{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:02:44Z","timestamp":1787022164126,"version":"build-2736575974"},"reference-count":21,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T00:00:00Z","timestamp":1740528000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec015\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Right heart catheterization (RHC) is the diagnostic standard for establishing residual pulmonary hypertension (PH) after pulmonary endarterectomy (PEA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH). A potential non-invasive alternative diagnostic test could be electrocardiography (ECG)-derived ventricular gradient optimized for right ventricular pressure overload (VG-RVPO).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec016\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We studied 66 CTEPH patients who underwent PEA. A subgroup of 20 patients also had a cardiac MRI before and after PEA. The diagnostic performance of the VG-RVPO for the detection of residual PH as well as the potential to replace RHC were assessed. Different cut-off values to define a normal VG-RVPO were evaluated. Also, we evaluated the association between mean pulmonary artery pressure (mPAP) and CMR derived indexed right ventricular (RV) mass and the VG-RVPO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec017\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During follow-up, 28 patients had residual PH (42%). A decrease in VG-RVPO after PEA was associated with decrease in mPAP or indexed RV mass post PEA (r\u2009=\u20090.55, p\u2009&lt;\u20090.05 and r\u2009=\u20090.64, p\u2009&lt;\u20090.05, respectively). If a normal VG-RVPO would exclude residual PH, the need for RHC would be reduced with 15\u201348%, but up to 36% of the CTEPH patients with residual PH would have been missed as they had a normal VG-RVPO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec018\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although there was an association between the change in VG-RPVO and changes in mPAP or indexed RV mass, our study demonstrated that VG-RPVO has limited value in excluding the presence of residual PH post-PEA as up to 36% of the CTEPH patients with residual PH would have been missed if residual PH would have been excluded based on a normal VG-RVPO.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0317826","type":"journal-article","created":{"date-parts":[[2025,2,26]],"date-time":"2025-02-26T13:36:07Z","timestamp":1740576967000},"page":"e0317826","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["The value of vector ECG in predicting residual pulmonary hypertension in CTEPH patients after pulmonary 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