Evidence map›Paper›PMID 41956701›Full record

Observational studyThe European respiratory journal2026

Chronic thromboembolism phenotypes after acute pulmonary embolism: identification with the SEARCH algorithm.

Timothy A Morris, Khadizhat Dakaeva, Mona Alotaibi, W Cameron McGuire, William Stringer, Jina Chung, Ramiz Fargo, Bassam Yagmour, Dinora Chinchilla, Janine R E Vintch and 4 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The European respiratory journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Timothy A MorrisDivision of Pulmonary and Critical Care Medicine, University of California San Diego, La Jolla, CA, USA t1morris@health.ucsd.edu.ORCID https://orcid.org/0000-0002-5122-9193
Khadizhat DakaevaDivision of Pulmonary and Critical Care Medicine, University of California San Diego, La Jolla, CA, USA.
Mona AlotaibiDivision of Pulmonary and Critical Care Medicine, University of California San Diego, La Jolla, CA, USA.ORCID https://orcid.org/0000-0001-8492-9930
W Cameron McGuireDivision of Pulmonary and Critical Care Medicine, University of California San Diego, La Jolla, CA, USA.ORCID https://orcid.org/0000-0003-0795-8361
William StringerDivision of Respiratory and Critical Care, Physiology and Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA.
Jina ChungDivision of Cardiology, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA.
Ramiz FargoRiverside University Health System Medical Center, University of California Riverside, Moreno Valley, CA, USA.
Bassam YagmourDivision of Pulmonary and Critical Care Medicine, University of California Irvine, Irvine, CA, USA.
Dinora ChinchillaDivision of Pulmonary and Critical Care Medicine, University of California Irvine, Irvine, CA, USA.
Janine R E VintchDivision of Respiratory and Critical Care, Physiology and Medicine, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA.
Savannah AriesDivision of Pulmonary and Critical Care Medicine, University of California San Diego, La Jolla, CA, USA.
Janet MaDivision of Cardiology, University of California San Diego, La Jolla, CA, USA.
James JuricaDivision of Pulmonary and Critical Care Medicine, University of California San Diego, La Jolla, CA, USA.
Timothy M FernandesDivision of Pulmonary and Critical Care Medicine, University of California San Diego, La Jolla, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic dyspnoea and exercise impairment are common after acute pulmonary embolism (PE) but poorly characterised. We performed a prospective observational study to validate an algorithm to diagnose discrete post-PE outcomes, including chronic thromboembolism phenotypes.

methodsSix pulmonologists independently reviewed records from 150 consecutive patients ≥3 months after acute PE who had undergone a stepwise diagnostic algorithm (SEARCH), which incorporates Symptom screening, cardiopulmonary Exercise testing, pulmonary Arterial perfusion scans, Resting echocardiography, Confirmatory imaging, and Haemodynamic measurements by rest and exercise right heart catheterisation (RHC). Clinical data were reviewed after the first post-PE evaluation and then 6 months later.

resultsSymptomatic recovery was most common and occurred in 66.2% of patients during the final evaluation. Dyspnoea without discernible physiological defects occurred in 2.1% and dyspnoea from alternative diagnoses in 19.7%. Chronic thromboembolism phenotypes were diagnosed in 12.0% of patients. Chronic thromboembolism with ventilatory inefficiency and/or small stroke volume augmentation during exercise was seen in 6.3%: 2.1% without pulmonary hypertension on RHC and 4.2% in whom RHC was not performed. Chronic thromboembolic pulmonary hypertension and chronic thromboembolism with exercise-induced pulmonary hypertension occurred in 2.1% and 3.5%, respectively. Krippendorff's α among the readers was 0.984 (95% CI 0.9663-0.9960), signifying very high diagnostic reliability. No patient developed chronic thromboembolism between the first and final evaluations.

conclusionsDyspnoea from chronic thromboembolism is common after acute PE, most of which is not associated with pulmonary hypertension. The SEARCH protocol reliably identifies chronic thromboembolism phenotypes after acute embolism. Validation of the SEARCH algorithm offers clinicians a straightforward method to diagnose post-PE conditions that are rarely distinguished clinically. Improved categorisation and definition of post-PE conditions will enhance clinical follow-up and allow more precise end-point adjudication in clinical trials of acute PE treatment.

Indexed as

AlgorithmsPulmonary EmbolismThromboembolismAcute DiseaseAdultAgedCardiac CatheterizationChronic DiseaseDyspneaEchocardiographyExercise TestFemaleHumansHypertension, PulmonaryMaleMiddle Aged

Identifiers

PMID41956701
PMCPMC13446208

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.