Vraka Argyro, Diamanti Eleni, Kularatne Mithum, Yerly Patrick, Lador Frédéric, Aubert John-David, Lechartier Benoit
Pulmonary Division, Lausanne University Hospital, University of Lausanne, 1011 Lausanne, Switzerland.
Division of Respiratory Medicine, Department of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
J Clin Med. 2023 Jun 28;12(13):4349. doi: 10.3390/jcm12134349.
Risk stratification in pulmonary arterial hypertension (PAH) is crucial in assessing patient prognosis. It serves a prominent role in everyday patient care and can be determined using several validated risk assessment scores worldwide. The recently published 2022 European Society of Cardiology (ESC)/European Respiratory Society (ERS) guidelines underline the importance of risk stratification not only at baseline but also during follow-up. Achieving a low-risk status has now become the therapeutic goal, emphasising the importance of personalised therapy. The application of these guidelines is also important in determining the timing for lung transplantation referral. In this review, we summarise the most relevant prognostic factors of PAH as well as the parameters used in PAH risk scores and their evolution in the guidelines over the last decade. Finally, we describe the central role that risk stratification plays in the current guidelines not only in European countries but also in Asian countries.
肺动脉高压(PAH)的风险分层对于评估患者预后至关重要。它在日常患者护理中发挥着重要作用,可通过全球多个经过验证的风险评估分数来确定。最近发布的2022年欧洲心脏病学会(ESC)/欧洲呼吸学会(ERS)指南强调了风险分层不仅在基线时而且在随访期间的重要性。实现低风险状态现已成为治疗目标,突出了个性化治疗的重要性。这些指南的应用在确定肺移植转诊时机方面也很重要。在本综述中,我们总结了PAH最相关的预后因素以及PAH风险评分中使用的参数及其在过去十年指南中的演变。最后,我们描述了风险分层在当前指南中不仅在欧洲国家而且在亚洲国家所起的核心作用。