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Advances in the Diagnosis and Treatment of Pulmonary Hypertension
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Advances in the Diagnosis and Treatment of Pulmonary Hypertension

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: closed (31 March 2025) | Viewed by 2464

Special Issue Editors

Dr. Takayuki Fujiwara

E-Mail Website
Guest Editor
Department of Cardiovascular Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
Interests: pulmonary hypertension; heart failure; thoracic aortic aneurysm/dissection; tissue-clearing technique; angiogenesis
Dr. Shun Minatsuki

E-Mail Website
Guest Editor
Department of Cardiovascular Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
Interests: pulmonary hypertension; endarterectomy; riociguat; left ventricular assistance devices; artificial heart; blood pumps; selexipag; macitentan
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Pulmonary hypertension (PH) is an intractable disease characterized by the narrowing or occlusion of pulmonary vessels, which leads to increased pulmonary arterial pressure and vascular resistance. Although the life expectancy of patients with PH has considerably improved since the advent of targeted drug or balloon pulmonary angioplasty, PH remains a progressive disease with significant morbidity and mortality. Therefore, the development of new drug-based therapies or other interventions is still required, and many preclinical research and clinical trials for PH treatment are ongoing.

This Special Issue aims to provide critical insights into the current knowledge of advances in diagnostics and treatments for PH. We cordially invite you to submit relevant papers for consideration for peer review and expeditious publication in this Special Issue of the Journal of Clinical Medicine. Both original investigations and comprehensive reviews are welcome.

Dr. Takayuki Fujiwara
Dr. Shun Minatsuki
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • pulmonary hypertension
  • balloon pulmonary angioplasty
  • lung transplantation
  • right heart failure
  • cardiac catheterization

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Published Papers (2 papers)

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Research

13 pages, 545 KiB  
Article
The Diagnostic Accuracy of an Electrocardiogram in Pulmonary Hypertension and the Role of “R V1, V2 + S I, aVL − S V1”
by Lukas Ley, Christoph B. Wiedenroth, Stefan Guth, Christian Gold, Athiththan Yogeswaran, Hossein Ardeschir Ghofrani and Dirk Bandorski
J. Clin. Med. 2024, 13(24), 7613; https://doi.org/10.3390/jcm13247613 - 13 Dec 2024
Viewed by 922
Abstract
Background: Pulmonary hypertension (PH) can cause characteristic electrocardiographic (ECG) changes due to right ventricular hypertrophy and/or strain. The aims of the present study were to explore the diagnostic accuracy of ECG parameters for the diagnosis of PH, applying the recently adjusted mean [...] Read more.
Background: Pulmonary hypertension (PH) can cause characteristic electrocardiographic (ECG) changes due to right ventricular hypertrophy and/or strain. The aims of the present study were to explore the diagnostic accuracy of ECG parameters for the diagnosis of PH, applying the recently adjusted mean pulmonary artery pressure (mPAP) threshold of >20 mmHg, and to determine the role of “R V1, V2 + S I, aVL − S V1”. Methods: Between July 2012 and November 2023, 100 patients without PH, with pulmonary arterial hypertension, or with chronic thromboembolic pulmonary hypertension were retrospectively enrolled. Results: The sensitivity and specificity of the ECG parameters for the diagnosis of PH varied from 3 to 98% and from 3 to 100% (means: 39% and 87%). After optimising the parameters’ cut-offs, the mean sensitivity (39% to 66%) increased significantly but the mean specificity (87% to 74%) slightly decreased. “R V1, V2 + S I, aVL − S V1” was able to predict an mPAP >20 mmHg (OR: 34.33; p < 0.001) and a pulmonary vascular resistance >5 WU (OR: 17.14, p < 0.001) but could not predict all-cause mortality. Conclusions: Even with improved cut-offs, ECG parameters alone are not able to reliably diagnose or exclude PH because of their low sensitivity. However, they still might be helpful to reveal a suspicion of PH, especially in early diagnostic stages, e.g., in primary care with general practitioners or non-specialised cardiologists and pulmonologists. “R V1, V2 + S I, aVL − S V1” was able to predict the diagnosis of (severe) PH but could not predict all-cause mortality. Nevertheless, it can still be useful in risk stratification. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Treatment of Pulmonary Hypertension)
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11 pages, 248 KiB  
Article
Echocardiographic Screening of Liver Transplant Candidates—Prevalence of Features of Portopulmonary Hypertension
by Olga Dzikowska-Diduch, Tomasz Cader, Krzysztof Jankowski, Aisha Ou-Pokrzewińska, Monika Sznajder, Jan Siwiec, Szymon Pucyło, Aleksandra Sikora, Marek Pacholczyk, Wojciech Lisik, Piotr Pruszczyk and Katarzyna Kurnicka
J. Clin. Med. 2024, 13(22), 6990; https://doi.org/10.3390/jcm13226990 - 20 Nov 2024
Viewed by 1027
Abstract
Background: The prevalence of portopulmonary hypertension (PoPH) is relatively low; however, its presence significantly worsens patients’ prognosis. When diagnosed, PoPH can be effectively treated, and specific therapies can lead to a substantial reduction in pulmonary circulation pressure, facilitating the safe performance of [...] Read more.
Background: The prevalence of portopulmonary hypertension (PoPH) is relatively low; however, its presence significantly worsens patients’ prognosis. When diagnosed, PoPH can be effectively treated, and specific therapies can lead to a substantial reduction in pulmonary circulation pressure, facilitating the safe performance of liver transplantation. Echocardiography is recommended as a first-line method for the non-invasive diagnosis of pulmonary hypertension and serves as a valuable screening tool for patients being evaluated for liver transplantation (LT). The objective of this study was to thoroughly assess the occurrence of echocardiographic signs indicative of pulmonary hypertension and hepatopulmonary syndrome (HPS) in candidates for LT. We assumed that our analysis also made it possible to assess how frequently these candidates require further invasive diagnostics for pulmonary hypertension at specialized centers and how often they may need targeted treatment for pulmonary arterioles as a bridge to transplantation, which could improve patient outcomes. Additionally, this study included a comprehensive review of the current literature. Methods: All LT candidates underwent standardized transthoracic echocardiography and contrast evaluation to identify intrapulmonary vascular shunts. Results: A total of 152 liver transplantation candidates (67 women, mean age 50.6 years) were included in the analysis. The estimated echocardiographic probability of pulmonary hypertension was classified as high in only one patient. However, 63 patients exhibited the visualization of microbubbles in the left heart chambers after an average of six cardiac cycles (ranging from three to nine cycles) following their appearance in the right heart. Conclusions: Our analysis shows that the features of PoPH and a high probability of PH were very rare in the LT candidates, and echocardiographic signs suggestive of hepatopulmonary syndrome were more prevalent. Liver transplant candidates need screening for PoPH and HPS, as both PoPH and HPS significantly worsen their prognosis, but specific PH treatment as a bridge to transplantation improves PoPH patients’ survival. Full article
(This article belongs to the Special Issue Advances in the Diagnosis and Treatment of Pulmonary Hypertension)
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