{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T05:25:32Z","timestamp":1792041932045,"version":"4.4.0"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,2,19]],"date-time":"2023-02-19T00:00:00Z","timestamp":1676764800000},"content-version":"vor","delay-in-days":49,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pulm. circ."],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Pulmonary hypertension (PH) in interstitial lung disease (ILD) is associated with increased mortality and impaired exertional capacity. Right heart catheterization is the diagnostic standard for PH but is invasive and not readily available. Noninvasive physiologic evaluation may predict PH in ILD. Forty\u2010four\u00a0patients with PH\u00a0and ILD (PH\u2010ILD) were compared with 22 with ILD\u00a0alone (non\u2010PH ILD). Six\u2010min\u00a0walk distance (6MWD, 223\u2009\u00b1\u2009131\u00a0vs. 331\u2009\u00b1\u2009125\u2009m, <jats:italic>p<\/jats:italic>\u2009=\u20090.02) and diffusing capacity for carbon monoxide (DLCO, 33\u2009\u00b1\u200914% vs. 55\u2009\u00b1\u200921%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) were lower in patients with PH\u2010ILD. PH\u2010ILD patients exhibited a lower gas\u2010exchange derived pulmonary vascular capacitance (GX<jats:sub>CAP<\/jats:sub>, 251\u2009\u00b1\u2009132\u00a0vs. 465\u2009\u00b1\u2009282\u2009mL\u2009\u00d7\u2009mmHg, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and extrapolated maximum oxygen uptake (VO<jats:sub>2max<\/jats:sub>) (56\u2009\u00b1\u200932% vs. 84\u2009\u00b1\u200937%, <jats:italic>p<\/jats:italic>\u2009=\u20090.003). Multivariate analysis was performed to determine predictors of VO<jats:sub>2<\/jats:sub><jats:sub>max<\/jats:sub>. GX<jats:sub>CAP<\/jats:sub> was the only variable that predicted extrapolated VO<jats:sub>2<\/jats:sub><jats:sub>max<\/jats:sub> among PH\u2010ILD and non\u2010PH ILD patients. Receiver operating characteristic curve analysis assessed the ability of individual noninvasive variables to distinguish between PH\u2010ILD and non\u2010PH ILD patients. GX<jats:sub>CAP<\/jats:sub> (area under the curve\u00a0[AUC] 0.85\u2009\u00b1\u20090.04, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) and delta ETCO<jats:sub>2<\/jats:sub> (AUC 0.84\u2009\u00b1\u20090.04, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) were the strongest predictors of PH\u2010ILD. A CART analysis selected GX<jats:sub>CAP<\/jats:sub>, estimated right ventricular systolic pressure (eRVSP) by echocardiogram, and FVC\/DLCO ratio as predictive variables for PH\u2010ILD. With this analysis, the AUC improved to 0.94 (sensitivity of 0.86 and sensitivity of 0.93). Patients with a GX<jats:sub>CAP<\/jats:sub>\u2009\u2264\u2009416\u2009mL\u2009\u00d7\u2009mmHg had an 82% probability of PH\u2010ILD. Patients with GX<jats:sub>CAP<\/jats:sub>\u2009\u2264\u2009416\u2009mL\u2009\u00d7\u2009mmHg and high FVC\/DLCO ratio &gt;1.7 had an 80% probability of PH\u2010ILD. Patients with GX<jats:sub>CAP<\/jats:sub>\u2009\u2264\u2009416\u2009mL\u2009\u00d7\u2009mmHg and an elevated eRVSP by echocardiogram &gt;43\u2009mmHg had 100% probability of PH\u2010ILD. The incorporation of GX<jats:sub>CAP<\/jats:sub> with either eRVSP or FVC\/DLCO ratio distinguishes between PH\u2010ILD and non\u2010PH\u2010ILD with high probability and may therefore assist in determining the need to proceed with a diagnostic right heart catheterization\u00a0and potential initiation of pulmonary arterial hypertension\u2010directed therapy in PH\u2010ILD patients.<\/jats:p>","DOI":"10.1002\/pul2.12197","type":"journal-article","created":{"date-parts":[[2023,1,28]],"date-time":"2023-01-28T07:44:35Z","timestamp":1674891875000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Noninvasive determinants of pulmonary hypertension in interstitial lung disease"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9299-8629","authenticated-orcid":false,"given":"Phillip","family":"Joseph","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine Yale New Haven Hospital and Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stella","family":"Savarimuthu","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine Yale New Haven Hospital and Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayi","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Yale School of Public Health  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiting","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine Yale New Haven Hospital and Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah T.","family":"Oakland","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine Yale New Haven Hospital and Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjorie","family":"Cullinan","sequence":"additional","affiliation":[{"name":"Department of Respiratory Care Yale New Haven Hospital  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul M.","family":"Heerdt","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Yale New Haven Hospital and Yale School of Medicine  New Haven Connecticut 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