Validating the Venous Excess Ultrasound Score (VExUS) for Right Atrial Pressure Assessment in Pulmonary Hypertension: A Multicenter Study

Highlight

• The Venous Excess Ultrasound Score (VExUS) demonstrates strong graded correlation with invasively measured right atrial pressure (RAP) in patients with pulmonary hypertension (PH).
• VExUS shows excellent diagnostic accuracy (AUC 0.97) for detecting elevated RAP >12 mmHg, surpassing isolated echocardiographic markers and matching composite echocardiographic RAP estimation.
• Accuracy of VExUS holds consistent across pre-capillary, post-capillary, and non-pulmonary hypertension hemodynamic profiles, emphasizing broad clinical applicability.
• This noninvasive tool may enhance bedside assessment of systemic venous congestion, guiding management in PH and other conditions of elevated venous pressure.