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Kinetic energy (KE) from 4D flow cardiovascular magnetic resonance (CMR) is a measure of intracardiac hemodynamics. In this observational case\u2013control study, we investigate physiological mechanisms influencing RV\u2010KE and LV\u2010KE in PH. Twenty PH patients and 12 healthy controls underwent CMR including cine images and 4D flow. LV contractility was derived from noninvasive pressure\u2010volume loops, and PVR from right heart catheterization. RV\u2010KE and LV\u2010KE were computed for systole, early and late diastolic filling, and indexed to stroke volume (SV). Systolic RV\u2010KE did not differ between patients and controls. In patients, systolic RV\u2010KE was associated with RV\u2010SV but not with PVR, suggesting that the RV may still be able to compensate for the increased afterload. Systolic LV\u2010KE indexed to LV\u2010SV, LV contractility, and heart rate were all higher in patients than controls, suggesting sympathetic upregulation as a possible driving mechanism behind increased systolic LV\u2010KE. LV contractility was negatively associated with systolic LV\u2010KE and LV\u2010SV. Late filling KE was increased in both ventricles in patients, suggesting an enhanced importance of the atrial kick to the filling of both ventricles.<\/jats:p>","DOI":"10.14814\/phy2.70563","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T20:06:48Z","timestamp":1757707608000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Increased contractility affects left ventricular kinetic energy in pulmonary hypertension"],"prefix":"10.14814","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3408-8488","authenticated-orcid":false,"given":"E.","family":"Bergstr\u00f6m","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences Lund, Clinical Physiology Lund University, Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0710-3710","authenticated-orcid":false,"given":"K.","family":"Pola","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund, Clinical Physiology Lund University, Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7936-1209","authenticated-orcid":false,"given":"B.","family":"Kjellstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund, Clinical Physiology Lund University, Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3365-7282","authenticated-orcid":false,"given":"J.","family":"T\u00f6ger","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Lund, Clinical Physiology Lund University, Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2262-3562","authenticated-orcid":false,"given":"P. 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