Clinical Risk Assessment of Acute Intermediate-Risk Pulmonary Embolism Using Repeat Transthoracic Echocardiography.
S, Z., YM, H., S, C., MM, M., & RE, G. (2026). Clinical Risk Assessment of Acute Intermediate-Risk Pulmonary Embolism Using Repeat Transthoracic Echocardiography.. Echocardiography (Mount Kisco, N.Y.). https://doi.org/10.1111/echo.70595
S Z, YM H, S C, MM M, RE G. Clinical Risk Assessment of Acute Intermediate-Risk Pulmonary Embolism Using Repeat Transthoracic Echocardiography.. Echocardiography (Mount Kisco, N.Y.). 2026; doi: 10.1111/echo.70595
S Z, YM H, S C, et al. Clinical Risk Assessment of Acute Intermediate-Risk Pulmonary Embolism Using Repeat Transthoracic Echocardiography.[J]. Echocardiography (Mount Kisco, N.Y.). 2026. DOI: 10.1111/echo.70595.
@article{s2026,
author = {Zoghi S and Hakim YM and Chen S and Morshedi MM and Goldman RE},
title = {Clinical Risk Assessment of Acute Intermediate-Risk Pulmonary Embolism Using Repeat Transthoracic Echocardiography.},
journal = {Echocardiography (Mount Kisco, N.Y.)},
year = {2026},
doi = {10.1111/echo.70595},
note = {PMID: 42599748},
}
TY - JOUR AU - Zoghi S AU - Hakim YM AU - Chen S AU - Morshedi MM AU - Goldman RE TI - Clinical Risk Assessment of Acute Intermediate-Risk Pulmonary Embolism Using Repeat Transthoracic Echocardiography. T2 - Echocardiography (Mount Kisco, N.Y.) PY - 2026 DO - 10.1111/echo.70595 AN - PMID:42599748 ER -
BACKGROUND: Current risk stratification algorithms for intermediate-risk pulmonary embolism (PE) inadequately identify patients who may benefit from escalated care interventions (ECIs) beyond anticoagulation and do not incorporate temporal assessments of right ventricular (RV) function. OBJECTIVES: To evaluate whether changes in tricuspid annular plane systolic excursion (TAPSE) on repeat transthoracic echocardiography (TTE) before ECIs are associated with clinical outcomes in acute intermediate-risk PE. METHODS: Acute intermediate-risk PE patients at a single quaternary care center were retrospectively identified. Inclusion required two or more TTE studies with TAPSE measurements before discharge or ECI initiation. Patients were stratified into worsening (ΔTAPSE < 0 mm) and stable/improving cohorts. The primary outcome was 30-day mortality. Secondary outcomes included 90-day mortality, intubation, ICU admission, vasopressor requirement, and ECIs. RESULTS: Eighty-eight patients met inclusion criteria (38 worsening, 50 stable/improving). Worsening TAPSE was associated with a significantly increased risk of 30-day mortality (RR 5.26; p = 0.003), 90-day mortality (RR 3.01; p = 0.004), and intubation (RR 1.86; p = 0.010). In univariate logistic regression, each 1 mm increase in ΔTAPSE was associated with lower odds of 30-day mortality (OR 0.86; p = 0.005). Among 53 patients with initial TAPSE ≥16 mm, those with subsequent decline had significantly higher 30-day mortality (33.3% vs. 8.7%; p = 0.048). CONCLUSION: Worsening RV function on repeat echocardiography was associated with short-term mortality in acute intermediate-risk PE, even with initially preserved cardiac function. Serial assessment of RV function may refine risk stratification, and the impact on patient triage and escalation decisions warrants prospective evaluation.