{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T15:45:36Z","timestamp":1769701536563,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":27,"URL":"https:\/\/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"}],"funder":[{"DOI":"10.13039\/501100006095","name":"Helse S\u00f8r-\u00d8st RHF","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010100","name":"Sykehuset \u00d8stfold","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010100","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pulmonary Medicine"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study was aimed at determining whether stress echocardiography could detect exercise pulmonary hypertension (ePH) in patients with mild chronic thromboembolic pulmonary disease (CTEPD) as compared with right\u2010heart catheterization (RHC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty\u2010six symptomatic patients with persistent residual perfusion defects detected using ventilation\/perfusion scintigraphy underwent a haemodynamic assessment by RHC and echocardiography at rest and during exercise. We compared pulmonary pressures in echocardiography with RHC values using the definitions in current ESC\/ERS guidelines for ePH [mean pulmonary artery pressure\/cardiac output (mPAP\/CO) slope &gt;\u20093\u2009mmHg\/L\/min] and PH (mPAP &gt;\u200920\u2009mmHg).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ten of the 36 patients (28%) exhibited an increase in the invasive mPAP\/CO slope of &gt;\u20093\u2009mmHg\/L\/min. The correlation between echocardiographic and invasive measures of the mPAP\/CO slope and systolic pulmonary pressure (sPAP) during peak exercise was\n                      <jats:italic>\u03c1<\/jats:italic>\n                      = 0.75 (95\n                      <jats:italic>%<\/jats:italic>\n                      <jats:italic>C<\/jats:italic>\n                      <jats:italic>I<\/jats:italic>\n                      = 0.53\u20130.97) and\n                      <jats:italic>\u03c1<\/jats:italic>\n                      = 0.75 (95\n                      <jats:italic>%<\/jats:italic>\n                      <jats:italic>C<\/jats:italic>\n                      <jats:italic>I<\/jats:italic>\n                      = 0.53\u20130.96), respectively. In bivariate logistic regression analyses, ePH was associated with the echocardiographic sPAP during peak exercise [\n                      <jats:italic>o<\/jats:italic>\n                      <jats:italic>d<\/jats:italic>\n                      <jats:italic>d<\/jats:italic>\n                      <jats:italic>s<\/jats:italic>\n                      \u2009\n                      <jats:italic>r<\/jats:italic>\n                      <jats:italic>a<\/jats:italic>\n                      <jats:italic>t<\/jats:italic>\n                      <jats:italic>i<\/jats:italic>\n                      <jats:italic>o<\/jats:italic>\n                      \u2009(\n                      <jats:italic>OR<\/jats:italic>\n                      ) = 1.13, 95\n                      <jats:italic>%<\/jats:italic>\n                      <jats:italic>C<\/jats:italic>\n                      <jats:italic>I<\/jats:italic>\n                      = 1.02\u20131.24] and with the echocardiographic mPAP\/CO slope (\n                      <jats:italic>OR<\/jats:italic>\n                      = 3.86, 95\n                      <jats:italic>%<\/jats:italic>\n                      <jats:italic>C<\/jats:italic>\n                      <jats:italic>I<\/jats:italic>\n                      = 1.24\u201312.03). In ROC analysis, AUC was 0.89 (95\n                      <jats:italic>%<\/jats:italic>\n                      <jats:italic>C<\/jats:italic>\n                      <jats:italic>I<\/jats:italic>\n                      = 0.78\u20131.00) for the optimal exercise sPAP cut\u2010off value of 56\u2009mmHg (\n                      <jats:italic>s<\/jats:italic>\n                      <jats:italic>e<\/jats:italic>\n                      <jats:italic>n<\/jats:italic>\n                      <jats:italic>s<\/jats:italic>\n                      <jats:italic>i<\/jats:italic>\n                      <jats:italic>t<\/jats:italic>\n                      <jats:italic>i<\/jats:italic>\n                      <jats:italic>v<\/jats:italic>\n                      <jats:italic>i<\/jats:italic>\n                      <jats:italic>t<\/jats:italic>\n                      <jats:italic>y<\/jats:italic>\n                      = 90\n                      <jats:italic>%<\/jats:italic>\n                      ,\n                      <jats:italic>s<\/jats:italic>\n                      <jats:italic>p<\/jats:italic>\n                      <jats:italic>e<\/jats:italic>\n                      <jats:italic>c<\/jats:italic>\n                      <jats:italic>i<\/jats:italic>\n                      <jats:italic>f<\/jats:italic>\n                      <jats:italic>i<\/jats:italic>\n                      <jats:italic>c<\/jats:italic>\n                      <jats:italic>i<\/jats:italic>\n                      <jats:italic>t<\/jats:italic>\n                      <jats:italic>y<\/jats:italic>\n                      = 87\n                      <jats:italic>%<\/jats:italic>\n                      ), and 0.84 (95\n                      <jats:italic>%<\/jats:italic>\n                      <jats:italic>C<\/jats:italic>\n                      <jats:italic>I<\/jats:italic>\n                      = 0.66\u20131.00) for the optimal mPAP\/CO slope cut\u2010off value of 3.7\u2009mmHg\/L\/min (\n                      <jats:italic>s<\/jats:italic>\n                      <jats:italic>e<\/jats:italic>\n                      <jats:italic>n<\/jats:italic>\n                      <jats:italic>s<\/jats:italic>\n                      <jats:italic>i<\/jats:italic>\n                      <jats:italic>t<\/jats:italic>\n                      <jats:italic>i<\/jats:italic>\n                      <jats:italic>v<\/jats:italic>\n                      <jats:italic>i<\/jats:italic>\n                      <jats:italic>t<\/jats:italic>\n                      <jats:italic>y<\/jats:italic>\n                      = 89\n                      <jats:italic>%<\/jats:italic>\n                      ,\n                      <jats:italic>s<\/jats:italic>\n                      <jats:italic>p<\/jats:italic>\n                      <jats:italic>e<\/jats:italic>\n                      <jats:italic>c<\/jats:italic>\n                      <jats:italic>i<\/jats:italic>\n                      <jats:italic>f<\/jats:italic>\n                      <jats:italic>i<\/jats:italic>\n                      <jats:italic>c<\/jats:italic>\n                      <jats:italic>i<\/jats:italic>\n                      <jats:italic>t<\/jats:italic>\n                      <jats:italic>y<\/jats:italic>\n                      = 79\n                      <jats:italic>%<\/jats:italic>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Stress echocardiographic assessments of the exercise sPAP and mPAP\/CO slope predicted ePH as measured using RHC with good discrimination and acceptable calibration, providing promising evidence in diagnosing ePH in patients with CTEPD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov identifier: NCT03405480<\/jats:p>\n       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