PONE-D-21-37582Heart rate recovery in 1 minute after the 6-minute walk test predicts adverse outcomes in pulmonary arterial hypertensionPLOS ONE

Dear Dr. Corrêa,

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PLOS ONE

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Additional Editor Comments:

The expert Reviewers were positively disposed to the study but have specific suggestions that require addressing and this may require additional data/information.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

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Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

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Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The authors present a brief, interesting and useful analysis of individuals with recently dx PAH comparing heart rate 1 minute after completing a six-minute walk and clinical changes. The study was prospective and spanned over 15 years with 102 subjects. Lower hear rate was linked to worse clinical outcomes. A bootstrap method was used to validate the findings. The paper is well written and supported by a table and figures.

The Methods section needs a description of inclusion/exclusion criteria, the study institutional approval number/information, and details on obtaining informed consent and protected management of human subject data.

The authors might consider increasing the data on the cohort. Such details as BMI, associated medical conditions, tobacco usage, cause of death, etc. would be of interest.

The authors might put together a second table that summarizes other studies of similar design and intent. The reader would find this a helpful addition to the author's original work and could be mentioned in the Discussion section.

Table 1 may have a few abbreviations not spelled out in the legend. Please correct.

The figures are quite blurry and should be sharped up and improved.

Reviewer #2: The paper is very interesting and important for the area. I suggest that the authors complete Table 1 with the medications used, the number of patients who used oxygen, how many stopped during the six-minute walk test, or if others also stopped. Adding how many desaturate during the test, this is very relevant. I suggest adding the percentage of the predicted distance traveled for the population studied.

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Reviewer #1: No

Reviewer #2: No

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Heart rate recovery in 1 minute after the 6-minute walk test predicts adverse outcomes in pulmonary arterial hypertension

PONE-D-21-37582R1

Dear Dr. Corrêa,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Nejka Potocnik

Academic Editor

PLOS ONE

Additional Editor Comments (optional): The authors present a brief, interesting and useful analysis of individuals with PAH comparing heart rate 1 minute after completing a six-minute walk and clinical changes. The study was prospective and spanned over 15 years with 102 subjects. Lower hear rate was linked to worse clinical outcomes. A bootstrap method was used to validate the findings. The paper is well written and ready to be bublished.

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The authors submitted a revised manuscript. Thye addressed the comments of the Reviewer and are thanked for the effort.

Reviewer #2: (No Response)

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No