摘要Background Echocardiogram is a simple and useful tool in disease assessment.In ventricular septal defect(VSD)patients with severe pulmonary hypertension(PH),it is difficult to judge whether further intervention is needed.Therefore,this study aimed to investigate the application of echocardiogram in predicting the severity of pulmonary hypertension and guide subsequent management.Methods This study included VSD patients who un-derwent right heart catheterization(RHC)examination in Guangdong Provincial People's Hospital from January 2011 to December 2022.An estimated pulmonary artery systolic pressure(ePASP)higher than 60 mmHg was de-fined as severe PH in this study.Logistic regression analysis and receiver operating characteristic curve(ROC)anal-ysis were used.Results A total of 186 VSD patients with severe PH(ePASP more than 60 mmHg)were included in this study,with 158 cases in the non-correctable group and 28 cases in the collectable group.In univariable logis-tic regression,left atrium dimension(LA),left ventricular end-diastolic dimension(LVDd),left ventricular end-sys-tolic dimension(LVDs),peak velocity of the pulmonary valve(PV),peak velocities from the early phase of the mi-tral inflow(MVE),bidirectional shunting and pericardial effusion were associated with a correctable shunt.When adjusted in multivariable model,only PV and bidirectional shunting remained statistically significant.The ROC curve found that PV exhibits good discriminative ability for correctable shunt(AUC[area under the curve]:0.779,95％CI:0.676-0.871)with a cut-off value of 1.465 m/s.The predictive performance of bidirectional shunting was not satisfactory,with a low AUC of 0.669(95％CI:0.571-0.766).Conclusions PV and bidirectional shunting are simple and clinically available parameters from echocardiogram in predicting PH severity,which not only avoids the repeated unnecessary cardiac catheterization,but also provides a reference basis for follow-up evaluation.