{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T07:02:56Z","timestamp":1775890976607,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":47,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"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":["Pulm. circ."],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Guidelines recommend different approaches to investigate for pulmonary hypertension (PH) by transthoracic echocardiography (TTE). We used data from the CIPHER study (NCT04193046) to prospectively evaluate TTE detection of PH. Participants newly referred to PH clinics who underwent right heart catheterization (RHC) within 6 weeks and TTE within 60 days of enrolment (blinded central TTE reading) were classified by TTE probability of PH applying (i) the 2015 European Society of Cardiology (ESC)\/European Respiratory Society (ERS) TTE algorithm or (ii) right ventricular systolic pressure (RVSP)\u2009&gt;\u200940\u2009mmHg. For calculation of sensitivity and specificity, \u2018non\u2010assessable\u2019 patients (peak tricuspid regurgitation velocity [TRV] missing or \u2264\u20092.8\u2009m\/s with missing data on other echocardiographic signs) and patients with missing RVSP were counted as PH\u2010negative. Performance was measured against RHC\u2010confirmed diagnosis of mean pulmonary artery pressure &gt;\u200920\u2009mmHg. Of 475 patients included, 345 (73%) had PH. Using the ESC\/ERS algorithm, PH probability was high, intermediate, low and non\u2010assessable for 198, 104, 22 and 151 patients and PH prevalence was 98%, 75%, 23%, and 44%, respectively. Seventy\u2010three\u00a0patients were missing RVSP and 292 had RVSP\u2009&gt;\u200940\u2009mmHg. The two TTE approaches achieved similar results: sensitivity was 79%\u201377%, specificity was 78%\u201379%. This prospective study of patients newly referred to PH centres for RHC found similar sensitivity and specificity when using either RVSP\u2009&gt;\u200940\u2009mmHg or the 2015 ESC\/ERS TTE algorithm. Among patients who were low\u2010probability or non\u2010assessable by ESC\/ERS algorithm, 42% had PH, highlighting the persistent need for additional non\u2010invasive investigative tools.<\/jats:p>","DOI":"10.1002\/pul2.70258","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T10:03:13Z","timestamp":1771322593000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Performance of Guideline\u2010Recommended Approaches to Echocardiographic Investigation for Pulmonary Hypertension: Analysis of the CIPHER Study"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2822-210X","authenticated-orcid":false,"given":"Luke S.","family":"Howard","sequence":"first","affiliation":[{"name":"National Pulmonary Hypertension Service, Hammersmith Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0184-6502","authenticated-orcid":false,"given":"David G.","family":"Kiely","sequence":"additional","affiliation":[{"name":"Sheffield Pulmonary Vascular Disease Unit and NIHR Biomedical Research Centre, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation Trust Sheffield UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allan","family":"Lawrie","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bradley A.","family":"Maron","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Maryland School of Medicine Baltimore Maryland USA"},{"name":"University of Maryland\u2010Institute for Health Computing Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioana R.","family":"Preston","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine Lahey Hospital and Medical Center Burlington Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephan","family":"Rosenkranz","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cologne Cardiovascular Research Center (CCRC), Heart Center University Hospital Cologne Cologne Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Toshner","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Cambridge Cambridge UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3926-1171","authenticated-orcid":false,"given":"Martin R.","family":"Wilkins","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College London London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiu\u2010Lian","family":"Fong","sequence":"additional","affiliation":[{"name":"Johnson &amp; Johnson New Brunswick New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debbie","family":"Quinn","sequence":"additional","affiliation":[{"name":"Johnson &amp; Johnson Allschwil Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dimitri","family":"Stamatiadis","sequence":"additional","affiliation":[{"name":"Johnson &amp; Johnson Allschwil Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthieu","family":"Villeneuve","sequence":"additional","affiliation":[{"name":"Johnson &amp; Johnson Allschwil Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1214-6723","authenticated-orcid":false,"given":"Kelly M.","family":"Chin","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine UT Southwestern Medical Center Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac237"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01032-2015"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2010.05.010"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2025.01.006"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02548-2021"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2021.100822"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2021.06.046"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s44156-022-00010-9"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3402\/ecrj.v3.32027"},{"key":"e_1_2_10_11_1","first-page":"556","article-title":"Usefulness of Combining NT\u2010proBNP Level and Right Atrial Diameter for Simple and Early Noninvasive Detection of Pulmonary Hypertension Among Adult Patients With Atrial Septal Defect","volume":"54","author":"Hartopo A. 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