Subclinical Atherosclerosis in Patients with Prior Pulmonary Thromboembolism

Objective: Recent studies have indicated that endothelial dysfunction is common in patients with a prior history of pulmonary thromboembolism (PTE). Based on the established relationship between endothelial dysfunction and atherosclerosis, we aimed to investigate carotid intima-media thickness (cIMT) as a marker of subclinical atherosclerosis in patients who have a prior history of PTE. Subjects and Methods: Medical records belonging to patients with a history of PTE and age- and gender-matched control subjects among those who underwent transthoracic echocardiography in Konya Training and Research Hospital were reviewed. Echocardiographic findings and cIMT measurements were recorded. cIMT measurements were compared between patient and control groups, and then independent correlates of cIMT were investigated using appropriate statistical methods. Results: A total of 110 patients (64.02 ± 12.67 years, males: n = 79 [71.81%]; females: n = 31 [28.19%]) were found to be eligible for assessment. Of these patients, 55 (50.00%) had a history of PTE. Patients with a history of PTE had significantly greater cIMT ( p = 0.040). In this group of patients, cIMT positively and significantly correlated with basal right ventricular (RV) diameter ( r = 0.271, p = 0.022), RV diastolic area ( r = 0.376, p = 0.002), and systolic pulmonary artery pressure ( r = 0.248, p = 0.037). In the multivariate linear regression analysis, only RV diastolic area was independently associated with cIMT in patients with PTE ( p = 0.010). Conclusion: Patients with a history of PTE have increased cIMT when compared to healthy subjects, and cIMT, which is a marker of subclinical atherosclerosis, is independently associated with RV diameter in these patients.