EUROMACS right-sided heart failure score

EUROMACS-RHF

Sum Soliman 2018 EUROMACS 9.5-point right-sided heart failure points from five caller-assigned flags after continuous-flow LVAD implant and return score and band (low 0-2, intermediate >2 to 4, high >4).

LIVE $0.005 USDC GET /api/calc/euromacs_rhf

Markdown: /docs/euromacs-rhf.md · Canonical: https://magentlab.com/docs/euromacs-rhf

Not a medical device. Not a diagnosis, dose, or listing recommendation.

What it computes

When to use

When an agent has already assigned RA/PCWP >0.54, hemoglobin ≤10 g/dL, multiple IV inotropes, INTERMACS class 1-3, and severe RV dysfunction and needs the published 0-9.5 total and band, not a device indication, Michigan RV-failure score, or CRITT score.

When not to use

Not a medical device. This is published arithmetic, not an LVAD indication, RVAD indication, or implant timing decision.
magent does not catheterize, echo, measure hemoglobin, or assign INTERMACS class; the caller supplies five flags. INTERMACS 1, 2, or 3 scores 2 (Soliman 2018). INTERMACS 1-2 only is not the primary paper.
Not the Michigan RV failure score. Not CRITT.
Bands follow Soliman 2018: low 0-2 inclusive, intermediate >2 to 4 inclusive, high >4. Score 2.0 is low; 2.5 is intermediate; 4.0 is intermediate; 4.5 is high. Half-points are not integer-rounded.

Formula

EUROMACS-RHF = 2*(rap_pcwp_gt_054) + 1*(hemoglobin_le_10) + 2.5*(multiple_iv_inotropes) + 2*(intermacs_1_to_3) + 2*(severe_rv_dysfunction); Soliman 2018; max 9.5; half-points not integer-rounded; bands low 0-2 inclusive, intermediate >2 to 4 inclusive, high >4; INTERMACS 1-3 (not 1-2 only)

Citation

Title: Derivation and Validation of a Novel Right-Sided Heart Failure Model After Implantation of Continuous Flow Left Ventricular Assist Devices: The EUROMACS (European Registry for Patients with Mechanical Circulatory Support) Right-Sided Heart Failure Risk Score
Authors: Soliman OII, Akin S, Muslem R, Boersma E, Manintveld OC, Krabatsch T, Gummert JF, de By TMMH, Bogers AJJC, Zijlstra F, Mohacsi P, Caliskan K, EUROMACS Investigators
Source: Circulation. 2018;137(9):891-906
DOI: 10.1161/CIRCULATIONAHA.117.030543

Worked example

All five flags false

Given: hemoglobin_le_10=falseintermacs_1_to_3=falsemultiple_iv_inotropes=falserap_pcwp_gt_054=falsesevere_rv_dysfunction=false

RA/PCWP >0.54 false → 0; Hb ≤10 false → 0; multiple IV inotropes false → 0; INTERMACS 1-3 false → 0; severe RV dysfunction false → 0
Score = 0 (max 9.5); band low

Inotropes, severe RV dysfunction, and RA/PCWP >0.54

Given: hemoglobin_le_10=falseintermacs_1_to_3=falsemultiple_iv_inotropes=truerap_pcwp_gt_054=truesevere_rv_dysfunction=true

RA/PCWP >0.54 → 2; multiple IV inotropes → 2.5; severe RV dysfunction → 2
Score = 6.5 (max 9.5); band high

Also searched as

EUROMACS RHF
EUROMACS right-sided heart failure score
Soliman 2018
LVAD right heart failure score
EUROMACS-RHF
RA/PCWP INTERMACS RHF score
continuous flow LVAD RHF score
right ventricular failure after LVAD

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/euromacs_rhf?rap_pcwp_gt_054=false&hemoglobin_le_10=false&multiple_iv_inotropes=false&intermacs_1_to_3=false&severe_rv_dysfunction=false

Full URL: https://api.magentlab.com/api/calc/euromacs_rhf?rap_pcwp_gt_054=false&hemoglobin_le_10=false&multiple_iv_inotropes=false&intermacs_1_to_3=false&severe_rv_dysfunction=false

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/euromacs_rhf?rap_pcwp_gt_054=false&hemoglobin_le_10=false&multiple_iv_inotropes=false&intermacs_1_to_3=false&severe_rv_dysfunction=false"

