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Right atrial pressure, pulmonary artery oxygen saturation and cardiac output reflect right ventricular function and are related to prognosis in patients with PAH. There is no universally accepted consensus on time and frequency of RHC follow-up in patients with PAH. Therefore the practice may vary according to center’s policy and experience. After mandatory initial RHC for diagnosis before initiation of a specific therapy, follow-up RHC should always be considered in case of clinical worsening.

A new reappraisal of hemodynamic parameters correlated to survival has identified the mean PAP, the RA pressure, and the cardiac index as significant. New survival equations adapted to modern era therapy have been derived and should replace the old NIH equation from the 80s (Eur Respir J 2010; 35: 1079–1087).