Knowledge Gaps and Controversies on Cardiopulmonary Exercise Testing in the Assessment of Pulmonary Vascular Disease: An Official Statement of the Pulmonary Vascular Research Institute Exercise and Right Ventricular Function Task Force

A major consequence of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is pulmonary hypertension (PH), which raises morbidity and mortality rates. This study assessed biomarker profiles, clinical characteristics and diagnostic efficacy of important coagulation and inflammatory markers in AECOPD patients who have varying degrees of PH severity. 

Noninvasive imaging markers may be helpful in identifying higher-risk patients with various lung diseases. Pulmonary artery to aorta ratio (PA/A ratio) on computed tomography (CT) is an indicator of pulmonary hypertension, but its relationship with other hemodynamic, imaging, and physiologic measurements, functional status, and outcomes requires further investigation.

Intermediate–high-risk (IHR) pulmonary embolism (PE) represents a heterogeneous group in whom guideline-based criteria may insufficiently capture biologic and hemodynamic variability relevant to early deterioration. Data-driven phenotyping may improve risk stratification and support individualized decisions regarding reperfusion therapy. In this retrospective cohort study (2012–2025), 553 guideline-defined IHR PE patients were analyzed using unsupervised machine learning.

Vasoreactivity, which refers to the reduction of mean pulmonary arterial pressure in response to inhaled vasodilators, is a well-established metric for prognostication and treatment selection in patients with pulmonary arterial hypertension.