{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:19:32Z","timestamp":1790813972783,"version":"4.1.0"},"reference-count":47,"publisher":"European Respiratory Society (ERS)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2010,7,28]]},"published-print":{"date-parts":[[2011,5]]},"abstract":"<jats:p>Current guidelines recommend right heart catheterisation (RHC) in symptomatic patients at risk of pre-capillary pulmonary hypertension (PH) with echocardiographic systolic pulmonary artery pressures \u226536 mmHg. Growing awareness for PH, a high prevalence of post-capillary PH and the inability to distinguish between pre- and post-capillary PH by echocardiography have led to unnecessary RHCs. The aim of our study was to assess whether standard noninvasive diagnostic procedures are able to safely exclude pre-capillary PH.<\/jats:p><jats:p>Data from 251 patients referred for suspicion of pre-capillary PH were used to develop a noninvasive diagnostic decision tree. A prospectively collected data set of 121 consecutive patients was utilised for temporal validation.<\/jats:p><jats:p>According to the decision tree, patients were stratified by the presence or absence of an electrocardiographic right ventricular strain pattern (RVS) and serum N-terminal brain natriuretic peptide (NT-proBNP) levels below and above 80 pg\u00b7mL<jats:sup>\u22121<\/jats:sup>. In the absence of RVS and elevated NT-proBNP, none of the patients in the prospective validation cohort were diagnosed with pre-capillary PH by RHC. Combining echocardiography with the diagnostic algorithm increased specificity to 19.3% (p = 0.0009), while sensitivity remained at 100%.<\/jats:p><jats:p>Employing ECG and NT-proBNP on top of echocardiography helps recognise one false positive case per five patients referred with dyspnoea and echocardiographic suspicion of PH, while not missing true pre-capillary PH.<\/jats:p>","DOI":"10.1183\/09031936.00089610","type":"journal-article","created":{"date-parts":[[2010,8,7]],"date-time":"2010-08-07T00:47:32Z","timestamp":1281142052000},"page":"1096-1103","source":"Crossref","is-referenced-by-count":95,"title":["A noninvasive algorithm to exclude pre-capillary pulmonary hypertension"],"prefix":"10.1183","volume":"37","author":[{"given":"D.","family":"Bonderman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Wexberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.M.","family":"Martischnig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Heinzl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M-B.","family":"Lang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Sadushi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Skoro-Sajer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.M.","family":"Lang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2010,8,6]]},"reference":[{"key":"2024102020253866000_37.5.1096.1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-115-5-343"},{"key":"2024102020253866000_37.5.1096.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ehj.2004.09.014"},{"key":"2024102020253866000_37.5.1096.3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199608293350901"},{"key":"2024102020253866000_37.5.1096.4","doi-asserted-by":"crossref","first-page":"2722","DOI":"10.1161\/01.CIR.89.6.2722","article-title":"Pulmonary hypertension in patients with human immunodeficiency virus infection. 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