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Unpublished clinical trial results are not taken into account.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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Pulmonary hypertension in patients with neurofibromatosis type I.
David Montani,Florence Coulet,Barbara Girerd,Mélanie Eyries,Emmanuel Bergot,Hervé Mal,Giuseppina Biondi,Claire Dromer,Thomas Hugues,Charles Marquette,Caroline O’Connell,Dermot S. O'Callaghan,Laurent Savale,Xavier Jaïs,Peter Dorfmüller,Hugues Begueret,Laurent Bertoletti,Olivier Sitbon,Christine Bellanné-Chantelot,Gérard Zalcman,Gérald Simonneau,Marc Humbert,Florent Soubrier +22 more
TL;DR: PH represents a rare but severe complication ofNF1, characterized by female predominance, late onset in the course of NF1, and severe functional and hemodynamic impairment.
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Hemodynamics of patients developing pulmonary arterial hypertension after shunt closure
Michele D'Alto,Emanuele Romeo,Paola Argiento,Anna Correra,Giuseppe Santoro,Gianpiero Gaio,Berardo Sarubbi,Raffaele Calabrò,Maria Giovanna Russo +8 more
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.
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Melatonin as a preventive and curative therapy against pulmonary hypertension
Gerald J. Maarman,Dee Blackhurst,Friedrich Thienemann,Lori A. Blauwet,Ghazwan Butrous,Neil H. Davies,Karen Sliwa,Sandrine Lecour +7 more
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.
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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.
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Optimising the management of pulmonary arterial hypertension patients: emergency treatments
Marion Delcroix,Robert Naeije +1 more
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.
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.
Journal ArticleDOI
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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