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Open AccessJournal ArticleDOI

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)

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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 Unpublished clinical trial results are not taken into account.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 …

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Journal ArticleDOI

Hemodynamics of patients developing pulmonary arterial hypertension after shunt closure

TL;DR: Assessment of retrospectively the hemodynamics of patients developing PAH after shunt closure found high baseline values of PVR, PVRi, and PVR/SVR are common findings in patients who develop PAH late afterShunt closure.
Journal ArticleDOI

Melatonin as a preventive and curative therapy against pulmonary hypertension

TL;DR: The data demonstrate that melatonin confers cardioprotection in this model of PH, and it is proposed that clinical investigation of the effects of melatonin on RV function in patients with PH should be considered.
Journal ArticleDOI

Use of echocardiographic pulmonary acceleration time and estimated vascular resistance for the evaluation of possible pulmonary hypertension

TL;DR: This study confirms that AT appears to be useful for the evaluation of pulmonary hypertension and finds no significant correlation between the estimation of right atrial pressure by echocardiography and the RAP obtained by RHC.
Journal ArticleDOI

Optimising the management of pulmonary arterial hypertension patients: emergency treatments

TL;DR: A model of transmural organisation of care for PAH patients, currently applied in Belgium, is described and a review of the main emergencies is provided, based on an analysis of the reasons of death.
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