Observational studyCritical care (London, England)2022
Intermediate-risk pulmonary embolism: echocardiography predictors of clinical deterioration.
Observational study in Critical care (London, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 14 citations in OpenAlex.
- Right Ventricular Global Longitudinal Strain and 30-Day Mortality in Intermediate-Risk Pulmonary Embolism: An External Validation Study.Echocardiography (Mount Kisco, N.Y.) · 2026Article
- Systemic Inflammation Response Index Predicts Thrombolytic Therapy Requirement in Intermediate-High Risk Acute Pulmonary Embolism: A Retrospective Study.Journal of clinical medicine · 2026Article
- Risk stratification in pulmonary embolism: current evidence and future directions.The Journal of cardiovascular surgery · 2026Review
- Contemporary Challenges in Venous Thromboembolism: Evolving Populations and Implications for Management and Risk Stratification.Journal of clinical medicine · 2026Review
- Pulmonary embolism consensus.Archivos de cardiologia de Mexico · 2026Article
- Refining Pulmonary Embolism Management: Balancing Innovation with Accuracy.American journal of respiratory and critical care medicine · 2025Article
- Rethinking Pulmonary Embolism Management with an Interventional Perspective.Journal of clinical medicine · 2025Review
- Cardiac Computed Tomography Measurements in Pulmonary Embolism Associated with Clinical Deterioration.The western journal of emergency medicine · 2025Article
- De Ritis Ratio to Predict Clinical Outcomes of Intermediate- and High-Risk Pulmonary Embolisms.Journal of clinical medicine · 2024Article
- Comparison of Treatment Approaches and Subsequent Outcomes within a Pulmonary Embolism Response Team Registry.Critical care research and practice · 2024Article
- The Diagnostic Value of Bedside Echocardiography and Lower Extremity Blood Vessels in Acute Pulmonary Embolism.Stem cells international · 2022Article
- Baseline Echocardiographic Predictors of Outcomes in Low-to-intermediate Risk Acute Pulmonary Embolism and Integration with Electrocardiographic Findings: A Systematic Review and Meta-analysis.Journal of cardiovascular echographyArticle
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe determine the predictive value of transthoracic echocardiographic (TTE) metrics for clinical deterioration within 5 days in adults with intermediate-risk pulmonary embolism (PE).
methodsThis was a prospective observational study of intermediate-risk PE patients. To determine associations of TTE and clinical predictors with clinical deterioration, we used univariable analysis, Youden's index for optimal thresholds, and multivariable analyses to report odds ratios (ORs) or area under the curve (AUC).
resultsOf 306 intermediate-risk PE patients, 115 (37.6%) experienced clinical deterioration. PE patients who had clinical deterioration within 5 days had greater baseline right ventricle (RV) dilatation and worse systolic function than the group without clinical deterioration as indicated by the following: RV basal diameter 4.46 ± 0.77 versus 4.20 ± 0.77 cm; RV/LV basal width ratio 1.14 ± 0.29 versus 1.02 ± 0.24; tricuspid annular plane systolic excursion (TAPSE) 1.56 ± 0.55 versus 1.80 ± 0.52 cm; and RV systolic excursion velocity 10.40 ± 3.58 versus 12.1 ± 12.5 cm/s, respectively. Optimal thresholds for predicting clinical deterioration were: RV basal width 3.9 cm (OR 2.85 [1.64, 4.97]), RV-to-left ventricle (RV/LV) ratio 1.08 (OR 3.32 [2.07, 5.33]), TAPSE 1.98 cm (OR 3.3 [2.06, 5.3]), systolic excursion velocity 10.10 cm/s (OR 2.85 [1.75, 4.63]), and natriuretic peptide 190 pg/mL (OR 2.89 [1.81, 4.62]). Significant independent predictors were: transient hypotension 6.1 (2.2, 18.9), highest heart rate 1.02 (1.00, 1.03), highest respiratory rate 1.02 (1.00, 1.04), and RV/LV ratio 1.29 (1.14, 1.47). By logistic regression and random forest analyses, AUCs were 0.80 (0.73, 0.87) and 0.78 (0.70, 0.85), respectively.
conclusionsBasal RV, RV/LV ratio, and RV systolic function measurements were significantly different between intermediate-risk PE patients grouped by subsequent clinical deterioration.
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