In this external validation study, RVGLS ≤ 17.7% was associated with increased 30-day mortality in intermediate-risk pulmonary embolism, supporting the prognostic value of the previously established threshold beyond the original derivation cohort.
RVGLS was significantly lower in non-survivors compared to survivors among intermediate-risk PE patients.
RVGLS demonstrated significant discriminatory performance for predicting 30-day all-cause mortality.
RV strain analysis was technically feasible in the large majority of intermediate-risk PE patients.
The previously established RVGLS cutoff of 17.7% retained prognostic validity in an independent, contemporary external cohort.
This research suggests that a specific heart measurement called right ventricular global longitudinal strain (RVGLS) can help predict which patients hospitalized with an intermediate-risk type of blood clot in the lungs (pulmonary embolism) are more likely to die within 30 days. RVGLS measures how well the right side of the heart stretches and contracts, and lower values indicate worse function. In this study of 119 patients, those who died within 30 days had noticeably lower RVGLS scores than those who survived, and the measurement was technically obtainable in over 92% of patients using standard echocardiography (heart ultrasound). The study specifically tested whether a previously identified threshold — an RVGLS of 17.7% or lower — would still be meaningful in a completely different group of patients treated at a different hospital and under more current medical guidelines. The findings confirmed that patients at or below this cutoff had significantly higher 30-day mortality, and the overall ability of RVGLS to distinguish survivors from non-survivors was strong, with an area under the curve of 0.802 (where 1.0 would be perfect prediction). This research matters because pulmonary embolism that falls in the 'intermediate risk' category presents a clinical challenge — these patients are sick but do not always receive aggressive treatments. Having a reliable, non-invasive measurement like RVGLS that can identify which patients in this group face the highest short-term risk of death could help clinicians make better-informed decisions about treatment intensity and monitoring. The confirmation of this threshold in an independent, contemporary cohort strengthens confidence that RVGLS may be a useful prognostic tool beyond the hospital where it was first studied.
Eguchi S, Eguchi A, Orihara Y, Pfeiffer M, Peterson B, Boehmer J, et al.. (2026). Right Ventricular Global Longitudinal Strain and 30-Day Mortality in Intermediate-Risk Pulmonary Embolism: An External Validation Study.. Echocardiography (Mount Kisco, N.Y.). https://doi.org/10.1111/echo.70612