PhD Scientific Days 2026

Health Sciences 1.

Beyond Survival: Long-Term Exercise Capacity After Pulmonary Embolism Across Treatment Strategies

Name of the presenter

Stubnya, János Domonkos

Institute/workplace of the presenter

Semmelweis University, Department of Intensive Therapy and Semmelweis University, Pediatric Center, Division of Neonatology

Authors

János Domonkos Stubnya MD¹, Hanna Dóra Szász MD², Anna Párkányi MD³, Máté Bercz MD³, János Fazakas MD³, András Kállai MD³
1: Semmelweis University, Department of Intensive Therapy and Semmelweis University, Pediatric Center, Division of Neonatology
2: St. John’s Central Hospital of North Buda, Department of Central Anesthesiology and Intensive Therapy
3: Semmelweis University, Department of Intensive Therapy

Text of the abstract

Introduction: Pulmonary embolism (PE) is a serious condition associated with high mortality and morbidity. A proportion of patients -up to 16% (95% CI 12.8–20.8%; Valerio et al., 2022)- may develop post-PE impairment. Therefore, assessing long-term changes in exercise capacity is crucial for evaluating the effectiveness of different therapeutic strategies and their impact on patient recovery.
Aims: The aim of the study was to analyse long-term outcomes after PE, focusing on exercise capacity, and to compare these parameters across different therapeutic approaches.
Methods: Patients were enrolled in a prospective, randomised interventional trial conducted at the Semmelweis University Department of Intensive Care Medicine (“Safe Implementation of Thrombolysis in PE Using ClotPro Viscoelastic Tests”; ethical approval no. 65187-5/2021/EÜIG). Follow-up at 1, 3, and 12 months, included a 6-minute walk test (6MWT), expressed as a percentage of the predicted values and reported as medians. Patients were divided into three groups: ClotPro-guided thrombolysis (TCP), standard 100 mg rt-PA thrombolysis (TnCP), and no thrombolysis (NT). Statistical analysis waw performed using GraphPad Prism with a mixed-effects model (REML) and Geisser-Greenhouse correction.
Results: A total of 23 patients were analysed, contributing 60 follow-up measurements. Median 6MWT (% of predicted) improved in all groups: TCP: 68.75% → 83.43% → 94.09% (Δ25.33%); TnCP: 64.84% → 74.71% → 79.18% (Δ14.33%); NT: 68.74% → 76.54% → 82.82% (Δ14.09%). A significant main effect of time was observed (F(0.79, 10.62) = 12.76, p = 0.0065), indicating a significant longitudinal improvement, with no significant effect of treatment group or time × treatment interaction was observed.
Conclusion: Exercise capacity improved significantly over time after pulmonary embolism, with no differences between treatment groups. These findings suggest that recovery in functional capacity is primarily time-dependent within the studied cohorts. The absence of group differences may be related to the limited sample size and resulting reduced statistical power, as well as missing follow-up data.
Funding: Supported by the 2025-2.1.1-EKÖP-20025-00014 University Scholarship Programme of the Ministry for Culture and Innovation from the source of the National Research, Development and Innovation Fund.