Photo Credit: Polesnoy

A cohort study published in ERJ Open Research explored the prognostic value of hemodynamic variables in PAH and compared their predictive power with existing risk tools and non-invasive measures. The study authors recruited 794 treatment-naïve patients with PAH to assess clinical, functional, exercise, laboratory, and hemodynamic parameters at baseline and after initial therapy. Through stepwise multivariate Cox regression analysis, right atrial pressure and pulmonary artery elastance emerged as independent predictors of mortality. The researchers identified six variables for their prognostic relevance: pulmonary arterial compliance, cardiac efficiency, pulmonary vascular resistance, S_vO2, cardiac index, and stroke volume index. Although hemodynamic parameters did not enhance prognostic accuracy for all-cause death compared with the European Society of Cardiology/European Respiratory Society (ESC/ERS) risk tools, they provided added value for predicting a combined endpoint of death, hospitalization, or treatment escalation. Furthermore, when evaluated independently, hemodynamic variables demonstrated a discriminatory ability comparable to ESC/ERS risk tools, particularly for assessing clinical worsening.