Medscape InDiscussion: Pulmonary Arterial Hypertension Medscape

Drs Vallerie McLaughlin and Marc Humbert discuss the 2022 guidelines on pulmonary arterial hypertension by the European Society of Cardiology (ESC) and the European Respiratory Society (ERS).
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/968551). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources
Pulmonary Arterial Hypertension https://emedicine.medscape.com/article/303098-overview
2022 ESC/ERS Guidelines for the Diagnosis and Treatment of Pulmonary Hypertension https://academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehac237/6673929
Pulmonary Arterial Hypertension Risk Stratification https://www.medscape.com/viewarticle/968547
Pulmonary Function Testing https://emedicine.medscape.com/article/303239-overview
Pulmonary Angiography Technique https://emedicine.medscape.com/article/2116480-overview

Drs Vallerie McLaughlin and Richard Channick discuss the diagnosis and treatment of chronic thromboembolic pulmonary hypertension.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/968550). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources
Pulmonary Hypertension https://www.medscape.com/answers/303098-93380/what-is-pulmonary-hypertension
Chronic Thromboembolic Pulmonary Hypertension (CTEPH) https://emedicine.medscape.com/article/2500057-overview
Pulmonary Embolism https://emedicine.medscape.com/article/300901-overview
Determinants of Diagnostic Delay in Chronic Thromboembolic Pulmonary Hypertension: Results From the European CTEPH Registry https://erj.ersjournals.com/content/52/6/1801687
Pulmonary Embolism Response Teams: Purpose, Evidence for Efficacy, and Future Research Directions https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6611377
V/Q Scan https://www.medscape.com/answers/300901-8522/how-is-vq-scanning-used-for-the-diagnosis-of-pulmonary-embolism-pe
Multidetector Computed Tomography for Acute Pulmonary Embolism https://www.nejm.org/doi/10.1056/NEJMoa052367
Pulmonary Thromboendarterectomy https://www.medscape.org/viewarticle/556058_4
Dynamic Risk Stratification of Patient Long-term Outcome After Pulmonary Endarterectomy: Results From the United Kingdom National Cohort https://pubmed.ncbi.nlm.nih.gov/27052413/
Balloon Pulmonary Angioplasty in Chronic Thromboembolic Pulmonary Hypertension https://err.ersjournals.com/content/26/143/160119
Balloon Pulmonary Angioplasty as a Treatment in Chronic Thromboembolic Pulmonary Hypertension: Past, Present, and Future https://pubmed.ncbi.nlm.nih.gov/32056029/
Pulmonary Arterial Hypertension Clinical Presentation https://emedicine.medscape.com/article/303098-clinical
Riociguat https://reference.medscape.com/drug/adempas-riociguat-999863
Long-term Clinical Value and Outcome of Riociguat in Chronic Thromboembolic Pulmonary Hypertension https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6396196/
Riociguat Prescribing Information https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/204819s006lbl.pdf

Drs Vallerie McLaughlin and Oksana Shlobin discuss methods of identifying and navigating challenging clinical scenarios in pulmonary arterial hypertension.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/968548). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources
What Is Pulmonary Hypertension? https://www.medscape.com/answers/303098-93380/what-is-pulmonary-hypertension
What Are the WHO Clinical Classifications of Pulmonary Hypertension? https://www.medscape.com/answers/303098-93381/what-are-the-who-clinical-classifications-of-pulmonary-hypertension
Interstitial Lung Disease: Pathophysiology and Genetic Predisposition https://www.medscape.com/viewarticle/408750
What Is the Role of Pulmonary Function Testing in the Evaluation of Restrictive Lung Disease? https://www.medscape.com/answers/301760-187987/what-is-the-role-of-pulmonary-function-testing-in-the-evaluation-of-restrictive-lung-disease
What Is the Six-Minute Walk Test (6mwt) in Pulmonary Function Testing? https://www.medscape.com/answers/303239-77869/what-is-the-six-minute-walk-test-6mwt-in-pulmonary-function-testing
Respiratory Failure-V/Q Mismatch https://emedicine.medscape.com/article/167981-overview#a4
Efficacy and Safety of Riociguat in Patients With Symptomatic Pulmonary Hypertension (PH) Associated With Idiopathic Interstitial Pneumonias (IIP) (RISE-IIP) https://clinicaltrials.gov/ct2/show/NCT02138825
Pulmonary Veno-Occlusive Disease https://emedicine.medscape.com/article/1464015-overview
Sodium-Glucose Cotransporter 2 Inhibitors: An Overview https://www.medscape.com/viewarticle/892957_9
Treatment Approach to Connective Tissue Disease-Associated Interstitial Lung Disease https://www.sciencedirect.com/science/article/abs/pii/S1471489222000728

