General measures and management of pulmonary arterial hypertension
This article aims to provide an overview on the recommendations of general measuremes, special circumstances and patient management according to the ESC/ERS guidelines. Amendments to the guideline recommendations are given as comments from the authors of this article.PMID:37963480 | DOI:10.1055/a-2145-4741 (Source: Pneumologie)
Source: Pneumologie - November 14, 2023 Category: Respiratory Medicine Authors: Mona Lichtblau Satenik Harutyunova Robert Nechwatal Laura Mayer Hans-Joachim Kabitz Finn Moritz Wilkens S ören Uiker Ekkehard Gr ünig Daniel Ritter Andreea Florea Nicola Benjamin Source Type: research
Pulmonary hypertension associated with lung disease
Pneumologie. 2023 Nov;77(11):916-925. doi: 10.1055/a-2145-4756. Epub 2023 Nov 14.ABSTRACTLung diseases and hypoventilation syndromes are often associated with pulmonary hypertension (PH). In most cases, PH is not severe. This is defined hemodynamically by a mean pulmonary arterial pressure (PAPm) > 20 mmHg, a pulmonary arterial wedge pressure (PAWP) ≤ 15 mmHg and a pulmonary vascular resistance of ≤ 5 Wood units (WU). Both the non-severe (PVR ≤ 5 WU) and much more the severe PH (PVR > 5 WU) have an unfavorable prognosis.If PH is suspected, it is recommended to primarily check whether risk factors for pulmonary ...
Source: Pneumologie - November 14, 2023 Category: Respiratory Medicine Authors: Michael Halank Katarina E Zeder Natascha Sommer Silvia Ulrich Matthias Held Thomas K öhler Vasile Foris Melanie Heberling Claus Neurohr Julia Ronczka Stephan Holt Dirk Skowasch Nikolaus Kneidinger J ürgen Behr Source Type: research
Pulmonary hypertension associated with left heart disease (group 2)
Pneumologie. 2023 Nov;77(11):926-936. doi: 10.1055/a-2145-4792. Epub 2023 Nov 14.ABSTRACTPulmonary hypertension associated with left heart disease (PH-LHD) corresponds to group two of pulmonary hypertension according to clinical classification. Haemodynamically, this group includes isolated post-capillary pulmonary hypertension (IpcPH) and combined post- and pre-capillary pulmonary hypertension (CpcPH). PH-LHD is defined by an mPAP > 20 mmHg and a PAWP > 15 mmHg, pulmonary vascular resistance (PVR) with a cut-off value of 2 Wood Units (WU) is used to differentiate between IpcPH and CpcPH. A PVR greater than 5 WU indi...
Source: Pneumologie - November 14, 2023 Category: Respiratory Medicine Authors: Kai Helge Schmidt Olympia Bikou R üdiger Blindt Leonhard Bruch Ralf Felgendreher Wolfgang Hohenforst-Schmidt Stephan Holt Dennis Ladage Elena Pfeuffer-Jovic Andreas Rieth Alexander Schmeisser Katharina Schnitzler Stefan Stadler Regina Steringer-Mascherba Source Type: research
Chronic thromboembolic pulmonary hypertension
Pneumologie. 2023 Nov;77(11):937-946. doi: 10.1055/a-2145-4807. Epub 2023 Nov 14.ABSTRACTChronic thromboembolic pulmonary disease (CTEPD) is an important late complication of acute pulmonary embolism, in which the thrombi transform into fibrous tissue, become integrated into the vessel wall, and lead to chronic obstructions. CTEPD is differentiated into cases without pulmonary hypertension (PH), characterized by a mean pulmonary arterial pressure up to 20 mmHg and a form with PH. Then, it is still referred to as chronic thromboembolic pulmonary hypertension (CTEPH).When there is suspicion of CTEPH, initial diagnostic tests...
