Richter et al developed a score for helping to identify a patient with an elevated pulmonary artery wedge pressure prior to diagnostic studies. The authors are from the University of California in Los Angeles and Tufts Medical Center in Boston.
Patient selection: LVEF > 50%, mPAP >= 25 mm Hg, not receiving therapy for pulmonary hypertension
Outcome: pulmonary artery wedge pressure > 15 mm Hg
Parameters:
(1) age in years
(2) body mass index (BMI) in kg per square meter
(3) left atrial enlargement
(4) right ventricular enlargement
Parameter
Finding
Points
age in years
<= 68 years
0
> 68 years
1
BMI
<= 30 kg per square m
0
> 30 kg per square m
1
left atrial enlargement
no
0
yes
1
right ventricular enlargement
no
1
yes
0
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• The higher the score the greater the chances of an elevated wedge pressure (> 15 mm Hg).
Score
Elevated Wedge Pressure
0
0%
1
29%
2
36%
3
69%
4
56%
Performance:
• The area under the ROC curve was 0.78.
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