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Updated: Jan 24, 2026
Evaluation of Right Ventricular Function in Experimental Models of Pulmonary Arterial Hypertension
Published on: June 27, 2025
Application of the DETECT algorithm for detection of risk of pulmonary arterial hypertension in systemic sclerosis:
Tomas Soukup1, Radek Pudil2, Katerina Kubinova3
12nd Department of Internal Medicine - Gastroenterology, soukutom@fnhk.cz.
Insights
A modified DETECT algorithm shows promise for early pulmonary arterial hypertension (PAH) detection in systemic sclerosis (SSc) patients. This tool identified more at-risk individuals than standard guidelines, potentially improving PAH screening.
Area of Science:
- Cardiology
- Rheumatology
- Pulmonology
Background:
- Pulmonary arterial hypertension (PAH) is a serious complication in systemic sclerosis (SSc).
- Early and reliable detection of PAH in SSc is crucial for timely intervention.
- Existing screening guidelines may not be fully optimal for SSc patients.
Purpose of the Study:
- To evaluate a modified DETECT algorithm for PAH risk assessment in SSc patients.
- To compare the modified DETECT algorithm's performance against current European Society of Cardiology/European Respiratory Society (ESC/ERS) 2009 guidelines.
- To assess the predictive value of the modified DETECT algorithm in a Czech SSc cohort.
Main Methods:
- Retrospective, single-centre, cross-sectional study of 60 SSc patients (ACR criteria).
- Application of a modified DETECT algorithm incorporating right ventricle diameter.
- Comparison of RHC recommendations between the modified DETECT and ESC/ERS 2009 guidelines.
Main Results:
- The modified DETECT calculator recommended RHC for 41.4% of patients, versus 24.1% for ESC/ERS 2009 guidelines.
- PAH was diagnosed in 12.1% of patients (7/58).
- The modified DETECT algorithm identified patients who were later diagnosed with PAH up to two years prior.
Conclusions:
- The modified DETECT algorithm successfully identified all PAH cases diagnosed by ESC/ERS 2009 guidelines and RHC.
- The modified DETECT calculator demonstrates a potential positive predictive role for early PAH detection in SSc.
- Further validation is warranted to confirm the clinical utility of the modified DETECT algorithm.
Objective:
The early, simple and reliable detection of pulmonary arterial hypertension (PAH) in SSc (DETECT) study described a new algorithm for early detection of PAH in patients with SSc. The aim of this retrospective, single-centre, cross-sectional study was to apply a modified DETECT calculator in patients with SSc in the East Bohemian region, Czech Republic, to assess the risk of PAH and to compare these results with PAH screening based on the European Society of Cardiology/European Respiratory Society (ESC/ERS) 2009 guidelines.
Methods:
Sixty patients were recruited with a diagnosis of SSc (according to ACR criteria), aged 27-78 years. A modified DETECT algorithm using the modified parameter of (1.4 × right ventricle diameter)(2) in place of right atrium area was applied to all patients. Right heart catheterization (RHC) was performed in all patients with an estimated (by echocardiography) increased systolic pulmonary artery pressure ≥50 mm Hg in accordance with the ESC/ERS guidelines; however, RHC was not performed in patients solely recommended for RHC using the modified DETECT algorithm.
Results:
Using the modified DETECT calculator, 24/58 (41.4%) patients were recommended for RHC, compared with 14/58 (24.1%) when applying the ESC/ERS 2009 guidelines. PAH was diagnosed in 7/58 (12.1%) patients. During follow-up, PAH was diagnosed in six patients. Of these, four were modified DETECT score-positive for 2 years and all for 1 year before PAH diagnosis.
Conclusion:
The modified DETECT algorithm detects all patients with PAH diagnosed according to ECS/ERS 2009 guidelines and RHC. Data of the 2-year follow-up indicate a possible positive predictive role for the modified DETECT calculator.
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