Pulmonary Hypertension: Advances in Clinical Diagnosis and Management

Dear Colleagues,

Pulmonary hypertension (PH) includes a range of conditions leading to elevated pressures within the pulmonary arteries, defined as a mean pulmonary artery pressure of >20 mmHg. This disease state is classified into five main groups, including pulmonary arterial hypertension, PH associated with left-sided heart disease, PH associated with lung disease, PH associated with pulmonary artery obstruction (most commonly due to chronic pulmonary embolism), and PH with less clear and/or multifactorial mechanisms. In the absence of therapy, the vascular remodeling with elevated pressures leads to failure of the right ventricle, which is the primary cause of death. Dyspnea is the most common symptom, but recognition of PH is often delayed by many months. When initial evaluation including echocardiography leads to a high suspicion of PH, this should ultimately lead to right heart catheterization for definitive diagnosis and appropriate classification and therapy. The therapeutic approach relies on careful assessment of the cause and severity of the PH. 

Groundbreaking advances have been made in the PH space over the past few decades, including the definition of PH, basic science knowledge, diagnostic approaches, risk stratification, and approaches to therapy. However, major deficiencies remain in understanding certain basic mechanisms of the disease and the ideal approaches to therapy. We will review the PH disease state, including these basic scientific aspects and the diagnostic and therapeutic approaches to different forms of PH.

Dr. Victor F. Tapson
Guest Editor

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