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- Title
Pulmonary Arterial Hypertension: Diagnosis, Treatment, and Novel Advances.
- Authors
Maron, Bradley A.; Abman, Steven H.; Elliott, C. Greg; Frantz, Robert P.; Hopper, Rachel K.; Horn, Evelyn M.; Nicolls, Mark R.; Shlobin, Oksana A.; Shah, Sanjiv J.; Kovacs, Gabor; Olschewski, Horst; Rosenzweig, Erika B.
- Abstract
The diagnosis and management of pulmonary arterial hypertension (PAH) includes several advances, such as a broader recognition of extrapulmonary vascular organ system involvement, validated point-of-care clinical assessment tools, and focus on the early initiation of multiple pharmacotherapeutics in appropriate patients. Indeed, a principal goal in PAH today is an early diagnosis for prompt initiation of treatment to achieve a minimal symptom burden; optimize the patient's biochemical, hemodynamic, and functional profile; and limit adverse events. To accomplish this end, clinicians must be familiar with novel risk factors and the revised hemodynamic definition for PAH. Fresh insights into the role of developmental biology (i.e., perinatal health) may also be useful for predicting incident PAH in early adulthood. Emergent or underused approaches to PAH management include a novel TGF-β ligand trap pharmacotherapy, remote pulmonary arterial pressure monitoring, next-generation imaging using inert gas-based magnetic resonance and other technologies, right atrial pacing, and pulmonary arterial denervation. These and other PAH state of the art advances are summarized here for the wider pulmonary medicine community.
- Subjects
PULMONARY hypertension diagnosis; PULMONARY hypertension treatment; HYPERTENSION; PULMONARY circulation; POINT-of-care testing; EXPERIMENTAL design; CARDIAC surgery; CARDIAC catheterization; RISK assessment; EARLY diagnosis
- Publication
American Journal of Respiratory & Critical Care Medicine, 2021, Vol 203, Issue 12, p1472
- ISSN
1073-449X
- Publication type
journal article
- DOI
10.1164/rccm.202012-4317SO