Admission electrocardiographic markers of atrial cardiomyopathy predict persistent pulmonary hypertension and chronic thromboembolic pulmonary hypertension after acute pulmonary embolism: a retrospective cohort study.

This single-center retrospective cohort included 1,579 consecutive adults with computed tomography pulmonary angiography-confirmed acute pulmonary embolism between August 2018 and August 2025.

All underwent admission electrocardiography and structured 3-month echocardiographic reassessment.

Persistent pulmonary hypertension occurred in 292 patients (18.5%), and confirmed chronic thromboembolic pulmonary hypertension in 44 (2.8%).

In the sinus rhythm subset, persistent pulmonary hypertension was associated with longer P-wave duration, greater dispersion, higher PTFV1, and more frequent interatrial block (all p < 0.001).