Guidelines for the diagnosis and treatment of pulmonary hypertension: the 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 the International Society of Heart and Lung Transplantation (ISHLT)
Nazzareno Galiè,Marius M. Hoeper,Marc Humbert,Adam Torbicki,Jean-Luc Vachiery,J.A. Barberà,Maurice Beghetti,Paul A. Corris,Sean Gaine,J S R Gibbs,Miguel Ángel Gómez-Sánchez,Guillaume Jondeau,Walter Klepetko,Christian Opitz,Andrew J. Peacock,LJ Rubin,Michael J. Zellweger,Gérald Simonneau +17 more
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TLDR
In this paper, a review of the published evidence for management and/or prevention of a given condition is carried out by experts in the field and a critical evaluation of diagnostic and therapeutic procedures is performed including assessment of the risk/benefit ratio.Abstract:
Guidelines and Expert Consensus Documents summarize and evaluate all currently available evidence on a particular issue with the aim to assist physicians in selecting the best management strategies for a typical patient, suffering from a given condition, taking into account the impact on outcome, as well as the risk/benefit ratio of particular diagnostic or therapeutic means. Guidelines are no substitutes for textbooks. The legal implications of medical guidelines have been discussed previously.
A great number of Guidelines and Expert Consensus Documents have been issued in recent years by the European Society of Cardiology (ESC) as well as by other societies and organizations. Because of the impact on clinical practice, quality criteria for development of guidelines have been established in order to make all decisions transparent to the user. The recommendations for formulating and issuing ESC Guidelines and Expert Consensus Documents can be found on the ESC website (http://www.escardio.org/knowledge/guidelines).
In brief, experts in the field are selected and undertake a comprehensive review of the published evidence for management and/or prevention of a given condition.
Unpublished clinical trial results are not taken into account. A critical evaluation of diagnostic and therapeutic procedures is performed including assessment of the risk/benefit ratio. Estimates of expected health outcomes for larger societies are included, where data exist. The level of evidence and the strength of recommendation of particular treatment options are weighed and graded according to predefined scales, as outlined in Tables 1 and 2 .
View this table:
Table 1
Classes of recommendations
View this table:
Table 2
Levels of evidence
The experts of the writing panels have provided disclosure statements of all relationships they may have which might be perceived as real or potential sources of conflicts of interest. These disclosure forms are kept on file at the European Heart House, headquarters of the ESC. Any changes in conflict of interest that arise …read more
Citations
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Monitoring for Pulmonary Hypertension Following Pulmonary Embolism: The INFORM Study
Victor F. Tapson,David Platt,Fang Xia,S Teal,Margarita de la Orden,Christine Divers,Carol A. Satler,Vijay N. Joish,Richard N. Channick +8 more
TL;DR: Despite exhibiting pulmonary hypertension-related symptoms, many pulmonary embolism patients did not undergo imaging tests that could diagnose pulmonary hypertension or chronic thromboembolic pulmonary hypertension, and this study suggests that physician education about the risk of pulmonary hypertension and chronic thROMboembolism after pulmonary emblism may need to be improved.
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Gene Expression Profiling in the Lungs of Patients With Pulmonary Hypertension Associated With Pulmonary Fibrosis
Marco Mura,Masaki Anraku,Zhihong Yun,Karen McRae,Mingyao Liu,Thomas K. Waddell,Lianne G. Singer,John Granton,Shaf Keshavjee,Marc de Perrot +9 more
TL;DR: Gene expression profiles distinguish PF phenotypes with and without APH, and this observation can have important implications for future trials.
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Incidence and risk factors of chronic thromboembolic pulmonary hypertension in patients after acute pulmonary embolism.
Suqiao Yang,Yuanhua Yang,Zhenguo Zhai,Tuguang Kuang,Juanni Gong,Shuai Zhang,Jianguo Zhu,Lirong Liang,Ying H. Shen,Chen Wang +9 more
TL;DR: CTEPH was not rare after acute PE in this Chinese population, especially within 3 years of diagnosis, but lower-limb varicose veins, intermediate-risk PE with elevated SPAP in the acute phase, and residual emboli during follow-up might increase the risk of CTEPH.
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Evaluation of right atrial function using right atrial speckle tracking analysis in patients with pulmonary artery hypertension.
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TL;DR: RALS and RALSR by two-dimensional speckle tracking echocardiography were useful for noninvasive evaluation of RA dysfunction and the severity of RHF in patients with PAH.
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How I manage pulmonary Langerhans cell histiocytosis
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TL;DR: Patients with advanced PLCH who complain of unexplained dyspnoea with decreased diffusing capacity of the lung for carbon monoxide should be screened for pulmonary hypertension by Doppler echocardiography, which must be confirmed by right heart catheterisation.
References
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Journal ArticleDOI
Updated clinical classification of pulmonary hypertension.
Gérald Simonneau,Michael A. Gatzoulis,Michael A. Gatzoulis,Ian Adatia,Ian Adatia,David S. Celermajer,David S. Celermajer,Christopher P. Denton,Ardeschir Ghofrani,Miguel Angel Gomez Sanchez,R. Krishna Kumar,Michael J. Landzberg,Roberto F. Machado,Horst Olschewski,Ivan M. Robbins,Rogiero Souza +15 more
TL;DR: In this paper, a clinical classification of pulmonary hypertension (PH) was established, categorizing PH into groups which share similar pathological and hemodynamic characteristics and therapeutic approaches, and the main change was to withdraw persistent pulmonary hypertension of the newborn (PPHN) from Group 1 because this entity carries more differences than similarities with other PAH subgroups.
