Added prognostic value of cardiopulmonary test variables in low-risk pulmonary artery hypertension patients

Abstract Background Pulmonary artery hypertension (PAH) results in progressive right heart failure, functional decline and finally death or the need for a lung transplant. Prognostic assessment based on 6-minutes walking test (6MWT) may be insufficient due to possibility of ceiling effect, especially young patients. Purpose To demonstrate added prognostic value by cardiopulmonary exercise testing (CPET) patients with low-risk 6MWT. Methods We conducted retrospective cohort study PAH referred two centres between June 2006 December 2021, who met following criteria: PAPm ≥25 mmHg, PCP≤15 PVR >3 UW, age>18 years had CPET performed same week as For variables showing statistical significance, optimal cut-off points were determined. The kappa statistic was used interrater reliability classification 6-minute using Kappa index. Finally, power assessed according TM6D (defined >440 metres) survival analysis. Results included total 313 (27% male). 116 (64.8%) walked more than 440 metres at TM6D, this subgroup being significantly younger those less (42±11 vs 48±16 years) higher proportion men (34.8% 23.4%). In metres, we applied model associated prognosis obtained (Eq CO2 VT1 ≥41 and/or peak VO2 <15 ml/kg/min). Of classified good 6MWT, 84 (72%) altered values. No substantial demonstrated 6MWT (K<0.6 all cases). Kaplan-Meier analysis showed that Eq ml/kg/min worse 5-year follow-up, despite 440m (Figure 1). Conclusion Young have good-prognosis and, however, high-risk adverse events. A combination has predictive Performing is mandatory these adequately stratify risk. Funding Acknowledgement Type funding sources: None.