Jose A, et al. - Researchers intended to assess the role of cardiac Magnetic Resonance Imaging (CMR) as a predictor of clinical worsening in a cohort of treatment-naïve pulmonary hypertension (PH) patients. They conducted a retrospective single-center analysis of all adults with a newly diagnosed treatment-naïve PH between January 1st, 2013 and January 1st, 2019. For this analysis, they enrolled individuals with World Health Organization (WHO)-Group I pulmonary arterial hypertension (PAH) or WHO-Group II/III PH disease, who underwent both CMR (Signa Horizon 1.5 T, General Electric, Milwaukee, WI and Siemens Espree 1.5 T, Munich, Germany) and RHC testing prior to targeted PAH treatment. They constructed Cox proportional hazards models. They recruited a sum of 38 individuals, of which 12 (32 %) experienced the primary outcome of clinical worsening. They found that both CMR and RHC measures of RV dysfunction were equally effective in predicting clinical worsening, regardless of PH etiology. Including those with WHO-Group II/III disease, both CMR and RHC measures independently and significantly predicted clinical worsening, even after adjustment for disease severity in treatment-naïve PH individuals.