The current recommendation from the Scleroderma Foundation and Pulmonary Hypertension Association for screening of PH [31] is to use a combination of DLCO, TDE (both high evidence), NT-proBNP, and the DETECT algorithm if DLCO% is less than 60 % and disease duration is more than 3 years (both moderate evidence) [11]. This evidence concerns the gene NPPB and pulmonary hypertension.