{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T09:07:13Z","timestamp":1788944833575,"version":"build-2803163510"},"reference-count":36,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Pulmonary hypertension (PH) is associated with increased pulmonary arterial pressure and impairment of right ventricular (RV) function. Reliable characterization of RV performance is important for prognosis, risk assessment, and therapeutic planning. Cardiac magnetic resonance (CMR) is considered the reference technique for quantifying RV volumes and function, but its expense and limited availability can restrict routine implementation. Echocardiography is more widely accessible; however, the extent to which individual echocardiographic indices correspond with CMR-derived RV ejection fraction (RVEF) remains incompletely defined. Objective: Our objective was to determine the correlation of RV fractional area change (RV-FAC), RV free-wall longitudinal strain (RV-FWLS), and RV global longitudinal strain (RV-GLS) with CMR-derived RVEF in individuals with PH. Methods: PubMed, Embase, ClinicalTrials.gov, Scopus, and the Cochrane Library were searched, yielding 404 records; six studies fulfilled the eligibility criteria. Studies were eligible when they enrolled patients with PH and provided extractable correlations between at least one prespecified echocardiographic measure and CMR-derived RVEF. Correlation coefficients were converted with Fisher\u2019s z transformation, combined using common-effect and random-effects approaches, and then transformed back to correlation coefficients. Pooled mean RV-FAC was evaluated as a separate outcome. Between-study heterogeneity was quantified with I2 and \u03c42, with random-effects estimates emphasized for interpretation. Results: Each evaluated echocardiographic measure was positively correlated with CMR-derived RVEF. RV-FWLS had the largest pooled correlation and the greatest consistency (r = 0.79, 95% CI: 0.73\u20130.83; I2 = 0.0%). The pooled correlation for RV-GLS was 0.75 (95% CI: 0.60\u20130.85; I2 = 80.3%), while that for RV-FAC was 0.72 (95% CI: 0.61\u20130.80; I2 = 61.8%). The random-effects pooled mean RV-FAC was 31.10% (95% CI: 26.77\u201335.43), with substantial heterogeneity (I2 = 90.9%). Conclusions: RV-FWLS showed the highest numerical and most consistent association with CMR-derived RVEF, suggesting that it may serve as a useful non-invasive adjunct for RV assessment in PH, especially where CMR is not readily available. Larger studies using harmonized acquisition and analysis methods are required for confirmation.<\/jats:p>","DOI":"10.3390\/diagnostics16182899","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T08:05:43Z","timestamp":1788941143000},"page":"2899","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Correlation of Echocardiographic Right Ventricular Functional Parameters with CMR-Derived Right Ventricular Ejection Fraction in Pulmonary Hypertension: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"16","author":[{"given":"Faizan","family":"Ahmed","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, NJ 07753, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayesha","family":"Zulfiqar","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dow University of Health Sciences, Karachi 74200, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramsha","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Peoples University of Medical and Health Sciences, Nawabshah 67480, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8783-1453","authenticated-orcid":false,"given":"Syeda Simrah","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dow University of Health Sciences, Karachi 74200, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saba","family":"Aliha","sequence":"additional","affiliation":[{"name":"Department of Medicine, Multan Medical and Dental College, Multan 60000, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4228-6476","authenticated-orcid":false,"given":"Muhammad Saad","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Jinnah Sindh Medical University, Karachi 75510, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6582-3078","authenticated-orcid":false,"given":"Sheraz","family":"Qasim","sequence":"additional","affiliation":[{"name":"Department of Medicine, Ameer-ud-Din Medical College, Post Graduate Medical Institute, Lahore 54000, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Campwala","sequence":"additional","affiliation":[{"name":"Department of Medicine, Dow University of Health Sciences, Karachi 74200, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maliha","family":"Khalid","sequence":"additional","affiliation":[{"name":"Department of Medicine, Jinnah Sindh Medical University, Karachi 75510, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adiesh","family":"Sood","sequence":"additional","affiliation":[{"name":"Department of Medicine, Adesh Institute of Medical Sciences and Research, Bathinda 151101, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3379-2942","authenticated-orcid":false,"given":"Umair","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Department of Medicine, CMH Multan Institute of Medical Sciences, Multan 60000, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7057-9975","authenticated-orcid":false,"given":"Haris Bin","family":"Tahir","sequence":"additional","affiliation":[{"name":"Department of Medicine, Lahore General Hospital, Lahore 54700, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7357-8624","authenticated-orcid":false,"given":"Nazila","family":"Dalir","sequence":"additional","affiliation":[{"name":"School of Medicine, St. George\u2019s University, St. George\u2019s, Grenada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taha","family":"Alam","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Ameer-ud-Din Medical College, Post Graduate Medical Institute, Lahore 54000, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1507-3835","authenticated-orcid":false,"given":"Ali Abbas","family":"Khaleel","sequence":"additional","affiliation":[{"name":"Department of Medicine, College of Medicine, Al-Mustansiriyah University, Baghdad 10001, Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3608-4923","authenticated-orcid":false,"given":"Anand Reddy","family":"Maligireddy","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, The University of Kansas Medical Center, Kansas City, KS 66160, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritu","family":"Yadav","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Suny Upstate University, Syracuse, NY 13210, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6836-4490","authenticated-orcid":false,"given":"Amro","family":"Taha","sequence":"additional","affiliation":[{"name":"Division of Cardiology, West Virginia University, Morgantown, WV 26506, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Ghani","sequence":"additional","affiliation":[{"name":"Division of Structural Cardiology, University of Arizona, Tucson, AZ 85721, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fawaz","family":"Alenezi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Duke University School of Medicine, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2968","DOI":"10.1002\/ehf2.13386","article-title":"Predictors and prognosis of right ventricular function in pulmonary hypertension due to heart failure with reduced ejection fraction","volume":"8","author":"Rauwolf","year":"2021","journal-title":"ESC Heart Fail."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"00226\u20132023","DOI":"10.1183\/23120541.00226-2023","article-title":"Echocardiographic evaluation of right ventricular diastolic function in pulmonary 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