A new scoring tool could catch deadly lung-pressure complications earlier

Pulmonary hypertension (PH) is a serious but often undetected complication in patients with interstitial lung disease (ILD), and there's currently no standardized screening guidance to catch it early. Researchers from Temple University presented interim data from the PHINDER study at CHEST 2026, showcasing the PVD-B65 scoring model as a potential solution for risk-stratifying these patients and predicting 1-year mortality.

The PVD-B65 score draws on four clinical markers — pulmonary fibrosis without emphysema, pulmonary vascular resistance >5 Wood Units, a 6-minute walk distance <150 m, and BNP >200 pg/dL — to classify patients as low, intermediate, or high risk. Among 119 ILD patients with confirmed PH, IPF emerged as the deadliest subtype, carrying the highest mean PVD-B65 score (7.9), while elevated mean pulmonary artery pressure (mPAP) was also a strong mortality predictor.

Key Takeaways:

• IPF was the most common ILD subtype (41%) and carried the highest mortality risk score
• Mean PVD-B65 scores were 4.2 (mild mPAP) vs. 5.3 (moderate-severe mPAP)
• 12% of IPF patients met high-risk criteria under the PVD-B65 model
• The FDA's 2025 approval of treprostinil has made PH-ILD treatment more feasible, raising the stakes for early detection

Why it matters: PH in ILD patients is underdiagnosed and carries significant mortality risk. A validated screening tool could help clinicians identify high-risk patients sooner, enabling timely treatment — especially now that effective therapies like treprostinil are available.