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European heart journal. Cardiovascular Imaging

The added value of echocardiography in pulmonary arterial hypertension risk assessment: an artificial intelligence machine learning-derived analysis of the ULTRA RIGHT VALUE registry

In a 401-patient multicentre European prospective pulmonary arterial hypertension (PAH) cohort, adding right ventricular echocardiographic parameters—especially right ventricular-pulmonary arterial (RV-PA) coupling indices—to the ESC/ERS and REVEAL 2.0 risk scores improved the c-index for morbi-mortality prediction from 0.73 to 0.78 and from 0.74 to 0.79, respectively (P<0.01), with machine learning identifying RV-PA coupling as the most influential dimension.