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Guidelines on the management of valvular heart disease The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology
Alec Vahanian,Helmut Baumgartner,Jeroen J. Bax,Butchart Eg,Robert Dion,Gerasimos Filippatos,Frank A. Flachskampf,Roger Hall,Bernard Iung,Jarosław D. Kasprzak,Patrick Nataf,Pilar Tornos,Lucia Torracca,Arnold Wenink,Silvia G. Priori,Jean-Jacques Blanc,Andrzej Budaj,John Camm,Veronica Dean,Jaap W. Deckers,Kenneth Dickstein,John Lekakis,Keith McGregor,Marco Metra,João Morais,Ady Osterspey,Juan Tamargo,José Luis Zamorano,Annalisa Angelini,Manuel J. Antunes,Miguel Ángel García Fernández,Christa Gohlke-Baerwolf,Gilbert Habib,John J.V. McMurray,Catherine M Otto,Luc Pierard,José L. Pomar,Bernard Prendergast,Raphael Rosenhek,Miguel Sousa Uva +39 more
TL;DR: Guidelines and Expert Consensus Documents aim to present management recommendations based on all of the relevant evidence on a particular subject in order to help physicians select the best possible management strategies for the individual patient suffering from a specific condition, taking into account the impact on outcome and also the risk–benefit ratio of a particular diagnostic or therapeutic procedure.
Journal ArticleDOI
Survival in Patients with Primary Pulmonary Hypertension: Results from a National Prospective Registry
Gilbert E. D'Alonzo,Robyn J. Barst,Stephen M. Ayres,Edward H. Bergofsky,Bruce H. Brundage,Katherine M. Detre,Alfred P. Fishman,Roberta M. Goldring,Berton M. Groves,Janet T. Kernis,Paul S. Levy,Giuseppe G. Pietra,Lynne Reid,John T. Reeves,Stuart Rich,Carol E. Vreim,George W. Williams,Margaret Wu +17 more
TL;DR: Mortality was most closely associated with right ventricular hemodynamic function and can be characterized by means of an equation using three variables: mean pulmonary artery pressure, mean right atrial pressure, and cardiac index.
Journal ArticleDOI
ESC guidelines for the diagnosis and treatment of acute and chronic heart failure 2008: the Task Force for the diagnosis and treatment of acute and chronic heart failure 2008 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association of the ESC (HFA) and endorsed by the European Society of Intensive Care Medicine (ESICM).
Kenneth Dickstein,Alain Cohen-Solal,Gerasimos Filippatos,John J.V. McMurray,Piotr Ponikowski,Philip A. Poole-Wilson,Anna Strömberg,Dirk J. van Veldhuisen,Dan Atar,Arno W. Hoes,Andre Keren,Alexandre Mebazaa,Markku S. Nieminen,Silvia G. Priori,Karl Swedberg,Alec Vahanian,John Camm,Raffaele De Caterina,Veronica Dean,Christian Funck-Brentano,Irene Hellemans,Steen Dalby Kristensen,Keith McGregor,Udo Sechtem,Sigmund Silber,Michal Tendera,Petr Widimsky,José Luis Zamorano,Angelo Auricchio,Jeroen J. Bax,Michael Böhm,Ugo Corrà,Paolo Della Bella,Perry M. Elliott,Ferenc Follath,Mihai Gheorghiade,Yonathan Hasin,Anders Hernborg,Tiny Jaarsma,Michel Komajda,Ran Kornowski,Massimo F Piepoli,Bernard Prendergast,Luigi Tavazzi,Jean Luc Vachiery,Freek W.A. Verheugt,Faiez Zannad +46 more
Journal ArticleDOI
Guidelines on the Diagnosis and Management of Acute Pulmonary Embolism: The Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC)
Adam Torbicki,Arnaud Perrier,Stavros Konstantinides,Giancarlo Agnelli,Nazzareno Galiè,Piotr Pruszczyk,Frank M. Bengel,Adrian J B Brady,Daniel Ferreira,Uwe Janssens,Walter Klepetko,Eckhard Mayer,Martine Remy-Jardin,Jean-Pierre Bassand,Alec Vahanian,John Camm,Raffaele De Caterina,Veronica Dean,Kenneth Dickstein,Gerasimos Filippatos,Christian Funck-Brentano,Irene Hellemans,Steen Dalby Kristensen,Keith McGregor,Udo Sechtem,Sigmund Silber,Michal Tendera,Petr Widimsky,José Luis Zamorano,José Luis Zamorano,Felicita Andreotti,Michael Ascherman,George Athanassopoulos,Johan De Sutter,David Fitzmaurice,Tamás Forster,Magda Heras,Guillaume Jondeau,Keld Kjeldsen,Juhani Knuuti,Irene Lang,Mattie J. Lenzen,Jose Lopez-Sendon,Petros Nihoyannopoulos,Leopoldo Pérez de Isla,Udo Schwehr,Lucia Torraca,Jean-Luc Vachiery +47 more
TL;DR: Non-thrombotic PE does not represent a distinct clinical syndrome but may be due to a variety of embolic materials and result in a wide spectrum of clinical presentations, making the diagnosis difficult.
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