Key result
Noninvasive mPAP/VO2 slope >12.4 linked to ~2.8-fold higher risk of clinical worsening in PH.
Why the study?
Does noninvasive mPAP/V'O2 slope predict invasive exercise pulmonary hypertension and clinical worsening in patients evaluated for pulmonary vascular disease?
Cohort (n=72)
No
Does noninvasive mPAP/V'O2 slope predict invasive exercise pulmonary hypertension and clinical worsening in patients evaluated for pulmonary vascular disease?
Noninvasive mPAP/V'O2 slope assessed via combined exercise echocardiography and CPET is a promising surrogate for invasive pulmonary exercise hemodynamics that strongly predicts exercise pulmonary hypertension and long-term clinical prognosis.
Answers are grounded in this paper and cite their sources.
May support noninvasive risk stratification in PH evaluation; leaves open need for prospective validation before clinical adoption.
Extract Exercise pulmonary hypertension (EPH), defined by a mean pulmonary arterial pressure (mPAP) to cardiac output (CO) slope >3 mmHg·L⁻¹·min⁻¹ during exercise right heart catheterization (exRHC) [1], is associated with exercise limitation, impaired right heart function and poor outcome [2–5].
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John et al. (2025) conducted a cohort in Suspected pulmonary hypertension (n=72). mPAP/VO2 slope >12.4 mmHg·L-1·min vs. mPAP/VO2 slope ≤12.4 mmHg·L-1·min was evaluated on Clinical worsening (all-cause mortality, transplantation, or disease-related hospitalisation) (HR 2.82, 95% CI 0.91-5.73, p=0.038).
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