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Recent Journal Updates

JAMAJun 2, 2026

Intra-arterial Alteplase After Thrombectomy for Acute Ischemic Stroke

Clinical Context

We think this might be relevant to the clinical guidance for Pulmonary Vascular Resistance Index (PVRI).

JAMAJun 2, 2026

Syphilis Linked to Higher Risk of Some Cardiovascular Outcomes

Clinical Context

We think this might be relevant to the clinical guidance for Pulmonary Vascular Resistance Index (PVRI).

JAMAJun 2, 2026

Intravenous Tenecteplase Prior to Endovascular Treatment for Ischemic Stroke

Clinical Context

We think this might be relevant to the clinical guidance for Pulmonary Vascular Resistance Index (PVRI).

PVR Index

Critical Unit Alert

Correct units: PVRI is expressed in WU·m² (Wood Units × meters squared). A systematic review (Kwan et al., 2019) found over 50% of literature uses incorrect units (like WU/m²), which can lead to clinical misinterpretation and dosing errors.

Hemodynamic Inputs

Mean PAP (mmHg)

PAWP (mmHg)

Cardiac Index (L/min/m²)

Normal Range (WU·m²)

Normal< 3.0
Elevated3.0 – 6.0
Severe> 6.0

Clinical Precision

Standardization to Body Surface Area (BSA) is critical in assessing pulmonary vascular remodeling. PVRI values are less sensitive to body habitus changes than absolute PVR, making it the preferred metric for transplant listing and complex PAH management.

Evidence-Based Hematology Protocol

Reference: Benza RL, et al. Predicting Survival in PAH: REVEAL Risk Score 2.0. Chest. 2019.

Normal thresholds per 2026 ESC/ERS Guidelines for Pulmonary Hypertension.

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

Primary Clinical Uses

Assessment of pulmonary vascular disease severity in pulmonary arterial hypertension (PAH)

Determining candidacy for ASD/VSD closure (PVRI >3 WU·m² is a relative contraindication)

Cardiac transplantation evaluation (PVRI >6 WU·m² is a relative contraindication per ISHLT)

Liver transplantation risk stratification (portopulmonary hypertension)

Perioperative hemodynamic monitoring in cardiac surgery

Guiding vasodilator therapy in critically ill patients

Why Indexing Matters

PVRI normalizes absolute PVR to body surface area (BSA). This accounts for varying body size, especially important in pediatric patients and adults with extremes of BSA. A systematic review by Kwan et al. (2019) found that 54.6% of published literature uses incorrect units (e.g., WU/m² instead of WU·m²), leading to potential clinical errors.

Last Comprehensive Review: 2026

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

Primary Clinical Uses

Assessment of pulmonary vascular disease severity in pulmonary arterial hypertension (PAH)

Determining candidacy for ASD/VSD closure (PVRI >3 WU·m² is a relative contraindication)

Cardiac transplantation evaluation (PVRI >6 WU·m² is a relative contraindication per ISHLT)

Liver transplantation risk stratification (portopulmonary hypertension)

Perioperative hemodynamic monitoring in cardiac surgery

Guiding vasodilator therapy in critically ill patients

Why Indexing Matters

Last Comprehensive Review: 2026

Related Cardiovascular Tools

Valvular Gradients

Friedewald LDL Equation

Blood Pressure Percentiles

SYNTAX Score

Cardiovascular Calculators Critical Care Calculators Emergency Medicine Calculators

Have feedback about this calculator?Let us know.

Recent Journal Updates

JAMAJun 2, 2026

Intra-arterial Alteplase After Thrombectomy for Acute Ischemic Stroke

Clinical Context

We think this might be relevant to the clinical guidance for Pulmonary Vascular Resistance Index (PVRI).

JAMAJun 2, 2026

Syphilis Linked to Higher Risk of Some Cardiovascular Outcomes

Clinical Context

We think this might be relevant to the clinical guidance for Pulmonary Vascular Resistance Index (PVRI).

JAMAJun 2, 2026

Intravenous Tenecteplase Prior to Endovascular Treatment for Ischemic Stroke

Clinical Context

We think this might be relevant to the clinical guidance for Pulmonary Vascular Resistance Index (PVRI).

PVR Index

Critical Unit Alert

Hemodynamic Inputs

Mean PAP (mmHg)

PAWP (mmHg)

Cardiac Index (L/min/m²)

Normal Range (WU·m²)

Normal< 3.0
Elevated3.0 – 6.0
Severe> 6.0

Clinical Precision

Evidence-Based Hematology Protocol

Reference: Benza RL, et al. Predicting Survival in PAH: REVEAL Risk Score 2.0. Chest. 2019.

Normal thresholds per 2026 ESC/ERS Guidelines for Pulmonary Hypertension.

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

Primary Clinical Uses

Assessment of pulmonary vascular disease severity in pulmonary arterial hypertension (PAH)

Determining candidacy for ASD/VSD closure (PVRI >3 WU·m² is a relative contraindication)

Cardiac transplantation evaluation (PVRI >6 WU·m² is a relative contraindication per ISHLT)

Liver transplantation risk stratification (portopulmonary hypertension)

Perioperative hemodynamic monitoring in cardiac surgery

Guiding vasodilator therapy in critically ill patients

Why Indexing Matters

Last Comprehensive Review: 2026

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

Primary Clinical Uses

Assessment of pulmonary vascular disease severity in pulmonary arterial hypertension (PAH)

Determining candidacy for ASD/VSD closure (PVRI >3 WU·m² is a relative contraindication)

Cardiac transplantation evaluation (PVRI >6 WU·m² is a relative contraindication per ISHLT)

Liver transplantation risk stratification (portopulmonary hypertension)

Perioperative hemodynamic monitoring in cardiac surgery

Guiding vasodilator therapy in critically ill patients

Why Indexing Matters

Last Comprehensive Review: 2026

Related Cardiovascular Tools

Valvular Gradients

Friedewald LDL Equation

Blood Pressure Percentiles

SYNTAX Score

Cardiovascular Calculators Critical Care Calculators Emergency Medicine Calculators

Have feedback about this calculator?Let us know.