Table 2.
ESC/ERS Risk Assessment Guidelines For Pulmonary Arterial Hypertension.
| Low Risk < 5% | Intermediate Risk 5–10% | High Risk > 10% | |
|---|---|---|---|
| CLINICAL SIGNS OF RIGHT HEART FAILURE | ABSENT | ABSENT | PRESENT |
| PROGRESSION OF SYMPTOMS | NO | SLOW | RAPID |
| SYNCOPE | NO | OCCASIONAL SYNCOPE | REPEATED SYNCOPE |
| WHO FUNCTIONAL CLASS | I, II | III | IV |
| 6MWD | >440 m | 165–440 m | <165 m |
| CARDIOPULMONARY EXERCISE TESTING | Peak VO2 > 15 mL/min/kg (>65% pred.) VE/VCO2 slope < 36 |
Peak VO2 11–15 mL/min/kg (35–65% pred.) VE/VCO2 slope 36–44.9 |
Peak VO2 < 11 mL/min/kg (<35% pred.) VE/VCO2 > 45 |
| NT-proBNP PLASMA LEVELS | BNP < 50 ng/L NT-proBNP < 300 ng/mL |
BNP 50–300 ng/L NT-proBNP 300–1400 ng/L |
BNP > 300 ng/L NT-proBNP > 1400 ng/L |
| IMAGING (ECHOCARDIOGRAPHY, CMR IMAGING) | RA area < 18 cm2 No pericardial effusion |
RA area 18–26 cm2 No or minimal, pericardial effusion |
RA area > 26 cm2 Pericardial effusion |
| HEMODYNAMICS | RAP < 8 mmHg CI > 2.5 L/min/m2 SvO2 > 65% |
RAP 8–14 mmHg CI 2.0–2.4 L/min/m2 SvO2 60–65% |
RAP > 14 mmHg CI < 2.0 L/min/m2 SvO2 < 60% |
World Health Organization (WHO), 6 min walking distance (6MWD), ventilatory equivalents for carbon dioxide (VE/VCO2), oxygen consumption (VO2), brain natriuretic peptide (BNP), N-terminal pro-brain natriuretic peptide (NT-proBNP), right atrial (RA), Right Atrial Pressure (RAP), Cardiac Index (CI).