Assessment of severity of pulmonary hypertension at baseline and during follow-up1
| Parameter | Goal |
|---|---|
| Clinical assessment | |
| NYHA functional class (I–IV) | Class I or II |
| Physical examination for RV failure (distension of jugular vein, peripheral edema) | Minimal RV failure |
| Exercise capacity | |
| Distance on 6-min walk test | > 440 m |
| Cardiopulmonary exercise testing | |
| Peak VO2 | > 15 mL/min per kg |
| Ventilatory equivalent for CO2 | < 36 |
| RV imaging | |
| Echocardiography (RVSP, RV size and function) | Normal or near normal |
| Cardiac magnetic resonance imaging (RV size and function, cardiac output) | Normal or near normal |
| Plasma biomarker | |
| Brain natriuretic peptide | Normal |
| Cardiopulmonary hemodynamics (by right-heart catheterization) | |
| Measures of pulmonary hypertension | |
| Mean pulmonary arterial pressure | Normal or near normal |
| Pulmonary vascular resistance | Normal or near normal |
| Measures of RV function | |
| Right atrial pressure | < 8 mm Hg |
| Cardiac index | ≥ 2.5 L/min per m2 |
| Mixed venous O2 saturation | > 65% |
Note: CO2 = carbon dioxide, NYHA = New York Heart Association, O2 = oxygen, RV = right ventricle, RVSP = right ventricular systolic pressure, VO2 = oxygen consumption.