Guidelines for the diagnosis and treatment of pulmonary hypertension: The Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS), endorsed by the International Society of Heart and Lung Transplantation (ISHLT)

Galiè, Nazzareno; Hoeper, Marius M.; Humbert, Marc; Torbicki, Adam; Vachiéry, JL; Barberá, JA; Beghetti, Maurice; Corris, Paul A.; Gaine, Seán; Js, Gibbs; Ma, Gómez-Sánchez; Jondeau, Guillaume; Klepetko, Walter; Opitz, Christian; Peacock, Andrew J.; Rubin, Lewis J.; Zellweger, M.; Simonneau, Gérald

doi:10.1093/eurheartj/ehp297

Cited by 3,021 publications

(2,357 citation statements)

References 242 publications

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“…our experience, perfusion lung scintigraphy should also be obtained for it allows detecting multiple segmental or lobar perfusion defects that are the hallmark of chronic thromboembolic pulmonary hypertension [24]. This is amenable of surgical repair if the organized clots are located in the proximal branches of the pulmonary circulation [1,2,8,10]. Conversely, if the chest radiograph does not meet the criteria for PH, it is unlikely that the disease be present.…”

Section: Discussionmentioning

confidence: 99%

“…Cardiac output was measured in triplicate by the thermodilution method, and the average value calculated. PH was diagnosed if the mean pulmonary artery pressure (MPAP) at rest was N 25 mmHg, and the mean pulmonary wedge pressure (MPWP) b15 mmHg [1,2]. Oxymetry was used to detect left-to-right shunting.…”

Section: Study Protocolmentioning

confidence: 99%

“…Pulmonary hypertension (PH), in its "pre-capillary" form, is a rare but devastating disorder that carries high morbidity, and mortality [1,2]. Clinical symptoms and signs are nonspecific, and the definitive diagnosis rests on the hemodynamic documentation of a mean pulmonary artery pressure exceeding 25 mmHg at rest with a normal pulmonary artery wedge pressure [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…Clinical symptoms and signs are nonspecific, and the definitive diagnosis rests on the hemodynamic documentation of a mean pulmonary artery pressure exceeding 25 mmHg at rest with a normal pulmonary artery wedge pressure [1,2].…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of chest radiography in predicting pulmonary hypertension: A case-control study

Miniati

Monti

Airò

et al. 2014

Thrombosis Research

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a b s t r a c t a r t i c l e i n f oObjective: To assess the accuracy of chest radiography (CXR) in predicting pulmonary hypertension (PH). Methods: We studied 108 consecutive patients with suspected PH who underwent right heart catheterization (RHC). All were PH treatment naives. Hemodynamic criteria included a mean pulmonary artery pressure N 25 mmHg at rest, and a mean pulmonary wedge pressure b 15 mmHg. Postero-anterior and lateral CXR were obtained shortly before RHC. To avoid a selection bias which could be introduced by examining only patients with suspected PH, we included in the analysis the CXR of 454 additional patients with different diagnosis: 57 with left heart failure (LHF) and pulmonary venous hypertension at RHC, 197 with chronic obstructive pulmonary disease, and 200 non-obstructed controls. CXR were examined independently by 4 raters, who were blinded to clinical, hemodynamic, and spirometric data. The diagnosis of PH was made if a prominent main pulmonary artery was associated with anyone of: isolated enlargement of right ventricle, right descending pulmonary artery N 16 mm in diameter, pruning of peripheral pulmonary vessels. Results: Eighty-two patients had PH confirmed at RHC. Weighted sensitivity of CXR was 96.9% (95% confidence interval, 94.9 to 98.2%), and weighted specificity 99.8% (95% confidence interval, 99.6 to 99.9%). By considering the 165 patients who underwent RHC, weighted sensitivity of CXR was unchanged, and weighted specificity decreased to 99.1%. None of the patients with PH were misclassified as having LHF, and vice versa. Conclusions: CXR is accurate in predicting PH. It may aid clinicians in selecting patients with suspected PH for hemodynamic ascertainment.

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Section: Discussionmentioning

confidence: 99%

Section: Study Protocolmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Accuracy of chest radiography in predicting pulmonary hypertension: A case-control study

Miniati

Monti

Airò

et al. 2014

Thrombosis Research

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“…However, echo-Doppler is an easily available, inexpensive and non-invasive way of obtaining a comprehensive assessment of pulmonary haemodynamics and is recommended as the initial investigation of choice in most guidelines 2,3…”

Section: How Is Ph Best Defined Classified and Investigated?mentioning

confidence: 99%

Contemporary insights into the pathogenesis, diagnosis and therapy of pulmonary arterial hypertension

Essop¹

2010

CardioVascular Journal of Africa

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SummaryCurrent data challenge the concept that pulmonary arterial hypertension (PAH) is purely a disorder of impaired vasomotor tone. Instead, we recognise today that the phenotype of PAH represents the complex and disordered regulation of expression of key signalling molecules and abnormal molecular trafficking. Discovery of mutations of the ubiquitous receptors of the transforming growth factor beta (TGF-β) superfamily in many patients with PAH has been instrumental in unravelling the pathobiology of this otherwise fatal disorder. Much still needs to be learnt before we are able to substantially alter the natural history of PAH. Until such time, therapies that fundamentally attempt to restore vasomotor tone continue to be developed and tested.Current clinical research in the therapeutic arena is focused on defining the best permutation of the three major groups of drugs – prostacyclin analogues, phosphodiesterase type-five inhibitors and the endothelin receptor antagonists. However, if we are to make any significant impact on the otherwise dismal outcome of PAH, we have to recognise that even more important than the challenge of new therapies, is the challenge in diagnosing the condition early in the course of its relentless progression to right heart failure and eventual death.

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Pulmonary Arterial Hypertension in Patients With Slow-Flow Vascular Malformations

Rodríguez‐Mañero¹,

Aguado²,

Redondo³

2010

Arch Dermatol

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Cited by 3,021 publications

References 242 publications

Accuracy of chest radiography in predicting pulmonary hypertension: A case-control study

Accuracy of chest radiography in predicting pulmonary hypertension: A case-control study

Contemporary insights into the pathogenesis, diagnosis and therapy of pulmonary arterial hypertension

Pulmonary Arterial Hypertension in Patients With Slow-Flow Vascular Malformations

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