{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T20:21:23Z","timestamp":1787602883411,"version":"build-2736575974"},"reference-count":19,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Current risk stratification algorithms for intermediate\u2010risk 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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\u2010risk PE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Acute intermediate\u2010risk 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 (\u0394TAPSE &lt; 0\u00a0mm) and stable\/improving cohorts. The primary outcome was 30\u2010day mortality. Secondary outcomes included 90\u2010day mortality, intubation, ICU admission, vasopressor requirement, and ECIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighty\u2010eight patients met inclusion criteria (38 worsening, 50 stable\/improving). Worsening TAPSE was associated with a significantly increased risk of 30\u2010day mortality (RR 5.26;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003), 90\u2010day mortality (RR 3.01;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.004), and intubation (RR 1.86;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.010). In univariate logistic regression, each 1\u00a0mm increase in \u0394TAPSE was associated with lower odds of 30\u2010day mortality (OR 0.86;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.005). Among 53 patients with initial TAPSE \u226516\u00a0mm, those with subsequent decline had significantly higher 30\u2010day mortality (33.3%\u00a0vs. 8.7%;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.048).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Worsening RV function on repeat echocardiography was associated with short\u2010term mortality in acute intermediate\u2010risk 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/echo.70595","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T15:38:50Z","timestamp":1786721930000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Risk Assessment of Acute Intermediate\u2010Risk Pulmonary Embolism Using Repeat Transthoracic Echocardiography"],"prefix":"10.1111","volume":"43","author":[{"given":"Shervin","family":"Zoghi","sequence":"first","affiliation":[{"name":"Department of Radiology UC Davis School of Medicine  Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaseen M.","family":"Hakim","sequence":"additional","affiliation":[{"name":"Department of Radiology UC Davis School of Medicine  Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuai","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Public Health Sciences UC Davis School of Medicine  Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maud M.","family":"Morshedi","sequence":"additional","affiliation":[{"name":"Department of Radiology UC Davis School of Medicine  Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger E.","family":"Goldman","sequence":"additional","affiliation":[{"name":"Department of Radiology UC Davis School of Medicine  Sacramento California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0885066610392658"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201711-2302CI"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/1076029619853037"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2017.10.024"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz405"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2516567"},{"issue":"12","key":"e_1_2_8_8_1","first-page":"e977","article-title":"2026 AHA\/ACC\/ACCP\/ACEP\/CHEST\/SCAI\/SHM\/SIR\/SVM\/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"153","author":"Creager M. 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