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The aim of this study is to investigate the association between endothelial dysfunction, measured by RHI as assessed by the peripheral arterial tonometry method, and PE complications defined as re-event of PE or DVT, systemic embolism or all-cause mortality
200 Patients will be identified through routine daily scanning of imaging records (CT, Echocardiography) for patients diagnosed with PE. Presenting signs and symptoms as well as clinical and imaging findings during the initial presentation and hospitalization will be incorporated into a computerized pre-specified electronic CRF. During hospitalization, an endothelial function test will be performed 48 hours post admission. A trained technician will perform the test using the EndoPAT device in order to assess patient RHI, a score less than 1.67 will be considerate as endothelial dysfunction. Patients will then be followed for pre-specified clinical events of up to 1 year post discharge and especially the development of chronic thromboembolic pulmonary disease, post thrombotic syndrome and clinical events. RHI will be assessed during 1-year follow up visit.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Normal endothelial function | patients diagnosed with PE and have normal endothelial function test- RHI score >=1.67 |
| |
| Endothelial dysfunction group | patients diagnosed with PE and have endothelial function- RHI<1.67 |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Endothelial dysfunction test | Diagnostic Test | The endothelial function test will be assessed after 48 hours post admission and 1 year post discharge using the non-invasive Endo-PAT2000 device. The device is intended for use as a diagnostic aid in the detection of coronary artery endothelial dysfunction (positive or negative) using a reactive hyperemia procedure. It is based on the use of Peripheral Arterial Tone (PAT) signal technology, during a clinically established procedure, which measure post-ischemic vascular responsiveness following upper arm blood flow occlusion. |
| Measure | Description | Time Frame |
|---|---|---|
| Post PE complications | The aim of this study is to investigate the association between endothelial dysfunction, measured by RHI as assessed by the peripheral arterial tonometry method, and PE complications defined as re-event of PE or DVT, systemic embolism or all-cause mortality | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Augmentation Index (AI) | To investigate the association between arterial stiffness as measured by Augmentation Index and post PE complications. | 2 years |
| HRV | To investigate the association between Heart Rate Variability and post PE complications. |
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Inclusion Criteria:
Exclusion Criteria:
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250 Stable patients hospitalized in ICCU or Cardiology department with a diagnosis of acute PE according to CT scanning or nuclear imaging
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Nir Shlomo, MSc | Contact | 052-7205057 | nir.shlomo@sheba.health.gov.il |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 18296591 | Background | Heit JA. The epidemiology of venous thromboembolism in the community. Arterioscler Thromb Vasc Biol. 2008 Mar;28(3):370-2. doi: 10.1161/ATVBAHA.108.162545. No abstract available. | |
| 17938798 | Background | Cohen AT, Agnelli G, Anderson FA, Arcelus JI, Bergqvist D, Brecht JG, Greer IA, Heit JA, Hutchinson JL, Kakkar AK, Mottier D, Oger E, Samama MM, Spannagl M; VTE Impact Assessment Group in Europe (VITAE). Venous thromboembolism (VTE) in Europe. The number of VTE events and associated morbidity and mortality. Thromb Haemost. 2007 Oct;98(4):756-64. doi: 10.1160/TH07-03-0212. |
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No IPD plan
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| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| ID | Term |
|---|---|
| D012140 | Respiratory Tract Diseases |
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|
| 2 years |
| Biochemistry | To assess the association between troponin levels to post PE complications | 2 years |
| 22959540 | Background | Goldhaber SZ. Venous thromboembolism: epidemiology and magnitude of the problem. Best Pract Res Clin Haematol. 2012 Sep;25(3):235-42. doi: 10.1016/j.beha.2012.06.007. Epub 2012 Aug 9. |
| 22672974 | Background | Centers for Disease Control and Prevention (CDC). Venous thromboembolism in adult hospitalizations - United States, 2007-2009. MMWR Morb Mortal Wkly Rep. 2012 Jun 8;61(22):401-4. |
| 11487036 | Background | Heit JA, Silverstein MD, Mohr DN, Petterson TM, Lohse CM, O'Fallon WM, Melton LJ 3rd. The epidemiology of venous thromboembolism in the community. Thromb Haemost. 2001 Jul;86(1):452-63. |
| 26204122 | Background | Becattini C, Cohen AT, Agnelli G, Howard L, Castejon B, Trujillo-Santos J, Monreal M, Perrier A, Yusen RD, Jimenez D. Risk Stratification of Patients With Acute Symptomatic Pulmonary Embolism Based on Presence or Absence of Lower Extremity DVT: Systematic Review and Meta-analysis. Chest. 2016 Jan;149(1):192-200. doi: 10.1378/chest.15-0808. Epub 2016 Jan 6. |
| 24182642 | Background | Cohen AT, Dobromirski M, Gurwith MM. Managing pulmonary embolism from presentation to extended treatment. Thromb Res. 2014 Feb;133(2):139-48. doi: 10.1016/j.thromres.2013.09.040. Epub 2013 Oct 14. |
| 20972417 | Background | Axtell AL, Gomari FA, Cooke JP. Assessing endothelial vasodilator function with the Endo-PAT 2000. J Vis Exp. 2010 Oct 15;(44):2167. doi: 10.3791/2167. |
| 15582310 | Background | Bonetti PO, Pumper GM, Higano ST, Holmes DR Jr, Kuvin JT, Lerman A. Noninvasive identification of patients with early coronary atherosclerosis by assessment of digital reactive hyperemia. J Am Coll Cardiol. 2004 Dec 7;44(11):2137-41. doi: 10.1016/j.jacc.2004.08.062. |
| 12588755 | Background | Bonetti PO, Lerman LO, Lerman A. Endothelial dysfunction: a marker of atherosclerotic risk. Arterioscler Thromb Vasc Biol. 2003 Feb 1;23(2):168-75. doi: 10.1161/01.atv.0000051384.43104.fc. |
| 11073878 | Background | Cai H, Harrison DG. Endothelial dysfunction in cardiovascular diseases: the role of oxidant stress. Circ Res. 2000 Nov 10;87(10):840-4. doi: 10.1161/01.res.87.10.840. |
| 10704159 | Background | Suwaidi JA, Hamasaki S, Higano ST, Nishimura RA, Holmes DR Jr, Lerman A. Long-term follow-up of patients with mild coronary artery disease and endothelial dysfunction. Circulation. 2000 Mar 7;101(9):948-54. doi: 10.1161/01.cir.101.9.948. |