Biochemical markers

  • BNP
    
Increase of NT-ProBNP levels (or BNP if NT-ProBNP not available) during follow-up is associated with worse prognosis. Measurement of the NT-ProBNP is recommended for initial risk stratification and it can be considered for monitoring the effect of treatment. However decision making should not be done on NT-ProBNP alone. It should be emphasized that NT-ProBNP is elevated in both right or left heart failure and therefore is not specific for PH worsening. 

  • Other markers
    Uric acid and Troponin, as well as other biomarkers need further investigation in patients with PAH and are not recommended for routine clinical practice.

a depending on age
b TAPSE and pericardial effusion have been selected because they can be measured in the majority of the patients

BNP brain natriuretic peptide
CI cardiac index
6MWT 6-minute walking test
RAP right atrial pressure
TAPSE tricuspid annular plance systolic excursion
WHO-FC     WHO functional class