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However, a standardised approach to interpreting haemodynamic parameters is lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a systematic literature search according to PRISMA guidelines to identify parameters that may be diagnostic for an abnormal haemodynamic response to exercise and offer optimal prognostic and differential-diagnostic value. We performed random-effects meta-analyses of the normal values and report effect sizes as weighted mean\u00b1<jats:sc>sd<\/jats:sc>. Results of diagnostic and prognostic studies are reported descriptively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 45 eligible studies with a total of 5598 subjects. The mean pulmonary arterial pressure (mPAP)\/cardiac output (CO) slope, pulmonary arterial wedge pressure (PAWP)\/CO slope and peak cardiac index (or CO) provided the most consistent prognostic haemodynamic parameters during exercise. The best cut-offs for survival and cardiovascular events were a mPAP\/CO slope &gt;3\u2005Wood units (WU) and PAWP\/CO slope &gt;2\u2005WU. A PAWP\/CO slope cut-off &gt;2\u2005WU best differentiated pre- from post-capillary causes of PAP elevation during exercise. Upper limits of normal (defined as mean+2<jats:sc>sd<\/jats:sc>) for the mPAP\/CO and PAWP\/CO slopes were strongly age-dependent and ranged in 30\u201370-year-old healthy subjects from 1.6 to 3.3\u2005WU and 0.6 to 1.8\u2005WU, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>An increased mPAP\/CO slope during exercise is associated with impaired survival and an independent, prognostically relevant cut-off &gt;3\u2005WU has been validated. A PAWP\/CO slope &gt;2\u2005WU may be suitable for the differentiation between pre- and post-capillary causes of PAP increase during exercise.<\/jats:p><\/jats:sec>","DOI":"10.1183\/13993003.03181-2021","type":"journal-article","created":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T16:50:51Z","timestamp":1648572651000},"page":"2103181","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":97,"title":["Diagnostic, prognostic and differential-diagnostic relevance of pulmonary haemodynamic parameters during exercise: a systematic review"],"prefix":"10.1183","volume":"60","author":[{"given":"Katarina","family":"Zeder","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Banfi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregor","family":"Steinrisser-Allex","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley A.","family":"Maron","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0703-2892","authenticated-orcid":false,"given":"Marc","family":"Humbert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8108-8240","authenticated-orcid":false,"given":"Gregory D.","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Berghold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Horst","family":"Olschewski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabor","family":"Kovacs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2022,3,24]]},"reference":[{"key":"2022101301251344000_60.4.2103181.1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00145608"},{"key":"2022101301251344000_60.4.2103181.2","unstructured":"World Health Organization Expert Committee on Chronic Cor Pulmonale . 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