Egbe AC, Taggart NW, Reddy YNV, et al. - Among patients with tetralogy of Fallot (TOF) that underwent cardiac catheterization for clinical indications at Mayo clinic between 1990 and 2015, researchers investigated for an independent link of right ventricular (RV) afterload with death and/or heart transplant in this retrospective study. The study sample comprised 266 patients with TOF (age 35 ± 14 years, TOF-pulmonary atresia 117 [44%]), with RV systolic pressure (RVSP) 72 ± 28 mmHg, pulmonary artery (PA) systolic pressure 45 ± 19 mmHg, mean PA pressure 27 ± 10 mmHg, pulmonary vascular resistance 4.2 ± 3.1 WU, and PA wedge pressure 14 ± 5 mmHg. Among participants, the factors that independently conferred risk for death and/or transplant were invasively measured RVSP and TOF-pulmonary atresia. In this patient population, RVSP (a composite measure of RV afterload) was found to be independently prognostic. A reliable evaluation of RVSP can be made using Doppler echocardiography.