AUTHOR=Wang Yin , Li Bo , Rong Chunyan , Lu Ming , Zhang Weihua 

TITLE=The effect of different treatment strategies on the right heart dysfunction during follow-up in the patients with acute pulmonary thromboembolism of intermediate-risk

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2025.1641886

DOI=10.3389/fcvm.2025.1641886

ISSN=2297-055X

ABSTRACT=BackgroundAcute pulmonary embolism (APE) is a disease with a high incidence and mortality rate. Currently, the preferred treatment methods for low - risk and high - risk of APE have been clearly defined, but there is still controversy regarding the optimal treatment for the intermediate - risk of APE. Patients with intermediate-risk APE have a relatively high thrombus burden, which can cause right heart function impairment during the follow-up period. It is still uncertain whether reperfusion therapy has an impact on right heart function during the follow-up period.ObjectivesThis study aims to evaluate the impact of reperfusion therapy on right heart function during the follow-up period in intermediate-risk APE patients by comparing the effects of different treatment strategies on right heart dysfunction (RHD) at 3 months.MethodsThis study retrospectively included 216 patients who met the inclusion and exclusion criteria of this study. According to the treatment methods used, the patients were divided into the thrombolysis group, the catheter-directed thrombectomy group and the anticoagulation group.ResultsIn this study, the median follow - up time was 4.2 (3.1, 5.4) months. Among the patients with intermediate-risk APE, the incidence of RHD in the catheter-directed thrombectomy group was lower than that in the anticoagulation group (P < 0.05). Among the patients with intermediate-high-risk APE, the incidence of RHD events after 3 months in both the thrombolysis group and the catheter-directed thrombectomy group was lower than that in the anticoagulation group (P < 0.05). Catheter-directed thrombectomy reduced the probability of RHD at 3 months to 0.12 of that with anticoagulation therapy alone (OR = 0.12, 95% CI: 0.015–0.994, P = 0.049).ConclusionIn patients with intermediate-risk APE, reperfusion therapy may reduce the occurrence of RHD impairment events after 3 months and improve the prognosis of patients.