A new screening method developed at the Lewis Katz School of Medicine at Temple University is showing potential for enhancing the detection of pulmonary arterial hypertension (PAH), a severe form of heart failure. PAH, linked to high blood pressure in lung circulation, often goes undiagnosed due to nonspecific symptoms like fatigue and shortness of breath.
The research, published online on April 5 in the American Heart Journal, introduces the virtual echocardiography screening tool (VEST). When integrated into electronic medical record (EMR) systems, VEST can provide accurate PAH risk scores without requiring labor-intensive manual calculations. This represents a pioneering development in pulmonary vascular medicine.
“Our EMR-based VEST tool proved highly accurate in identifying individuals likely to have PAH,” said Anjali Vaidya, MD, FACC, FASE, FACP. Dr. Vaidya is Co-Director of the Advanced Pulmonary Hypertension Program at Temple University Hospital and Professor of Medicine at the Lewis Katz School of Medicine. She emphasized that this technology could significantly impact heart failure and pulmonary vascular care by enabling earlier detection when treatment is most effective.
In prior studies, Dr. Vaidya’s team applied VEST scoring to echocardiogram data to estimate pressure in the pulmonary artery and identify changes suggesting further testing. They discovered that many patients had positive VEST scores over 200 days before being referred for specialized PH care.
For their latest study, Dr. Vaidya’s team developed an EMR-based algorithm for VEST and tested it on nearly 5,000 patients who underwent echocardiograms. The automatically calculated scores were compared with manually computed ones to identify high-risk patients for PAH. Further analysis determined whether these individuals had been referred to a PH center or undergone right heart catheterization—a standard procedure for PH diagnosis.
“Among the highest-risk patients flagged by the tool, degree of PH was severe—but a third had never been referred to a PH specialist,” Dr. Vaidya noted.
When referrals occurred, nearly all patients received confirmatory testing and were diagnosed with serious disease—demonstrating how the tool can facilitate timely referrals that save lives. Conversely, few non-referred patients received diagnostic right heart catheterization or treatment.
The simplicity and accuracy of VEST make it suitable for broad application. “VEST has already been adopted at Temple,” Dr. Vaidya added. “We are now collaborating with other centers nationally and internationally to facilitate its implementation elsewhere.”
With widespread adoption of this automated EMR-VEST algorithm, earlier diagnoses could become more common—improving survival rates and quality of life for those living with PAH.
Other researchers involved include Suneesh Anand, Gabriela Narowska, Chethan Gangireddy, Martin Keane, Daniel Edmundowicz, Paul Forfia, and John Enevoldsen from Temple University’s Advanced Pulmonary Hypertension Program and Division of Cardiology.
Dr. Vaidya has disclosed a financial interest in the EMR-based Virtual Echocardiography Screening Tool (VEST) algorithm.
