{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:48:53Z","timestamp":1791550133142,"version":"4.3.4"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"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":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Right heart catheterization defines pulmonary hypertension (PH) hemodynamics, but simple markers of pulmonary vascular load remain useful. Inferior\u2010lead T\u2010wave inversion (TWI) is seen in right ventricular pressure overload; its association with pulmonary vascular resistance (PVR) and prognosis is uncertain. We retrospectively studied a cohort of 98 patients who underwent electrocardiography (ECG), echocardiography, and right heart catheterization within 48\u2009h from 2021 to 2023. Inferior TWI amplitudes in leads II, III, and aVF were measured as absolute values and summed. Associations with PVR, performance for PVR\u2009&gt;\u20095 Wood units, and all\u2010cause mortality were evaluated. Twenty\u2010five patients (26%) had PVR\u2009&gt;\u20095 Wood units. The inferior TWI sum correlated with PVR (\n                    <jats:italic>\u03c1<\/jats:italic>\n                    \u2009=\u20090.326,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001) and discriminated PVR\u2009&gt;\u20095 Wood units better than conventional ECG markers (area under the curve, 0.78). A cutoff &gt;\u20090.10\u2009mV yielded 72% sensitivity, 84% specificity, and an odds ratio of 13.1 (95% confidence interval [CI], 4.5\u201338.1;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). During a median follow\u2010up of 731 days, 19 patients died. Inferior TWI sum &gt;\u20090.15\u2009mV was associated with higher mortality (log\u2010rank\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.015) and remained associated after adjustment for age and log\n                    <jats:sub>2<\/jats:sub>\n                    N\u2010terminal pro\u2010B\u2010type natriuretic peptide (NT\u2010proBNP) (hazard ratio, 3.83; 95% CI, 1.48\u20139.90;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.007). Adding this ECG marker increased the global chi\u2010square from 12.0 to 19.3. Quantitative inferior\u2010lead TWI was associated with high PVR and all\u2010cause mortality in patients evaluated for PH. It may complement non\u2010invasive assessment and right heart catheterization but requires external validation.\n                  <\/jats:p>","DOI":"10.1002\/pul2.70420","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:49:52Z","timestamp":1791546592000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quantitative Inferior T\u2010Wave Inversion as a Marker of High Pulmonary Vascular Resistance and All\u2010Cause Mortality in Patients Evaluated for Pulmonary Hypertension"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2389-7183","authenticated-orcid":false,"given":"Hidekazu","family":"Ikemiyagi","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Nephrology, and Neurology, Graduate School of Medicine University of the Ryukyus Okinawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayane","family":"Miyagi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nephrology, and Neurology, Graduate School of Medicine University of the Ryukyus Okinawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruno","family":"Nagata","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nephrology, and Neurology, Graduate School of Medicine University of the Ryukyus Okinawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Shiohira","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nephrology, and Neurology, Graduate School of Medicine University of the Ryukyus Okinawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Toma","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nephrology, and Neurology, Graduate School of Medicine University of the Ryukyus Okinawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5085-0810","authenticated-orcid":false,"given":"Takeshi","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nephrology, and Neurology, Graduate School of Medicine University of the Ryukyus Okinawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Iwabuchi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nephrology, and Neurology, Graduate School of Medicine University of the Ryukyus Okinawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4909-754X","authenticated-orcid":false,"given":"Kenya","family":"Kusunose","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Nephrology, and Neurology, Graduate School of Medicine University of the Ryukyus Okinawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac237"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01324-2024"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01321-2024"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13247613"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2007.06.005"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.4103\/2045-8932.93546"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.01312.2007"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-11-1517"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10102147"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2010.05.010"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jev014"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-0461"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcha.2018.05.003"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.02311-2021"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/2045894018776496"}],"container-title":["Pulmonary Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pul2.70420","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pul2.70420","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pul2.70420","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:49:53Z","timestamp":1791546593000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pul2.70420"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/pul2.70420"],"URL":"https:\/\/doi.org\/10.1002\/pul2.70420","archive":["Portico"],"relation":{},"ISSN":["2045-8940","2045-8940"],"issn-type":[{"value":"2045-8940","type":"print"},{"value":"2045-8940","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-07-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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