Source: Pneumologie - November 14, 2023 Category: Respiratory Medicine Authors: Stefan Guth Heinrike Wilkens Michael Halank Matthias Held Lukas Hobohm Stavros Konstantinides Albert Omlor Hans-J ürgen Seyfarth Hans-Joachim Sch äfers Eckhard Mayer Christoph B Wiedenroth Source Type: research
New aspects in pediatric pulmonary hypertension - Commented 2022ERS/ESC-PH guidelines
Pneumologie. 2023 Nov;77(11):947-955. doi: 10.1055/a-2145-4832. Epub 2023 Nov 14.ABSTRACTPulmonary hypertension (PH) in childhood differs from that of adulthood particularly in the specific pathophysiology of congenital heart disease-associated pulmonary arterial hypertension, the presence of developmental lung disease, and the frequent association with chromosomal, genetic, and syndromal abnormalities. Treatment of children with PH requires a modified diagnostic algorithm tailored to childhood, as well as pathophysiologically oriented therapeutic strategies. In the current 2022 ERS/ESC-PH guidelines, the specific features...
Source: Pneumologie - November 14, 2023 Category: Respiratory Medicine Authors: Christian Apitz Rainer Kozlik-Feldmann Christina A Eichstaedt Matthias Gorenflo Astrid E Lammers Ralf Geiger Source Type: research
Pulmonary arterial hypertension in congenital heart disease - Part I
Pneumologie. 2023 Nov;77(11):956-961. doi: 10.1055/a-2146-7434. Epub 2023 Nov 14.ABSTRACTThe number of adults with congenital heart disease (CHD) is steadily rising and amounts to approximately 360,000 in Germany. CHD is often associated with pulmonary arterial hypertension (PAH), which may develop early in untreated CHD. Despite timely treatment of CHD, PAH often persists or recurs in older age and is associated with significant morbidity and mortality.The revised European Society of Cardiology/European Respiratory Society 2022 guidelines for the diagnosis and treatment of PH represent a significant contribution to the op...
Source: Pneumologie - November 14, 2023 Category: Respiratory Medicine Authors: Harald Kaemmerer Gerhard Paul Diller Ingo D ähnert Christina A Eichstaedt Andreas Eicken Annika Freiberger Sebastian Freilinger Ralf Geiger Matthias Gorenflo Ekkehard Gr ünig Alfred Hager Ulrike Herberg Michael Huntgeburth Ann-Sophie Kaemmerer Rainer Ko Source Type: research
The new European Guidelines for Pulmonary Hypertension with Updated Commentary of the PH-DACH Conference - A position paper of the German Society for Pneumology and Respiratory Medicine (DGP)
Pneumologie. 2023 Nov;77(11):852-853. doi: 10.1055/a-2146-7472. Epub 2023 Nov 14.NO ABSTRACTPMID:37963474 | DOI:10.1055/a-2146-7472 (Source: Pneumologie)
Source: Pneumologie - November 14, 2023 Category: Respiratory Medicine Authors: Ekkehard Gr ünig Nicola Benjamin J ürgen Behr Dirk Skowasch Katrin Milger-Kneidinger Michael Halank Wolfgang M Kuebler Gabor Kovacs Mona Lichtblau Stefan Guth Christian Apitz Harald Kaemmerer Khodr Tello Silvia Ulrich unter der Schirmherrschaft der Deut Source Type: research
New definition and classification of pulmonary hypertension
Pneumologie. 2023 Nov;77(11):854-861. doi: 10.1055/a-2145-4648. Epub 2023 Nov 14.ABSTRACTIn the recent ESC/ERS guidelines on the diagnosis and management of pulmonary hypertension (PH) several important changes have been made in respect of the definition and classification of PH.The mPAP cut-off for defining PH was lowered. PH is now defined by an mPAP > 20 mmHg assessed by right heart catheterization. Moreover, the PVR threshold for defining precapillary PH was lowered. Precapillary PH is now defined by a PVR > 2 WU and a pulmonary arterial wedge pressure (PAWP) ≤ 15 mmHg. Furthermore, the increasing evidence for ...
