{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T12:39:35Z","timestamp":1792413575705,"version":"4.4.0"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by\/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"}],"funder":[{"DOI":"10.13039\/501100000274","name":"British Heart Foundation","doi-asserted-by":"publisher","award":["FS\/IPBSRF\/24\/27116"],"award-info":[{"award-number":["FS\/IPBSRF\/24\/27116"]}],"id":[{"id":"10.13039\/501100000274","id-type":"DOI","asserted-by":"publisher"}]}],"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                    Invasive right heart catheterization (RHC) remains the reference standard for diagnosing pulmonary hypertension (PH), but there is a pressing need for non\u2010invasive techniques to assess pulmonary hemodynamics. This study evaluates 4D\u2010flow MRI\u2010derived wall shear stress (WSS) for PH detection using the updated 2022 hemodynamic criteria, and the prediction of right ventriculo\u2010pulmonary arterial (RV\u2010PA) uncoupling to assess disease severity. 3D WSS was measured in the main (MPA), right (RPA), and left (LPA) pulmonary arteries in a retrospective validation cohort (41 PH patients, 23 non\u2010PH) and then assessed in a prospective test cohort (23 PH patients, 17 healthy controls). For methodological validation, a patient\u2010specific computational fluid dynamics (CFD) was performed in a subset of 16 patients from the validation cohort. RV\u2010PA uncoupling was assessed on the cine MRI, using RV global longitudinal strain (GLS)\u2009&lt;\u2009\u221215.3% and RVSV\/RVESV\u2009&lt;\u20091. Both 3D peak and time\u2010averaged WSS were significantly reduced in PH patients compared with healthy controls. Global WSS metrics demonstrated the strongest correlations with invasive hemodynamic parameters, including mPAP (\n                    <jats:italic>r<\/jats:italic>\n                    \u2009=\u2009\u22120.75,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and PVR (\n                    <jats:italic>r<\/jats:italic>\n                    \u2009=\u2009\u22120.76,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). ROC curve analysis identified a peak WSS cutoff of &lt;\u20090.30\u2009Pa (AUC 0.98) for PH detection, a threshold achieving 90% sensitivity and 100% specificity in the test cohort. Furthermore, a peak WSS threshold of &lt;\u20090.18\u2009Pa demonstrated excellent discriminative ability for RV\u2010PA uncoupling. These findings support the potential integration of WSS analysis into routine CMR protocols as a non\u2010invasive complement to RHC, showing promise for both diagnosis and a longitudinal biomarker for monitoring PH.\n                  <\/jats:p>","DOI":"10.1002\/pul2.70426","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T11:41:17Z","timestamp":1792410077000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["4D\u2010Flow MRI\u2010Derived Wall Shear Stress as a Non\u2010Invasive Biomarker for the Detection and Hemodynamic Characterization of Pulmonary Hypertension"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5118-7977","authenticated-orcid":false,"given":"Ben","family":"Statton","sequence":"first","affiliation":[{"name":"Medical Research Council, Laboratory of Medical Sciences Imperial College London London UK"},{"name":"Institute of Clinical Sciences Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6459-1271","authenticated-orcid":false,"given":"Chl\u00f6e","family":"Armour","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute Imperial College London London UK"},{"name":"Department of Chemical Engineering Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5556-9825","authenticated-orcid":false,"given":"Kai'en","family":"Leong","sequence":"additional","affiliation":[{"name":"Department of Cardiology Royal Melbourne Hospital Melbourne Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3125-1083","authenticated-orcid":false,"given":"Jan","family":"Sedlacik","sequence":"additional","affiliation":[{"name":"Medical Research Council, Laboratory of Medical Sciences Imperial College London London UK"},{"name":"Institute of Clinical Sciences Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6049-4418","authenticated-orcid":false,"given":"Alaine","family":"Berry","sequence":"additional","affiliation":[{"name":"Medical Research Council, Laboratory of Medical Sciences Imperial College London London UK"},{"name":"Institute of Clinical Sciences Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Jin","sequence":"additional","affiliation":[{"name":"Siemens Healthineers Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3925-4441","authenticated-orcid":false,"given":"Daniel","family":"Giese","sequence":"additional","affiliation":[{"name":"Siemens Healthineers Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1273-0484","authenticated-orcid":false,"given":"Francesco Lo","family":"Guidice","sequence":"additional","affiliation":[{"name":"National Pulmonary Hypertension Service Imperial College Healthcare NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2822-210X","authenticated-orcid":false,"given":"Luke","family":"Howard","sequence":"additional","affiliation":[{"name":"National Pulmonary Hypertension Service Imperial College Healthcare NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8079-205X","authenticated-orcid":false,"given":"Deepa","family":"Gopalan","sequence":"additional","affiliation":[{"name":"National Pulmonary Hypertension Service Imperial College Healthcare NHS Trust London 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