Abstract
BackgroundRisk assessment of pulmonary arterial hypertension (PAH) contributes to its management. Unfortunately, the existing risk assessment approaches are defective for clinicians to practice in daily clinical settings to some extent.MethodsWe designed a modified Risk Assessment Score of PAH (mRASP) comprising four non-invasive variables which were World Health Organization functional class(WHO FC), 6-min walk distance (6MWD), N-terminal of the pro-hormone brain natriuretic peptide(NT-pro BNP), and right atrial area(RAA), then validated it in the prediction of one-year survival rate for patients with PAH by contrast with the REVEAL risk score.ResultsFor the validation cohort(n = 216), the predicted one-year survival rate were 95–100%, 90–95%, and < 90% in the mRASP risk score strata of 0–2, 3–5, and 6–8, respectively; meanwhile, the observed one-year survival rates were 97.1, 92.6, and 52.2%, in each corresponding stratum, respectively. The mRASP (c-index = 0.727) demonstrated similar predictive power in contrast with the REVEAL risk assessment score (c-index = 0.715) in the prediction of one-year survival rate.ConclusionThe mRASP is an eligible risk assessment tool for the prognostic assessment of PAH. In contrast with the REVEAL score, it demonstrated similar predictive power and accuracy, with extra simplicity and convenience.
Highlights
Risk assessment of pulmonary arterial hypertension (PAH) contributes to its management
The eligible patients registered between May, 2014 and May, 2015 of Department of Cardiopulmonary Circulation, Shanghai Pulmonary Hospital were enrolled into the establishment cohort which was used to establish the model of modified Risk Assessment Score of PAH (mRASP) by means of retrospectively corresponding the patients’ score of the mRASP in May, 2015 to the observed survival rate between May, 2015 and May, 2016
Model establishment of the mRASP The model of modified risk assessment score of PAH was established by using the establishment cohort
Summary
Risk assessment of pulmonary arterial hypertension (PAH) contributes to its management. Pulmonary arterial hypertension is a pathophysiological disorder complicating both of cardiovascular and respiratory diseases. One approach which can distinctly classify the risk strata of PAH is the French registry risk equation, which concerns sex, 6MWD and cardiac output merely [3, 4]. Another one is the risk assessment score of Registry to Evaluate Early and Long-Term Pulmonary. Arterial Hypertension Disease Management (REVEAL) which is a simplified risk score based on the prognostic equation, and is designed to be simple and easy enough to be adopted in everyday clinical practice, compared with the relatively complex REVEAL risk equation [5].
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