Risk stratification of pulmonary hypertension
ESC/ERS 3-risk strata: SPAHR/COMPERA 1.0
ESC/ERS 4-risk strata/ COMPERA 2.0
TAPSE/sPAP (mm/mmHg)
REVEAL 2.0
WHO group 1 subgroup
Male > 60 years
All causes hospitalization ≤ 6 months
eGFR < 60 ml/min/1.73 m² or renal insufficiency
Systolic blood pressure, mmHg
Heart rate, BPM
WHO-FC
6MWD, m
BNP, ng/L or
NT-proBNP, ng/L
PE on echocardiogram
DLCO ≤ 40% pred
RAP > 20 mmHg within 1 year
PVR < 5 WU
REVEAL Lite 2
eGFR < 60 ml/min/1.73 m² or renal insufficiency
Systolic blood pressure, mmHg
Heart rate, BPM
WHO-FC **
6MWD, m **
BNP, ng/L or
NT-proBNP, ng/L **
FPHR noninvasive
FPHR invasive
Result
Reference
Dardi F, Boucly A, Benza R, Frantz R, Mercurio V, Olschewski H, et al. Risk stratification and treatment goals in pulmonary arterial hypertension. Eur Respir J [Internet]. 2024 Oct 31;64(4):2401323. Available from: https://publications.ersnet.org//content/erj/64/4/2401323.abstract
Colalillo A, Hoffmann-Vold AM, Pellicano C, Romaniello A, Gabrielli A, Hachulla E, et al. The role of TAPSE/sPAP ratio in predicting pulmonary hypertension and mortality in the systemic sclerosis EUSTAR cohort. Autoimmunity Reviews [Internet]. 2023 Apr 1;22(4):103290. Available from: https://www.sciencedirect.com/science/article/pii/S1568997223000241
Palacios-Moguel P, Cueto-Robledo G, González-Pacheco H, Ortega-Hernández J, Torres-Rojas MB, Navarro-Vergara DI, et al. The role of the TAPSE/sPAP ratio as a predictor of mortality in Pulmonary Arterial Hypertension: Its value for patient risk stratification. JHLT Open [Internet]. 2025 Feb 1;7:100168. Available from: https://www.sciencedirect.com/science/article/pii/S2950133424001174
Benza RL, Gomberg-Maitland M, Elliott CG, Farber HW, Foreman AJ, Frost AE, McGoon MD, Pasta DJ, Selej M, Burger CD, Frantz RP. Predicting Survival in Patients With Pulmonary Arterial Hypertension: The REVEAL Risk Score Calculator 2.0 and Comparison With ESC/ERS-Based Risk Assessment Strategies. Chest. 2019 Aug;156(2):323-337. doi: 10.1016/j.chest.2019.02.004. Epub 2019 Feb 14. PMID: 30772387.
Évora García M, Pérez Peñate G, Ojeda Suárez C, Galván Fernández H, Veliz Flores I, Villar Hernández J, et al. REVEAL Lite 2 risk assessment in Pulmonary Hypertension associated to respiratory disease. Eur Respir J [Internet]. 64(suppl 68):PA3421. Available from: https://publications.ersnet.org//content/erj/64/suppl_68/PA3421