CTEPH.
| Index |
No CTED/CTEPH Mean (sd) N=16 |
CTED Mean (sd) N=21 |
CTEPH Mean (sd) N=14 |
| FEV1 L | 2.52(0.76) | 3.07(1.03) | 2.91(0.81) |
| FEV1 SR | -1.17(1.14) | -0.70(1.19) | -0.52(0.94) |
| FVC L | 3.39(0.84) | 3.99(1.34) | 3.75(0.91) |
| FVC SR | -0.84(1.07) | -0.58(1.17) | -0.47(0.73) |
| TLCO mM.min.kPa | 7.45(1.45) | 8.42(2.23) | 7.42(2.02) |
| TLCO SR | -0.41(0.83) | -0.34(1.19) | -0.74(0.95) |
| KCO mM.min.kPa.L | 1.47(0.20) | 1.48(0.28) | 1.37(0.23) |
| KCO SR | 0.19(0.90) | 0.02(1.13) | -0.42(1.06) |
| VA L | 5.1(0.98) | 5.76(1.43) | 5.43(1.05) |
| VA SR | -0.74(0.91) | -0.44(1.18) | -0.44(0.77) |
Conclusions: LFTs do not differ significantly in patients with persisting dyspnoea due to CTED / CTEPH. Other abnormalities may be identified.
1. S. R. Kahn et al. Functional and Exercise Limitations After a First Episode of Pulmonary Embolism. Chest 151; 5. 1058?1068.