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The revised definition of pulmonary hypertension: exploring the impact on patient management
At the 6th World Symposium on Pulmonary Hypertension (PH), it was proposed that the mean pulmonary arterial pressure (mPAP) threshold used to define PH should be lowered from ≥25 mmHg to >20 mmHg. The rationale for this change is that the ≥25 mmHg threshold is arbitrary, whereas the revised thres...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6915058/ https://www.ncbi.nlm.nih.gov/pubmed/31857795 http://dx.doi.org/10.1093/eurheartj/suz211 |
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author | Simonneau, Gérald Hoeper, Marius M |
author_facet | Simonneau, Gérald Hoeper, Marius M |
author_sort | Simonneau, Gérald |
collection | PubMed |
description | At the 6th World Symposium on Pulmonary Hypertension (PH), it was proposed that the mean pulmonary arterial pressure (mPAP) threshold used to define PH should be lowered from ≥25 mmHg to >20 mmHg. The rationale for this change is that the ≥25 mmHg threshold is arbitrary, whereas the revised threshold is based on scientific evidence. For the definition of all forms of pre-capillary PH, the inclusion of a pulmonary vascular resistance (PVR) ≥3 Wood Units was also proposed, placing greater emphasis on an elevated PVR to identify pulmonary vascular disease. Here, we discuss the possible impact of the revised definition of PH on future clinical management. This change may facilitate earlier PH detection, particularly in at-risk patient groups that are already undergoing screening programmes, e.g. those with systemic sclerosis or mutations associated with PH. As an mPAP above the upper limit of normal (>20 mmHg) but <25 mmHg is associated with increased risk of morbidity and mortality compared with a normal mPAP, early identification of patients in this group is important to enable close monitoring and timely treatment initiation once clinically indicated. Treatments currently approved for PH are not necessarily suitable for patients with an mPAP 21–24 mmHg, as the management of this group has not been widely examined. The revised definition may facilitate inclusion of these patients in prospective trials, allowing the evaluation of appropriate management strategies. |
format | Online Article Text |
id | pubmed-6915058 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-69150582019-12-19 The revised definition of pulmonary hypertension: exploring the impact on patient management Simonneau, Gérald Hoeper, Marius M Eur Heart J Suppl Articles At the 6th World Symposium on Pulmonary Hypertension (PH), it was proposed that the mean pulmonary arterial pressure (mPAP) threshold used to define PH should be lowered from ≥25 mmHg to >20 mmHg. The rationale for this change is that the ≥25 mmHg threshold is arbitrary, whereas the revised threshold is based on scientific evidence. For the definition of all forms of pre-capillary PH, the inclusion of a pulmonary vascular resistance (PVR) ≥3 Wood Units was also proposed, placing greater emphasis on an elevated PVR to identify pulmonary vascular disease. Here, we discuss the possible impact of the revised definition of PH on future clinical management. This change may facilitate earlier PH detection, particularly in at-risk patient groups that are already undergoing screening programmes, e.g. those with systemic sclerosis or mutations associated with PH. As an mPAP above the upper limit of normal (>20 mmHg) but <25 mmHg is associated with increased risk of morbidity and mortality compared with a normal mPAP, early identification of patients in this group is important to enable close monitoring and timely treatment initiation once clinically indicated. Treatments currently approved for PH are not necessarily suitable for patients with an mPAP 21–24 mmHg, as the management of this group has not been widely examined. The revised definition may facilitate inclusion of these patients in prospective trials, allowing the evaluation of appropriate management strategies. Oxford University Press 2019-12 2019-12-17 /pmc/articles/PMC6915058/ /pubmed/31857795 http://dx.doi.org/10.1093/eurheartj/suz211 Text en Published on behalf of the European Society of Cardiology. © The Author(s) 2019. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Articles Simonneau, Gérald Hoeper, Marius M The revised definition of pulmonary hypertension: exploring the impact on patient management |
title | The revised definition of pulmonary hypertension: exploring the impact on patient management |
title_full | The revised definition of pulmonary hypertension: exploring the impact on patient management |
title_fullStr | The revised definition of pulmonary hypertension: exploring the impact on patient management |
title_full_unstemmed | The revised definition of pulmonary hypertension: exploring the impact on patient management |
title_short | The revised definition of pulmonary hypertension: exploring the impact on patient management |
title_sort | revised definition of pulmonary hypertension: exploring the impact on patient management |
topic | Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6915058/ https://www.ncbi.nlm.nih.gov/pubmed/31857795 http://dx.doi.org/10.1093/eurheartj/suz211 |
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