Screening Strategies for Pulmonary Hypertension in Patients With Interstitial Lung Disease: A Multidisciplinary...

Area of Science:

• Pulmonology
• Cardiology
• Critical Care Medicine

Background:

• Pulmonary hypertension (PH) is a frequent complication of interstitial lung disease (ILD), significantly increasing mortality.
• Standardized screening for PH in ILD patients is lacking, despite its association with poor outcomes.
• Effective therapies for PH in ILD are now available, underscoring the need for routine screening.

Purpose of the Study:

• To establish expert consensus on screening strategies for PH in patients with ILD.
• To provide guidance for identifying ILD patients who may have PH.
• To facilitate timely diagnosis and management of PH in ILD.

Main Methods:

• A modified Delphi consensus process involving 16 pulmonologists expert in PH and ILD.
• Three rounds of surveys were used to gather and refine expert opinions on PH screening.
• Panelists rated statements on PH screening strategies using a Likert scale.

Main Results:

• Consensus was reached on multiple PH suspicion triggers: symptoms, clinical signs, imaging (CT), pulse oximetry, natriuretic peptides (BNP/NT-proBNP), and pulmonary function/6-min walk test changes.
• Echocardiography and natriuretic peptides (BNP/NT-proBNP) were identified as key screening tools.
• Right heart catheterization remains the gold standard for PH confirmation.

Conclusions:

• Early PH evaluation in ILD patients is warranted, especially with available therapies.
• Existing ILD evaluation protocols can be adapted for PH risk assessment.
• This consensus provides a framework to aid physicians in identifying and evaluating ILD patients for PH, guiding timely right heart catheterization.