Drs Vallerie McLaughlin and Ioana Preston discuss how equations and prediction models guide risk stratification of patients diagnosed with pulmonary arterial hypertension.
Relevant disclosures can be found with the episode show notes on Medscape (https://www.medscape.com/viewarticle/968547). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources
Pulmonary Arterial Hypertension https://emedicine.medscape.com/article/303098-overview
REVEAL Registry: Registry to Evaluate Early and Long-term PAH Disease Management https://clinicaltrials.gov/ct2/show/NCT00370214
Predicting Survival in Pulmonary Arterial Hypertension: Insights From the Registry to Evaluate Early and Long-term Pulmonary Arterial Hypertension Disease Management (REVEAL) https://doi.org/10.1161/CIRCULATIONAHA.109.898122
Predicting Survival in Patients With Pulmonary Arterial Hypertension: The REVEAL Risk Score Calculator 2.0 and Comparison With ESC/ERS-Based Risk Assessment Strategies https://doi.org/10.1016/j.chest.2019.02.004
Development and Validation of an Abridged Version of the REVEAL 2.0 Risk Score Calculator, REVEAL Lite 2, for Use in Patients With Pulmonary Arterial Hypertension https://doi.org/10.1016/j.chest.2020.08.2069
REVEAL Lite 2 Risk Calculator https://pahriskcalculatorlt.com/
Brain-Type Natriuretic Peptide (BNP) https://emedicine.medscape.com/article/2087425-overview
2015 ESC/ERS Guidelines for the diagnosis and Treatment of Pulmonary Hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT) https://doi.org/10.1093/eurheartj/ehv317
Risk Assessment in Pulmonary Arterial Hypertension https://erj.ersjournals.com/content/51/3/1702606
A Comprehensive Risk Stratification at Early Follow-up Determines Prognosis in Pulmonary Arterial Hypertension https://doi.org/10.1093/eurheartj/ehx257
Risk Assessment, Prognosis and Guideline Implementation in Pulmonary Arterial Hypertension https://doi.org/10.1183/13993003.00889-2017
Risk Assessment in Pulmonary Arterial Hypertension https://doi.org/10.1183/13993003.02606-2017
Regular Risk Assessment in Pulmonary Arterial Hypertension - A Whistleblower for Hidden Disease Progression https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8888324
A Pragmatic Approach to Risk Assessment in Pulmonary Arterial Hypertension Using the 2015 European Society of Cardiology/European Respiratory Society Guidelines https://openheart.bmj.com/content/8/2/e001725.long
Risk Assessment in Precapillary Pulmonary Hypertension: A Comparative Analysis https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-021-01624-z
Diagnostic and Predictive Value of Right Heart Catheterization-Derived Measurements in Pulmonary Hypertension https://doi.org/10.36740/WLek202103130
Scleroderma https://emedicine.medscape.com/article/331864-overview
COMPERA 2.0: A Refined 4-Strata Risk Assessment Model for Pulmonary Arterial Hypertension https://doi.org/10.1183/13993003.02311-2021

