The changing face of pulmonary hypertension diagnosis: a historical perspective on the influence of diagnostics and biomarkers

Abstract

Pulmonary hypertension is a complex, multifactorial disease that results in right heart failure and premature death. Since the initial reports of pulmonary hypertension in the late 1800s, the diagnosis of pulmonary hypertension has evolved with respect to its definition, screening tools, and diagnostic techniques. This historical perspective traces the earliest roots of pulmonary hypertension detection and diagnosis through to the current recommendations for classification. We highlight the diagnostic tools used in the past and present, and end with a focus on the future directions of early detection. Early detection of pulmonary hypertension and pulmonary arterial hypertension and the proper determination of etiology are vital for the early therapeutic intervention that can prolong life expectancy and improve quality of life. The search for a non-invasive screening tool for the identification and classification of pulmonary hypertension is ongoing, and we discuss the role of animal models of the disease in this search.

Circulating nerve growth factor receptor positive cells are associated with severity and prognosis of pulmonary arterial hypertension

“…IL-6, osteopontin, and N-terminal propeptide of procollagen III) are also reportedly correlated with PAH. 2 Therefore, the abilities of EPC and MSC markers to predict the severity and prognosis of PAH should also be compared with the biomarkers mentioned above. Finally, although NGFR is reportedly expressed on the surface of MSCs, the present study did not demonstrate that circulating NGFR positive cells have properties of MSCs.…”

“…However, RHC is an invasive test; moreover, early diagnosis of PAH based solely on hemodynamic parameters obtained from RHC is problematic, because approximately two-thirds of the pulmonary vascular bed has already irreversibly deteriorated by the time of PAH diagnosis. 2 Therefore, identification of biomarkers for the diagnosis of PAH and assessment of its severity at an early stage are important priorities in the field of pulmonary vascular medicine. Vascular remodeling is caused by the proliferation and abnormal signal transduction of vascular endothelium and smooth muscle cells.…”

Individually tailored 12-week home-based exercise program improves both physical capacity and sleep quality in patients with pulmonary arterial hypertension

“…Pulmonary arterial hypertension (PAH) is a rare and severe disease characterized by an increase in pulmonary artery pressure and pulmonary vascular resistance, which ultimately lead to right ventricular failure and death. 1 Most patients with optimal PAH-targeted medical therapy suffer from clinical symptoms, reduced exercise tolerance and have a poor quality of life. 2 The significance of physical exercise as an important component of therapy has already been proven in the scope of various cardiopulmonary diseases.…”

Role of microRNAs derived from exosomes in pulmonary hypertension

“…Considerable evidence from basic and clinical experiment has demonstrated that pulmonary vascular remodeling caused by impairment of endothelial cells (ECs), pulmonary artery spasm, adhesion and mligration of inflammatory cells to the pulmonary artery wall, adventitial fibrosis, intimal occlusive fibrosis, and fibrinoid necrosis are typical pathological features in many forms of PH. Pulmonary vascular remodeling is the result, and, likely, contributes to increased pulmonary vascular pressures by increasing pulmonary vascular resistance [6,7]. However, the mechanism of pulmonary vascular remodeling has not been fully elucidated, there is still a lack of effective drugs to prevent and reverse pulmonary vascular remodeling.…”