Echocardiography generates parameters with prognostic value such as peri-cardial effusion, right atrium area, LV eccentricity index, RV Doppler index, TAPSE/TAM and the TEI index (see also the chapter "Diagnosis >> Echocardiography")

In contrast systolic PAP pressure estimation by TR velocity, although of high significance for the diagnosis, is very poorly related to outcome during follow-up. Whenever possible the echocardiography should be performed by the same cardiologist each time. It is important as well that supplemental oxygen is mentioned in the report together with SaO₂ measured by a pulse oxymeter.

Echocardiographic follow-up should be done in accordance with the Echo guidelines of the SGPH/SSC (see the recommendations). It should be performed annually or in case of clinical deterioration and after modification of the therapy.

No single echocardiographic parameter should be used as an isolated indicator for adapting therapy. But the data should be evaluated in the clinical context and together with other parameters (6 MWD, PFT, NT- BNP etc.). In case of clinical and/or echocardiographic RV dysfunction worsening, RHC should be considered.