Drs Vallerie McLaughlin and Paul Forfia discuss the diagnosis of PAH. What are the causes and why does it take so long?
Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/968546). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources
Pulmonary Arterial Hypertension https://emedicine.medscape.com/article/303098-overview
The 'Great Wait' for Diagnosis in Pulmonary Arterial Hypertension https://onlinelibrary.wiley.com/doi/full/10.1111/resp.13814
Systemic Consequences of Pulmonary Hypertension and Right-Sided Heart Failure https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.116.022362
Management of Coronary Artery Disease and Chronic Stable Angina https://www.medscape.com/viewarticle/881468
What Is Myocardial Ischemia? https://www.medscape.com/answers/352401-192899/what-is-myocardial-ischemia
Chronic Obstructive Pulmonary Disease (COPD) https://emedicine.medscape.com/article/297664-overview
Group 4 Pulmonary Hypertension https://emedicine.medscape.com/article/2500057-overview
Pulmonary Arterial Hypertension in Connective Tissue Disorders: Pathophysiology and Treatment https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6405825
Scleroderma https://emedicine.medscape.com/article/331864-overview
Pulmonary Hypertension Phenotypes in Patients With Systemic Sclerosis https://err.ersjournals.com/content/30/161/210053.long
Mixed Connective-Tissue Disease (MCTD) https://emedicine.medscape.com/article/335815-overview
Systemic Lupus Erythematosus (SLE) https://emedicine.medscape.com/article/332244-overview
Sjogren Syndrome https://emedicine.medscape.com/article/332125-overview
Pulmonary Arterial Hypertension in Patients Infected With the Human Immunodeficiency Virus https://www.sciencedirect.com/science/article/abs/pii/S0733865121000679?via%3Dihub
Portal Hypertension https://emedicine.medscape.com/article/182098-overview
Liver Abnormalities in Pulmonary Arterial Hypertension https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8544777/
Pulmonary Hypertension in Adults With Congenital Heart Disease https://www.sciencedirect.com/science/article/abs/pii/S0733865121000692?via%3Dihub
Atrial Septal Defect https://emedicine.medscape.com/article/162914-overview
Anorexigens and Pulmonary Hypertension in the United States https://linkinghub.elsevier.com/retrieve/pii/S0012-3692(15)32749-5
Methamphetamine and the Risk of Pulmonary Arterial Hypertension https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6880795/
Echocardiography in Pulmonary Arterial Hypertension: Comprehensive Evaluation and Technical Considerations https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8348437/pdf/jcm-10-03229.pdf
Echocardiography https://emedicine.medscape.com/article/1820912-overview
Echocardiography Can Identify Patients With Increased Pulmonary Vascular Resistance by Assessing Pressure Reflection in the Pulmonary Circulation https://www.ahajournals.org/doi/10.1161/circimaging.109.913467
Pulmonary Resistance https://reference.medscape.com/calculator/189/pulmonary-resistance
Right Heart Adaptation to Pulmonary Arterial Hypertension: Physiology and Pathobiology https://www.sciencedirect.com/science/article/pii/S0735109713058701?via%3Dihub
RV Systolic Pressure (TR Jet) https://reference.medscape.com/calculator/200/rv-systolic-pressure-tr-jet
Modified Bernoulli Formula https://reference.medscape.com/calculator/150/modified-bernoulli-equation
Limitations and Strengths of Doppler/Echo Pulmonary Artery Systolic Pressure-Right Heart Catheterization Correlations: A Systematic Literature Review https://onlinelibrary.wiley.com/doi/10.1111/echo.12594

Drs Vallerie McLaughlin and Raymond Benza discuss the classifications and causes of pulmonary hypertension.
Relevant disclosures can be found with the episode show notes on Medscape.com (https://www.medscape.com/viewarticle/968545). The topics and discussions are planned, produced, and reviewed independently of advertiser. This podcast is intended only for US healthcare professionals.
Resources
Pulmonary Arterial Hypertension https://emedicine.medscape.com/article/303098-overview#a4
The Definition of Pulmonary Hypertension: History, Practical Implications and Current Controversies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8753640/pdf/EDU-0076-2021.pdf
Pulmonary Hypertension https://phassociation.org/types-pulmonary-hypertension-groups/
Group 2 Pulmonary Hypertension https://emedicine.medscape.com/article/2500055-overview
Group 3 Pulmonary Hypertension https://emedicine.medscape.com/article/2500056-overview
Group 4 Pulmonary Hypertension https://emedicine.medscape.com/article/2500057-overview
Predicting Survival in Pulmonary Arterial Hypertension: Insights From the Registry to Evaluate Early and Long-Term Pulmonary Arterial Hypertension Disease Management (REVEAL) https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.109.898122
Evidence-Based Detection of Pulmonary Arterial Hypertension in Systemic Sclerosis: The DETECT Study https://ard.bmj.com/content/73/7/1340