Source: Pneumologie - November 14, 2023 Category: Respiratory Medicine Authors: Philipp Douschan Benjamin Egenlauf Henning Gall Ekkehard Gr ünig Alfred Hager Melanie Heberling Thomas Koehler Horst Olschewski Hans-J ürgen Seyfarth Athiththan Yogeswaran Silvia Ulrich Gabor Kovacs Source Type: research
Genetic diagnostics and molecular approaches in pulmonary arterial hypertension
Pneumologie. 2023 Nov;77(11):862-870. doi: 10.1055/a-2145-4663. Epub 2023 Nov 14.ABSTRACTThe recently published new European guidelines for diagnosis and treatment of pulmonary hypertension now offer the so far most extensive description of genetic testing and counselling for pulmonary arterial hypertension patients. In addition, the importance of a clinical screening of healthy mutation carriers is highlighted as well as the genetic testing of patients with a suspicion of pulmonary veno-occlusive disease. We frame the respective parts of the guidelines on genetic testing and counselling in the context of recent data and p...
Source: Pneumologie - November 14, 2023 Category: Respiratory Medicine Authors: Christina A Eichstaedt Olympia Bikou Natascha Sommer Ralph T Schermuly Soni S Pullamsetti Norbert Weissmann Lars Harbaum Christoph Tabeling Max Wi ßmüller Vasile Foris Wolfgang M Kuebler Katrin Hinderhofer Andrea Olschewski Grazyna Kwapiszewska Source Type: research
Diagnostic Algorithm and Screening of Pulmonary Hypertension
Pneumologie. 2023 Nov;77(11):871-889. doi: 10.1055/a-2145-4678. Epub 2023 Nov 14.ABSTRACTThe new guidelines for the diagnosis and treatment of pulmonary hypertension include a new diagnostic algorithm and provide specific recommendations for the required diagnostic procedures, including screening methods. These recommendations are commented on by national experts under the auspices of the DACH. These comments provide additional decision support and background information, serving as a further guide for the complex diagnosis of pulmonary hypertension.PMID:37963477 | DOI:10.1055/a-2145-4678 (Source: Pneumologie)
Source: Pneumologie - November 14, 2023 Category: Respiratory Medicine Authors: Khodr Tello Manuel J Richter Nils Kremer Henning Gall Benjamin Egenlauf Stephan Sorichter Melanie Heberling Philipp Douschan Alfred Hager Athiththan Yogeswaran J ürgen Behr Panagiota Xanthouli Matthias Held Source Type: research
Targeted therapy for pulmonary arterial hypertension in patients without comorbidities
Pneumologie. 2023 Nov;77(11):890-900. doi: 10.1055/a-2145-4711. Epub 2023 Nov 14.ABSTRACTThe 2022 guidelines on pulmonary hypertension from the European Society of Cardiology (ESC) and the European Respiratory Society (ERS) provide therapeutic strategies that account for the variability in the clinical presentation of newly diagnosed patients. We summarize treatment recommendations for pulmonary arterial hypertension (PAH) in patients without significant comorbidities, particularly for idiopathic, hereditary, drug/toxin-induced, or connective tissue disease-associated PAH. In this group of patients, multidimensional assess...
Source: Pneumologie - November 14, 2023 Category: Respiratory Medicine Authors: Hans Klose Lars Harbaum Manuel J Richter Mona Lichtblau Alberto M Marra Hans-Joachim Kabitz Satenik Harutyunova Katrin Milger-Kneidinger Tobias J Lange Source Type: research
Medication treatment in pulmonary arterial hypertension with comorbidities - Which phenotypes and points to consider
Pneumologie. 2023 Nov;77(11):901-906. doi: 10.1055/a-2145-4726. Epub 2023 Nov 14.ABSTRACTWithin the last decade, the age at diagnosis of patients with pulmonary arterial hypertension has increased, which led to a change of the clinical phenoype being associated with more comorbidities. Cluster analyses of registry data have identified cardiac, cardio-pulmonary and classical phenotypes of pulmonary arterial hypertension.Subgroup analyses of randomised controlled trials and registry data indicate, that in patients with pulmonary arterial hypertension and cardiac comorbidities, especially the left-heart phenotype, a closely s...
