Work

Pulmonary vasoreactive reserve in patients with idiopathic pulmonary arterial hypertension: characteristics and clinical significance

Year: 2026

Type: article

Abstract: Introduction: We hypothesized that differences in pulmonary hemodynamics during acute vasoreactive testing (AVT), beyond the conventional Sitbon criteria, may be described as pulmonary vasoreactive reserve (VRR) that could be used to assess disease severity and prognosis in idiopathic pulmonary arterial hypertension (IPAH) patients. The study aimed to evaluate the clinical significance of VRR in patients with IPAH. Methods: = 52): ΔmPAP < 15%. A comparison was performed between the standard model of survival prediction using the 2022 European Society of Cardiology/European Respiratory Society (ESC/ERS) three-strata risk stratification scale and the experimental model with ΔmPAP grading. Results: = 0.0003] were considered independent predictors of survival. The inclusion of Δ%mPAP slightly improved prognostic value for the 2022 ESC/ERS three-strata risk stratification scale in comparison with the standard 2022 ESC/ERS three-strata approach (mean absolute percentage error, MAPE = 9.66%; C-index = 0.7552742616033755 vs. MAPE = 9.82%; C-index = 0.7510548523206751). Conclusion: The assessment of VRR may warrant further investigation as an additional marker of the disease severity and prognosis in IPAH patients.

Source: Frontiers in Cardiovascular Medicine

DOI: 10.3389/fcvm.2026.1893751