{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T17:35:32Z","timestamp":1790703332096,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T00:00:00Z","timestamp":1628208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Even though right heart catheterization (RHC) is the gold\u2010standard method to characterise Pulmonary Hypertension (PH), it cannot be performed in all the patients with suspected PH. Clinical and echocardiographic scores have been developed to differentiate PH secondary to heart failure with preserved ejection fraction (PH\u2010HFpEF) from pre\u2010capillary PH. We aimed to compare the performance of non\u2010invasive parameters in a population with suspected PH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively included consecutive patients who underwent RHC for suspected PH. Patients with a non\u2010invasive evaluation clearly suggestive of left heart disease were excluded. We assessed the performance of non\u2010invasive pulmonary vascular resistance (PVR), echocardiographic pulmonary to left atrial ratio (ePLAR), and Opotowsky, Richter, Berthelot, and D'Alto scores using the area under curve (AUC) of the receiver operating characteristic curves.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 142 included patients, 61 patients had pre\u2010capillary PH, 49 had PH\u2010HFpEF, and 32 patients did not meet invasive criteria for PH. We were able to perform the aforementioned scores in 71\u2013100% of our patients. Using the original cut\u2010offs, Opotowsky was the score that best predicted precapillary PH (96% sensitivity, 41% specificity, AUC .69), followed by D'Alto (98% sensitivity, 22% specificity, AUC .60) and Berthelot (32% sensitivity, 90% specificity, AUC .60). Richter score did not discriminate between phenotypes (AUC .50). Using optimised cut\u2010offs, a Berthelot score\u00a0&lt;\u00a09 predicted precapillary PH with 73% sensitivity and 74% specificity (AUC .73). Single echocardiographic parameters as non\u2010invasive PVR (85% sensitivity, 59% specificity, AUC .72) and ePLAR (73% sensitivity, 76% specificity, AUC .75) showed better prediction performance than the composite studied scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Combined clinical and echocardiographic characteristics can be used to predict pre\u2010capillary PH with moderate performance. The application of these non\u2010invasive parameters in clinical practice can help refine referral to RHC in a population with clinically suspected PH.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.15172","type":"journal-article","created":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T11:42:15Z","timestamp":1628250135000},"page":"1558-1566","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["External validation of different clinical and echocardiographic scores to distinguish post\u2010 from precapillary pulmonary hypertension"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6691-9146","authenticated-orcid":false,"given":"Marta","family":"Fontes Oliveira","sequence":"first","affiliation":[{"name":"Cardiology Department Centro Hospitalar Universit\u00e1rio do Porto Largo do Prof. Abel Salazar  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8724-6262","authenticated-orcid":false,"given":"Maria Isilda","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Centre of Physical Activity Health and Leisure Faculdade de Desporto da Universidade do Porto R. Dr. Pl\u00e1cido da Costa 91  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3985-0718","authenticated-orcid":false,"given":"In\u00eas","family":"Furtado","sequence":"additional","affiliation":[{"name":"Pulmonary Vascular Disease Unit Centro Hospitalar Universit\u00e1rio do Porto Largo do Prof. Abel Salazar  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu\u00edsa","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Pulmonary Vascular Disease Unit Centro Hospitalar Universit\u00e1rio do Porto Largo do Prof. Abel Salazar  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabienne","family":"Gon\u00e7alves","sequence":"additional","affiliation":[{"name":"Pulmonary Vascular Disease Unit Centro Hospitalar Universit\u00e1rio do Porto Largo do Prof. Abel Salazar  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9932-3736","authenticated-orcid":false,"given":"Ab\u00edlio","family":"Reis","sequence":"additional","affiliation":[{"name":"Pulmonary Vascular Disease Unit Centro Hospitalar Universit\u00e1rio do Porto Largo do Prof. Abel Salazar  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4509-0260","authenticated-orcid":false,"given":"M\u00e1rio","family":"Santos","sequence":"additional","affiliation":[{"name":"Cardiology Department Centro Hospitalar Universit\u00e1rio do Porto Largo do Prof. Abel Salazar  Porto Portugal"},{"name":"Pulmonary Vascular Disease Unit Centro Hospitalar Universit\u00e1rio do Porto Largo do Prof. Abel Salazar  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,8,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01032-2015"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.115.302922"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa052256"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv512"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00202814"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01913-2018"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2013.06.003"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2013.05.016"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.03.035"},{"issue":"5","key":"e_1_2_8_11_1","first-page":"1261","article-title":"A simple derived prediction score for the identification of an elevated pulmonary artery wedge pressure using precatheterization clinical data in patients referred to a","volume":"149","author":"Richter SE","year":"2016","journal-title":"pulmonary hypertension center. Chest"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0000000000000485"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2016.10.002"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.112.976654"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.09.004"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2011-301247"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.10.032"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jex244"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jev014"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2010.05.010"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0894-7317(96)90019-X"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.15172","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/echo.15172","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.15172","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T08:38:14Z","timestamp":1693211894000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/echo.15172"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,6]]},"references-count":21,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1111\/echo.15172"],"URL":"https:\/\/doi.org\/10.1111\/echo.15172","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"value":"0742-2822","type":"print"},{"value":"1540-8175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,6]]},"assertion":[{"value":"2021-02-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-08-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}