Source: Pneumologie - November 14, 2023 Category: Respiratory Medicine Authors: Ekkehard Gr ünig Michael Halank Claus Neurohr J ürgen Behr Katrin Milger-Kneidinger Julia Ronczka Mona Lichtblau Nicola Benjamin Tobias J Lange Silvia Ulrich Heinrike Wilkens Christian Groh é Dirk Skowasch Source Type: research
General measures and management of pulmonary arterial hypertension
This article aims to provide an overview on the recommendations of general measuremes, special circumstances and patient management according to the ESC/ERS guidelines. Amendments to the guideline recommendations are given as comments from the authors of this article.PMID:37963480 | DOI:10.1055/a-2145-4741 (Source: Pneumologie)
Source: Pneumologie - November 14, 2023 Category: Respiratory Medicine Authors: Mona Lichtblau Satenik Harutyunova Robert Nechwatal Laura Mayer Hans-Joachim Kabitz Finn Moritz Wilkens S ören Uiker Ekkehard Gr ünig Daniel Ritter Andreea Florea Nicola Benjamin Source Type: research
Pulmonary hypertension associated with lung disease
Pneumologie. 2023 Nov;77(11):916-925. doi: 10.1055/a-2145-4756. Epub 2023 Nov 14.ABSTRACTLung diseases and hypoventilation syndromes are often associated with pulmonary hypertension (PH). In most cases, PH is not severe. This is defined hemodynamically by a mean pulmonary arterial pressure (PAPm) > 20 mmHg, a pulmonary arterial wedge pressure (PAWP) ≤ 15 mmHg and a pulmonary vascular resistance of ≤ 5 Wood units (WU). Both the non-severe (PVR ≤ 5 WU) and much more the severe PH (PVR > 5 WU) have an unfavorable prognosis.If PH is suspected, it is recommended to primarily check whether risk factors for pulmonary ...
Source: Pneumologie - November 14, 2023 Category: Respiratory Medicine Authors: Michael Halank Katarina E Zeder Natascha Sommer Silvia Ulrich Matthias Held Thomas K öhler Vasile Foris Melanie Heberling Claus Neurohr Julia Ronczka Stephan Holt Dirk Skowasch Nikolaus Kneidinger J ürgen Behr Source Type: research
Pulmonary hypertension associated with left heart disease (group 2)
Pneumologie. 2023 Nov;77(11):926-936. doi: 10.1055/a-2145-4792. Epub 2023 Nov 14.ABSTRACTPulmonary hypertension associated with left heart disease (PH-LHD) corresponds to group two of pulmonary hypertension according to clinical classification. Haemodynamically, this group includes isolated post-capillary pulmonary hypertension (IpcPH) and combined post- and pre-capillary pulmonary hypertension (CpcPH). PH-LHD is defined by an mPAP > 20 mmHg and a PAWP > 15 mmHg, pulmonary vascular resistance (PVR) with a cut-off value of 2 Wood Units (WU) is used to differentiate between IpcPH and CpcPH. A PVR greater than 5 WU indi...
Source: Pneumologie - November 14, 2023 Category: Respiratory Medicine Authors: Kai Helge Schmidt Olympia Bikou R üdiger Blindt Leonhard Bruch Ralf Felgendreher Wolfgang Hohenforst-Schmidt Stephan Holt Dennis Ladage Elena Pfeuffer-Jovic Andreas Rieth Alexander Schmeisser Katharina Schnitzler Stefan Stadler Regina Steringer-Mascherba Source Type: research
