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Risk stratification and treatment goals in pulmonary arterial hypertension

Dardi, Fabio ; Boucly, Athénaïs ; Benza, Raymond ; Frantz, Robert ; Mercurio, Valentina ; Olschewski, Horst ; Rådegran, Göran LU ; Rubin, Lewis J. and Hoeper, Marius M. (2024) In The European respiratory journal 64(4).
Abstract

Risk stratification has gained an increasing role in predicting outcomes and guiding the treatment of patients with pulmonary arterial hypertension (PAH). The most predictive prognostic factors are three noninvasive parameters (World Health Organization functional class, 6-min walk distance and natriuretic peptides) that are included in all currently validated risk stratification tools. However, suffering from limitations mainly related to reduced specificity of PAH severity, these variables may not always be adequate in isolation for guiding individualised treatment decisions. Moreover, with effective combination treatment regimens and emerging PAH therapies, markers associated with pulmonary vascular remodelling are expected to become... (More)

Risk stratification has gained an increasing role in predicting outcomes and guiding the treatment of patients with pulmonary arterial hypertension (PAH). The most predictive prognostic factors are three noninvasive parameters (World Health Organization functional class, 6-min walk distance and natriuretic peptides) that are included in all currently validated risk stratification tools. However, suffering from limitations mainly related to reduced specificity of PAH severity, these variables may not always be adequate in isolation for guiding individualised treatment decisions. Moreover, with effective combination treatment regimens and emerging PAH therapies, markers associated with pulmonary vascular remodelling are expected to become of increasing relevance in guiding the treatment of patients with PAH. While reaching a low mortality risk, assessed with a validated risk tool, remains an important treatment goal, preliminary data suggest that invasive haemodynamics and cardiac imaging may add incremental value in guiding treatment decisions.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
The European respiratory journal
volume
64
issue
4
publisher
European Respiratory Society
external identifiers
  • pmid:39209472
  • scopus:85208449813
ISSN
1399-3003
DOI
10.1183/13993003.01323-2024
language
English
LU publication?
yes
id
c024107a-8d0a-4e1d-a7b1-72c208aee996
date added to LUP
2025-01-15 15:16:11
date last changed
2025-03-26 22:52:07
@article{c024107a-8d0a-4e1d-a7b1-72c208aee996,
  abstract     = {{<p>Risk stratification has gained an increasing role in predicting outcomes and guiding the treatment of patients with pulmonary arterial hypertension (PAH). The most predictive prognostic factors are three noninvasive parameters (World Health Organization functional class, 6-min walk distance and natriuretic peptides) that are included in all currently validated risk stratification tools. However, suffering from limitations mainly related to reduced specificity of PAH severity, these variables may not always be adequate in isolation for guiding individualised treatment decisions. Moreover, with effective combination treatment regimens and emerging PAH therapies, markers associated with pulmonary vascular remodelling are expected to become of increasing relevance in guiding the treatment of patients with PAH. While reaching a low mortality risk, assessed with a validated risk tool, remains an important treatment goal, preliminary data suggest that invasive haemodynamics and cardiac imaging may add incremental value in guiding treatment decisions.</p>}},
  author       = {{Dardi, Fabio and Boucly, Athénaïs and Benza, Raymond and Frantz, Robert and Mercurio, Valentina and Olschewski, Horst and Rådegran, Göran and Rubin, Lewis J. and Hoeper, Marius M.}},
  issn         = {{1399-3003}},
  language     = {{eng}},
  month        = {{10}},
  number       = {{4}},
  publisher    = {{European Respiratory Society}},
  series       = {{The European respiratory journal}},
  title        = {{Risk stratification and treatment goals in pulmonary arterial hypertension}},
  url          = {{http://dx.doi.org/10.1183/13993003.01323-2024}},
  doi          = {{10.1183/13993003.01323-2024}},
  volume       = {{64}},
  year         = {{2024}},
}