Parameters

Name	Type	Required	Description
`rap_pcwp_gt_054`	boolean	required	RA/PCWP ratio >0.54 as assigned by the caller (Soliman 2018). true scores 2. magent does not catheterize or compute the ratio.
`hemoglobin_le_10`	boolean	required	Hemoglobin ≤10 g/dL as assigned by the caller (Soliman 2018). true scores 1. magent does not measure hemoglobin.
`multiple_iv_inotropes`	boolean	required	Use of multiple intravenous inotropes as assigned by the caller (Soliman 2018). true scores 2.5. magent does not order inotropes.
`intermacs_1_to_3`	boolean	required	INTERMACS class 1, 2, or 3 as assigned by the caller (Soliman 2018). true scores 2. The primary paper uses classes 1-3, not 1-2 only. magent does not assign INTERMACS class.
`severe_rv_dysfunction`	boolean	required	Severe RV dysfunction on echocardiography as assigned by the caller (Soliman 2018). true scores 2. magent does not echo.

Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

POST /api/calc/euromacs_rhf Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 PREVIEW

1 to 25 items. Each item uses the same keys as the GET query parameters.
POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request (fixture)

{
  "items": [
    {
      "hemoglobin_le_10": "false",
      "intermacs_1_to_3": "false",
      "multiple_iv_inotropes": "false",
      "rap_pcwp_gt_054": "false",
      "severe_rv_dysfunction": "false"
    },
    {
      "hemoglobin_le_10": "false",
      "intermacs_1_to_3": "false",
      "multiple_iv_inotropes": "false",
      "rap_pcwp_gt_054": "false",
      "severe_rv_dysfunction": "false"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/euromacs_rhf",
  "items": [
    {
      "band": "low",
      "components": [
        {
          "factor": "rap_pcwp_gt_054",
          "points": 0,
          "present": false
        },
        {
          "factor": "hemoglobin_le_10",
          "points": 0,
          "present": false
        },
        {
          "factor": "multiple_iv_inotropes",
          "points": 0.0,
          "present": false
        },
        {
          "factor": "intermacs_1_to_3",
          "points": 0,
          "present": false
        },
        {
          "factor": "severe_rv_dysfunction",
          "points": 0,
          "present": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Soliman OII, Akin S, Muslem R, Boersma E, Manintveld OC, Krabatsch T, Gummert JF, de By TMMH, Bogers AJJC, Zijlstra F, Mohacsi P, Caliskan K, EUROMACS Investigators",
        "doi": "10.1161/CIRCULATIONAHA.117.030543",
        "id": "soliman-2018",
        "pmid": "28972007",
        "source": "Circulation. 2018;137(9):891-906",
        "title": "Derivation and Validation of a Novel Right-Sided Heart Failure Model After Implantation of Continuous Flow Left Ventricular Assist Devices: The EUROMACS (European Registry for Patients with Mechanical Circulatory Support) Right-Sided Heart Failure Risk Score"
      },
      "formula": "euromacs_rhf",
      "formula_expression": "EUROMACS-RHF = 2*(rap_pcwp_gt_054) + 1*(hemoglobin_le_10) + 2.5*(multiple_iv_inotropes) + 2*(intermacs_1_to_3) + 2*(severe_rv_dysfunction); Soliman 2018; max 9.5; half-points not integer-rounded; bands low 0-2 inclusive, intermediate >2 to 4 inclusive, high >4; INTERMACS 1-3 (not 1-2 only)",
      "max_score": 9.5,
      "score": 0.0,
      "hemoglobin_le_10": false,
      "intermacs_1_to_3": false,
      "multiple_iv_inotropes": false,
      "rap_pcwp_gt_054": false,
      "severe_rv_dysfunction": false
    },
    {
      "band": "low",
      "components": [
        {
          "factor": "rap_pcwp_gt_054",
          "points": 0,
          "present": false
        },
        {
          "factor": "hemoglobin_le_10",
          "points": 0,
          "present": false
        },
        {
          "factor": "multiple_iv_inotropes",
          "points": 0.0,
          "present": false
        },
        {
          "factor": "intermacs_1_to_3",
          "points": 0,
          "present": false
        },
        {
          "factor": "severe_rv_dysfunction",
          "points": 0,
          "present": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Soliman OII, Akin S, Muslem R, Boersma E, Manintveld OC, Krabatsch T, Gummert JF, de By TMMH, Bogers AJJC, Zijlstra F, Mohacsi P, Caliskan K, EUROMACS Investigators",
        "doi": "10.1161/CIRCULATIONAHA.117.030543",
        "id": "soliman-2018",
        "pmid": "28972007",
        "source": "Circulation. 2018;137(9):891-906",
        "title": "Derivation and Validation of a Novel Right-Sided Heart Failure Model After Implantation of Continuous Flow Left Ventricular Assist Devices: The EUROMACS (European Registry for Patients with Mechanical Circulatory Support) Right-Sided Heart Failure Risk Score"
      },
      "formula": "euromacs_rhf",
      "formula_expression": "EUROMACS-RHF = 2*(rap_pcwp_gt_054) + 1*(hemoglobin_le_10) + 2.5*(multiple_iv_inotropes) + 2*(intermacs_1_to_3) + 2*(severe_rv_dysfunction); Soliman 2018; max 9.5; half-points not integer-rounded; bands low 0-2 inclusive, intermediate >2 to 4 inclusive, high >4; INTERMACS 1-3 (not 1-2 only)",
      "max_score": 9.5,
      "score": 0.0,
      "hemoglobin_le_10": false,
      "intermacs_1_to_3": false,
      "multiple_iv_inotropes": false,
      "rap_pcwp_gt_054": false,
      "severe_rv_dysfunction": false
    }
  ]
}

