ArticleEClinicalMedicine2021
Validity of echocardiographic tricuspid regurgitation gradient to screen for new definition of pulmonary hypertension.
Article in EClinicalMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 54 citations in OpenAlex.
- Point-of-care ultrasound to evaluate volume status in congestive heart failure.Journal of cardiovascular imaging · 2026Review
- Beyond IPF: Pulmonary Function Test Predictors of Echocardiographic Pulmonary Hypertension Across the Spectrum of ILD.Pulmonary circulation · 2026Article
- Significance of echocardiographic metrics including TRV and TAPSE/SPAP in mild haemodynamic pulmonary hypertension - data from EVIDENCE-PAH UK.Echo research and practice · 2026Article
- Predictive value of simple echocardiographic parameters for screening pulmonary hypertension under the revised definition: a study for general hospitals.Open heart · 2026Article
- Assessment of Right Ventricular Adaptability to Pressure Overloading for Critical Therapeutic Decision-Making Processes.Journal of clinical medicine · 2026Review
- Article
- Performance of Guideline-Recommended Approaches to Echocardiographic Investigation for Pulmonary Hypertension: Analysis of the CIPHER Study.Pulmonary circulation · 2026Article
- Clinical validation of a machine-learned, point-of-care system to IDENTIFY pulmonary hypertension.ERJ open research · 2025Article
- How to Assess Pulmonary Circulation and Right Heart Chambers in Systemic Sclerosis Patients?Diagnostics (Basel, Switzerland) · 2025Review
- Impedance cardiography parameters reflecting left ventricular function are markers of pulmonary arterial hypertension.Frontiers in cardiovascular medicine · 2025Article
- The Diagnostic Value of Transthoracic Echocardiography Parameters Under the New Diagnostic Criteria for Pulmonary Hypertension.Canadian respiratory journal · 2025Article
- Definition, classification and diagnosis of pulmonary hypertension.The European respiratory journal · 2024Article
- Diagnosis and Management of Pulmonary Hypertension: New Insights.Diagnostics (Basel, Switzerland) · 2024Review
- Scoping review of post-TB pulmonary vascular disease: Proceedings from the 2nd International Post-Tuberculosis Symposium.Pulmonary circulation · 2024Article
- Two prospective, multicenter studies for the identification of biomarker signatures for early detection of pulmonary hypertension (PH): The CIPHER and CIPHER-MRI studies.Pulmonary circulation · 2024Article
- Echocardiographic evaluation of right ventricular diastolic function in pulmonary hypertension.ERJ open research · 2023Article
- Pulmonary Hypertension: A Contemporary Review.American journal of respiratory and critical care medicine · 2023Review
- Tricuspid Regurgitation Velocity and Mean Pressure Gradient for the Prediction of Pulmonary Hypertension According to the New Hemodynamic Definition.Diagnostics (Basel, Switzerland) · 2023Article
- Reappraisal of the Transthoracic Echocardiographic Algorithm in Predicting Pulmonary Hypertension Redefined by Updated Pulmonary Artery Mean Pressure Threshold.Anatolian journal of cardiology · 2023Article
- Adaptive versus maladaptive right ventricular remodelling.ESC heart failure · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCurrently an echocardiographic threshold for the tricuspid regurgitation gradient (TRG) of > 31 mmHg is recommended for screening for pulmonary hypertension (PH). Invasively diagnosed PH was recently redefined as mean pulmonary arterial pressure (mPAP) > 20 mmHg instead of ≥ 25 mmHg. We investigated the ability of TRG to screen for the new PH-definition.
methodsRetrospective assessment of echocardiography and right heart catheterisation data from 1572 patients entering the Giessen PH-Registry during 2008-2018. Accuracy of different TRG thresholds and other echocardiographic parameters was evaluated using receiver operating characteristic curves.
findings1264 patients fulfilled the new PH-definition. Positive (PPV) and negative predictive values and accuracy of TRG > 46 mmHg were 95%, 39%, and 73%, respectively, for the new PH-definition. Lowering the TRG cut-off to 31 mmHg and below worsened PPV to ≤ 89%. The PPV of TRG for pre-capillary PH (mPAP > 20 mmHg and pulmonary vascular resistance ≥ 3 Wood Units) was ≤ 85%. In patients with TRG ≤ 46 mmHg, tricuspid annular plane systolic excursion/TRG and TRG/right ventricular outflow tract acceleration time were superior to TRG in screening for newly defined pre-capillary PH.
interpretationIn patients with suspected PH referred to a tertiary care centre, the PPV of TRG to meet the new PH-definition depended strongly on the TRG cut-off used. Our data do not support lowering the TRG cut-off. Combining TRG with other echocardiographic parameters might improve the validity of echocardiographic screening for PH.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.