if pulmonary hypertension is suspected based on the above assessments, echocardiography is performed as the next step. a meta-analysis of doppler echocardiography for predicting the results of right heart catheterization reported a sensitivity and specificity of 88% and 56%, respectively. thus, doppler echocardiography can suggest the presence of pulmonary hypertension, but right heart catherization (described below) remains the gold standard for diagnosis of pah.