Uncertainties in the diagnosis and treatment of pulmonary arterial hypertension. 2008

Hossein A Ghofrani, and Martin W Wilkins, and Stuart Rich
Department of Internal Medicine, Medical Clinic II/V, University Hospital Giessen and Marburg GmbH, Klinikstrasse 36, 35392 Giessen, Germany. ardeschir.ghofrani@innere.med.uni-giessen.de

The availability of new treatments for patients with pulmonary arterial hypertension has increased awareness and interest in the medical community for pulmonary vascular diseases in general. Many uncertainties exist, however, regarding the diagnosis and treatment of patients with pulmonary arterial hypertension that are particularly pertinent for the management of patients with idiopathic pulmonary arterial hypertension and pulmonary hypertension associated with underlying diseases. This review highlights controversial issues around the definition and diagnosis of pulmonary hypertension, the interpretation of hemodynamic variables, and the interpretation of clinical responsiveness to chronic therapies. In addition, we propose guidelines applicable to the conduct of new therapeutic trials in pulmonary arterial hypertension, which aim to provide greater confidence in the efficacy and safety of new treatments currently under development.

UI MeSH Term Description Entries
D006976 Hypertension, Pulmonary Increased VASCULAR RESISTANCE in the PULMONARY CIRCULATION, usually secondary to HEART DISEASES or LUNG DISEASES. Pulmonary Hypertension
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes
D017410 Practice Guidelines as Topic Works about directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. Clinical Guidelines as Topic,Best Practices,Best Practice
D019468 Disease Management A broad approach to appropriate coordination of the entire disease treatment process that often involves shifting away from more expensive inpatient and acute care to areas such as preventive medicine, patient counseling and education, and outpatient care. This concept includes implications of appropriate versus inappropriate therapy on the overall cost and clinical outcome of a particular disease. (From Hosp Pharm 1995 Jul;30(7):596) Disease Managements,Management, Disease,Managements, Disease
D035501 Uncertainty The condition in which reasonable knowledge regarding risks, benefits, or the future is not available.

Related Publications

Hossein A Ghofrani, and Martin W Wilkins, and Stuart Rich
June 2017, Acta medica portuguesa,
Hossein A Ghofrani, and Martin W Wilkins, and Stuart Rich
August 2016, Cardiology clinics,
Hossein A Ghofrani, and Martin W Wilkins, and Stuart Rich
August 2004, Cardiology clinics,
Hossein A Ghofrani, and Martin W Wilkins, and Stuart Rich
June 2009, Journal of the American College of Cardiology,
Hossein A Ghofrani, and Martin W Wilkins, and Stuart Rich
October 1984, La Revue du praticien,
Hossein A Ghofrani, and Martin W Wilkins, and Stuart Rich
August 2005, Minerva medica,
Hossein A Ghofrani, and Martin W Wilkins, and Stuart Rich
March 2019, Expert review of cardiovascular therapy,
Hossein A Ghofrani, and Martin W Wilkins, and Stuart Rich
January 2010, Praxis,
Hossein A Ghofrani, and Martin W Wilkins, and Stuart Rich
December 2012, European respiratory review : an official journal of the European Respiratory Society,
Hossein A Ghofrani, and Martin W Wilkins, and Stuart Rich
June 2021, American journal of respiratory and critical care medicine,
Copied contents to your clipboard!