Table 1. European guideline for assessing prognosis
Better prognosisDeterminants of prognosisWorse prognosis
NoClinical evidence of right ventricle failureYes
SlowRate of progression of symptomsRapid
NoSyncopeYes
I, IIWHO FCIV
Longer (>500 m)#6MWTShorter (<300 m)
Peak O2 consumption >15 mL·min−1·kg−1Cardio-pulmonary exercise testingPeak O2 consumption <12 mL·min−1·kg−1
Normal or near normalBNP/NT-proBNP plasma levelsVery elevated and rising
No pericardial effusion; TAPSE >2.0 cmEchocardiographic findingsPericardial effusion; TAPSE <1.5 cm
Pra <8 mmHg and CI ≥2.5 L·min−1·m−2HaemodynamicsPra >15 mmHg or CI ≤2.0 L·min−1·m−2
  • WHO FC: World Health Organization functional class; 6MWT: 6-min walk test; BNP: brain natriuretic peptide; NT-proBNP: N-terminal pro-B-type natriuretic peptide; TAPSE: tricuspid annular plane systolic excursion; Pra: right atrial pressure; CI: cardiac index. #: depending on age; : TAPSE and pericardial effusion have been selected as they can be measured in the majority of patients. Reproduced from [9] with permission from the publisher.