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Life
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Advances in the Treatment of Pulmonary Hypertension and Pulmonary Embolism
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Advances in the Treatment of Pulmonary Hypertension and Pulmonary Embolism

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 16 June 2025 | Viewed by 2795

Special Issue Editors

Dr. Egidio Imbalzano

E-Mail Website
Guest Editor
Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
Interests: pulmonary hypertension; pulmonary embolism; clinical cardiology; echocardiography; metabolism
Special Issues, Collections and Topics in MDPI journals
Dr. Marco Vatrano

E-Mail Website
Guest Editor
Cardiology Unit—P.O. “Pugliese”—A.O.U. “Renato Dulbecco”, Catanzaro, Italy
Interests: pulmonary hypertension; pulmonary embolism; interventional cardiology; echocardiography
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In your opinion, is pulmonary hypertension a rare disease? Furthermore, is pulmonary embolism a serious disease? Your answer would probably be immediately affirmative, but things are more complex! In fact, when we face and treat these two diseases, many doubts still accompany our decisions. For example, which initial treatment is preferable in the patient with newly diagnosed pulmonary hypertension? “Can we” or “should we” start with two drugs right away? If the patient has many comorbidities, how do we manage it?

Moreover, if a patient presents an acute pulmonary embolism with severe hemodynamic compromise, what type of thrombolysis do we perform (systemic or local)? If thrombolysis is not possible, should we ask for the intervention of a cardiac surgeon or interventional cardiologist?

The purpose of this Special Issue is to attempt finding the answers to these and other questions on the therapeutic management of patients with pulmonary hypertension or pulmonary embolism, based on the most recent and interesting scientific evidence.

Topics which will be welcomed in this Special Issue of Life include, but are not limited to, the following:

  • Treatment of pulmonary arterial hypertension; 
  • Future therapeutic perspectives of pulmonary arterial hypertension;
  • Treatment of groups 2, 3, and 4 pulmonary hypertension;
  • Treatment of acute pulmonary embolism;
  • Prevention of pulmonary embolism recurrence;
  • Percutaneous treatment of high-risk acute pulmonary embolism;
  • Artificial intelligence (AI) and machine learning applications.

Dr. Egidio Imbalzano
Dr. Marco Vatrano
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. Life is an international peer-reviewed open access monthly 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
  • pulmonary embolism
  • therapy
  • cardiac imaging
  • artificial intelligence

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

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13 pages, 1405 KiB  
Article
How to Reliably Measure Stroke Volume Index in Pulmonary Arterial Hypertension: A Comparison of Thermodilution, Direct and Indirect Fick, and Cardiac MRI
by Andrea Baccelli, Deepa Gopalan, Rachel J. Davies, Gulammehdi Haji, Wendy Gin-Sing, Luke S. Howard and Francesco Lo Giudice
Life 2025, 15(1), 54; https://doi.org/10.3390/life15010054 - 3 Jan 2025
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Abstract
Background. Stroke volume index (SVI) is an important prognostic parameter in pulmonary arterial hypertension (PAH). The direct Fick (DF) method represents the gold standard for measuring it. Indirect Fick (IF) and thermodilution (TD) are simpler and widely used alternatives. However, data on the [...] Read more.
Background. Stroke volume index (SVI) is an important prognostic parameter in pulmonary arterial hypertension (PAH). The direct Fick (DF) method represents the gold standard for measuring it. Indirect Fick (IF) and thermodilution (TD) are simpler and widely used alternatives. However, data on the accuracy of these methods in estimating SVI in PAH are scant. We aimed to compare these different invasive methods, and in a subgroup of patients, to a non-invasive method using MRI. Methods. We enrolled 103 PAH patients undergoing a diagnostic or follow-up right heart catheterization at our centre (mean age 56 years, 56% female). The Bland–Altman analysis was used to assess agreement between methods. Potential demographic, clinical, and hemodynamic biases were explored. The accuracy of cardiac magnetic resonance (CMR)-derived SVI was assessed in a subset of patients. Results. The mean bias for IF-SVI vs. DF-SVI was −5.53 mL/min/m2 with a median percentage error (PE) of 15%. The mean bias was lower, 0.09 mL/min/m2, for TD-SVI vs. DF-SVI with a median PE of 10%. Low cardiac index and severe tricuspid regurgitation (TR) were associated with a greater bias between TD and DF. CMR-SVI showed good accuracy and precision even in patients with severe TR, compared to DF. Conclusions. The indirect Fick is the less reliable method to assess SVI also in PAH patients. Thermodilution is a valid alternative to direct Fick, but it should be used with caution in patients with severe TR or low cardiac index. SVI measured by cardiac MRI is a promising non-invasive alternative, especially in patients with severe TR. Our observation needs to be confirmed by other series and larger studies. Full article
(This article belongs to the Special Issue Advances in the Treatment of Pulmonary Hypertension and Pulmonary Embolism)
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Review

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30 pages, 2155 KiB  
Review
Management of Pulmonary Arterial Hypertension: Current Strategies and Future Prospects
by Munish Sharma, Vivek Paudyal, Saifullah Khalid Syed, Rubi Thapa, Nadeem Kassam and Salim Surani
Life 2025, 15(3), 430; https://doi.org/10.3390/life15030430 - 8 Mar 2025
Viewed by 1466
Abstract
Primary pulmonary hypertension (PPH), now known as pulmonary arterial hypertension (PAH), has induced significant treatment breakthroughs in the past decade. Treatment has focused on improving patient survival and quality of life, and delaying disease progression. Current therapies are categorized based on targeting different [...] Read more.
Primary pulmonary hypertension (PPH), now known as pulmonary arterial hypertension (PAH), has induced significant treatment breakthroughs in the past decade. Treatment has focused on improving patient survival and quality of life, and delaying disease progression. Current therapies are categorized based on targeting different pathways known to contribute to PAH, including endothelin receptor antagonists (ERAs), phosphodiesterase-5 inhibitors (PDE-5 inhibitors), prostacyclin analogs, soluble guanylate cyclase stimulators, and activin signaling inhibitors such as Sotatercept. The latest addition to treatment options is soluble guanylate cyclase stimulators, such as Riociguat, which directly stimulates the nitric oxide pathway, facilitating vasodilation. Looking to the future, advancements in PAH treatment focus on precision medicine involving the sub-stratification of patients through a deep characterization of altered Transforming Growth Factor-β(TGF-β) signaling and molecular therapies. Gene therapy, targeting specific genetic mutations linked to PAH, and cell-based therapies, such as mesenchymal stem cells, are under investigation. Besides prevailing therapies, emerging PH treatments target growth factors and inflammation-modulating pathways, with ongoing trials assessing their long-term benefits and safety. Hence, this review explores current therapies that delay progression and improve survival, as well as future treatments with curative potential. Full article
(This article belongs to the Special Issue Advances in the Treatment of Pulmonary Hypertension and Pulmonary Embolism)
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