Noninvasive determinants of pulmonary hypertension in interstitial lung disease

Abstract Pulmonary hypertension (PH) in interstitial lung disease (ILD) is associated with increased mortality and impaired exertional capacity. Right heart catheterization is the diagnostic standard for PH but is invasive and not readily available. Noninvasive physiologic evaluation may predict PH in ILD. Forty‐four patients with PH and ILD (PH‐ILD) were compared with 22 with ILD alone (non‐PH ILD). Six‐min walk distance (6MWD, 223 ± 131 vs. 331 ± 125 m, p = 0.02) and diffusing capacity for carbon monoxide (DLCO, 33 ± 14% vs. 55 ± 21%, p 1.7 had an 80% probability of PH‐ILD. Patients with GXCAP ≤ 416 mL × mmHg and an elevated eRVSP by echocardiogram >43 mmHg had 100% probability of PH‐ILD. The incorporation of GXCAP with either eRVSP or FVC/DLCO ratio distinguishes between PH‐ILD and non‐PH‐ILD with high probability and may therefore assist in determining the need to proceed with a diagnostic right heart catheterization and potential initiation of pulmonary arterial hypertension‐directed therapy in PH‐ILD patients.