Doctorate Program in Biomedical Sciences, Postgraduate Unit, National Autonomous University of Mexico, Mexico City, Mexico.
Cardiorespiratory Emergencies, Hospital General de México "Dr Eduardo Liceaga", Mexico City, Mexico.
Asian Cardiovasc Thorac Ann. 2024 Jun;32(5):336-344. doi: 10.1177/02184923241272913. Epub 2024 Aug 12.
Acute pulmonary embolism (APE) is one of the leading causes of cardiovascular emergencies and the third leading cause of death. Although efforts focus on treating the acute event, patients who survive APE may develop long-term sequelae. Research reveals that approximately half of patients who have suffered an APE do not regain their previous level of function and experience a reduction in their quality of life for several years after the episode. Acute pulmonary embolism can be classified according to the risk of short-term mortality, with most mortality and morbidity concentrated in high-risk and intermediate-risk cases. The first-line treatment for APE is systemic anticoagulation. However, identifying and more aggressively treating people with intermediate to high risk, who have a more favorable risk profile for reperfusion treatments, could reduce short-term mortality and mitigate post-pulmonary embolism syndrome (PPES). Post-pulmonary embolism syndrome refers to a variety of persistent symptoms and functional limitations that occur after an APE. The presence of persistent dyspnea, functional limitations, and/or decreased quality of life after an APE has been recently termed "PPES," although this entity encompasses different manifestations. The most severe cause of persistent dyspnea is chronic thromboembolic pulmonary hypertension, where increased pulmonary artery pressure is due to the fibrotic organization of unresolved APE. Post-PE Syndrome is not always systematically addressed in management guidelines, and its prevalence may be underestimated. More research is needed to fully understand its causes and risk factors. Interventions such as cardiopulmonary rehabilitation have been suggested to improve the quality of life of patients with PPES. A comprehensive, evidence-based approach is essential to effectively prevent and manage PPES and improve the long-term outcomes and well-being of affected patients.
急性肺栓塞（APE）是心血管急症的主要原因之一，也是导致死亡的第三大原因。尽管人们致力于治疗急性事件，但幸存的 APE 患者可能会出现长期后遗症。研究表明，大约一半的 APE 患者在事件发生后数年无法恢复到以前的功能水平，生活质量下降。APE 可以根据短期死亡率的风险进行分类，大多数死亡率和发病率集中在高危和中危病例中。APE 的一线治疗是全身抗凝。然而，识别并更积极地治疗中高危人群，这些人群具有更有利于再灌注治疗的风险特征，可能会降低短期死亡率并减轻肺栓塞后综合征（PPES）。肺栓塞后综合征是指 APE 后发生的各种持续症状和功能限制。APE 后持续呼吸困难、功能受限和/或生活质量下降的存在最近被称为“PPES”，尽管该实体包含不同的表现。持续性呼吸困难的最严重原因是慢性血栓栓塞性肺动脉高压，其中由于未解决的 APE 纤维化组织导致肺动脉压升高。PE 后综合征在管理指南中并不总是系统地解决，其流行率可能被低估。需要更多的研究来充分了解其原因和危险因素。心肺康复等干预措施已被建议用于改善 PPES 患者的生活质量。需要采取全面的、基于证据的方法来有效预防和管理 PPES，并改善受影响患者的长期结局和幸福感。