Response

Field	Type	Description
`formula`	string	euromacs_rhf
`formula_expression`	string	Exact expression used
`score`	number	Soliman 2018 EUROMACS-RHF points 0-9.5 (half-points allowed; not integer-rounded)
`max_score`	number	Always 9.5
`band`	string	Soliman 2018 band: low (0-2 inclusive), intermediate (>2 to 4 inclusive), or high (>4). A band, not a device indication.
`rap_pcwp_gt_054`	boolean	Whether RA/PCWP >0.54 was assigned true
`hemoglobin_le_10`	boolean	Whether hemoglobin ≤10 g/dL was assigned true
`multiple_iv_inotropes`	boolean	Whether multiple IV inotropes was assigned true
`intermacs_1_to_3`	boolean	Whether INTERMACS class 1-3 was assigned true
`severe_rv_dysfunction`	boolean	Whether severe RV dysfunction was assigned true
`components`	array	Per-factor Soliman 2018 points
`citation`	object	Soliman et al. Circulation 2018 citation
`disclaimer`	string	Not-a-device notice

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "band": "low",
  "components": [
    {
      "factor": "rap_pcwp_gt_054",
      "points": 0,
      "present": false
    },
    {
      "factor": "hemoglobin_le_10",
      "points": 0,
      "present": false
    },
    {
      "factor": "multiple_iv_inotropes",
      "points": 0.0,
      "present": false
    },
    {
      "factor": "intermacs_1_to_3",
      "points": 0,
      "present": false
    },
    {
      "factor": "severe_rv_dysfunction",
      "points": 0,
      "present": false
    }
  ],
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Soliman OII, Akin S, Muslem R, Boersma E, Manintveld OC, Krabatsch T, Gummert JF, de By TMMH, Bogers AJJC, Zijlstra F, Mohacsi P, Caliskan K, EUROMACS Investigators",
    "doi": "10.1161/CIRCULATIONAHA.117.030543",
    "id": "soliman-2018",
    "pmid": "28972007",
    "source": "Circulation. 2018;137(9):891-906",
    "title": "Derivation and Validation of a Novel Right-Sided Heart Failure Model After Implantation of Continuous Flow Left Ventricular Assist Devices: The EUROMACS (European Registry for Patients with Mechanical Circulatory Support) Right-Sided Heart Failure Risk Score"
  },
  "formula": "euromacs_rhf",
  "formula_expression": "EUROMACS-RHF = 2*(rap_pcwp_gt_054) + 1*(hemoglobin_le_10) + 2.5*(multiple_iv_inotropes) + 2*(intermacs_1_to_3) + 2*(severe_rv_dysfunction); Soliman 2018; max 9.5; half-points not integer-rounded; bands low 0-2 inclusive, intermediate >2 to 4 inclusive, high >4; INTERMACS 1-3 (not 1-2 only)",
  "max_score": 9.5,
  "score": 0.0,
  "hemoglobin_le_10": false,
  "intermacs_1_to_3": false,
  "multiple_iv_inotropes": false,
  "rap_pcwp_gt_054": false,
  "severe_rv_dysfunction": false
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

HTTP	Code	When
400	`invalid_flag`	boolean clinical flags must be true or false Returned before settlement; you are not charged.
400	`invalid_items`	POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
400	`invalid_item_count`	items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
400	`invalid_item`	each items entry must be a JSON object Returned before settlement; you are not charged.

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Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /docs/mcp.

Guarantees

HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
Execution is timeout-bounded and concurrency-capped.
Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.