Kim Ho Cheol, Chandel Abhimanyu, King Christopher S, Kim Min Jee, Shawabkeh Malek, Arunachalam Ambalavanan, Tomic Rade, Nathan Steven D
Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Advanced Lung Disease and Transplant Program, Inova Heart and Vascular Institute, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA, 22042, USA.
Lung. 2025 Jan 22;203(1):27. doi: 10.1007/s00408-024-00783-2.
Pulmonary hypertension (PH) is associated with morbidity and mortality in patients with interstitial lung disease (ILD). Several prediction models have been proposed to predict PH in ILD patients. We sought to discern how previously described prediction models perform in predicting PH in patients with ILD.
Patients with ILD who completed a baseline right heart catheterization, from Inova Fairfax Hospital, Northwestern Memorial Hospital, and Asan Medical Center in Korea were enrolled. The performance of various prediction models (FORD model, the FORD calculator, the PH-ILD Detection tool, and the mean pulmonary artery pressure prediction model) were assessed using receiver operating characteristic (ROC) curves and area under the receiver operating characteristic curve (AUROC). There were four definitions of pulmonary hypertension against which the models were evaluated.
There were a total of 192 patients with ILD, of whom 32.8% (n = 63/192) met the modified 5th world symposium on PH definition of precapillary PH. Among the models assessed, the FORD calculator had an AUROC (0.733) that was marginally highest. Subgroup analysis revealed that the FORD index had the highest AUROC (0.817) in patients with idiopathic pulmonary fibrosis, while the FORD calculator had the highest AUROC (0.751) in patients with non-IPF ILD.
The FORD model can be used to predict group 3 PH in both IPF patients and non-IPF ILD patients. It could serve as a tool for ILD patient selection for right heart catheterization as well as an enrichment tool for clinical trials targeting the pulmonary vasculature.
肺动脉高压（PH）与间质性肺疾病（ILD）患者的发病率和死亡率相关。已经提出了几种预测模型来预测ILD患者的PH。我们试图了解先前描述的预测模型在预测ILD患者的PH方面表现如何。
纳入了来自韩国峨山医学中心、弗吉尼亚州费尔法克斯英诺瓦医院和西北纪念医院完成基线右心导管检查的ILD患者。使用受试者工作特征（ROC）曲线和受试者工作特征曲线下面积（AUROC）评估各种预测模型（FORD模型、FORD计算器、PH-ILD检测工具和平均肺动脉压预测模型）的性能。针对四种肺动脉高压定义对模型进行了评估。
共有192例ILD患者，其中32.8%（n = 63/192）符合第五届世界肺动脉高压研讨会修订的毛细血管前PH定义。在评估的模型中，FORD计算器的AUROC（0.733）略高。亚组分析显示，FORD指数在特发性肺纤维化患者中的AUROC最高（0.817），而FORD计算器在非IPF-ILD患者中的AUROC最高（0.751）。
FORD模型可用于预测IPF患者和非IPF-ILD患者的3组PH。它可以作为ILD患者选择进行右心导管检查的工具，以及针对肺血管系统的临床试验的富集工具。
