Journal ArticleDOI
Riociguat for the Treatment of Chronic Thromboembolic Pulmonary Hypertension
Hossein Ardeschir Ghofrani,Andrea Maria D'Armini,Friedrich Grimminger,Marius M. Hoeper,Pavel Jansa,Nick H. Kim,Eckhard Mayer,Gérald Simonneau,Martin R. Wilkins,Arno Fritsch,Dieter Neuser,Gerrit Weimann,Chen Wang +12 more
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TLDR
Riociguat significantly improved exercise capacity and pulmonary vascular resistance in patients with chronic thromboembolic pulmonary hypertension.Abstract:
BACKGROUND Riociguat, a member of a new class of compounds (soluble guanylate cyclase stim ulators), has been shown in previous clinical studies to be beneficial in the treat ment of chronic thromboembolic pulmonary hypertension. METHODS In this phase 3, multicenter, randomized, double-blind, placebo-controlled study, we randomly assigned 261 patients with inoperable chronic thromboembolic pul monary hypertension or persistent or recurrent pulmonary hypertension after pul monary endarterectomy to receive placebo or riociguat. The primary end point was the change from baseline to the end of week 16 in the distance walked in 6 minutes. Secondary end points included changes from baseline in pulmonary vascular resis tance, N-terminal pro–brain natriuretic peptide (NT-proBNP) level, World Health Organization (WHO) functional class, time to clinical worsening, Borg dyspnea score, quality-of-life variables, and safety. RESULTS By week 16, the 6-minute walk distance had increased by a mean of 39 m in the riociguat group, as compared with a mean decrease of 6 m in the placebo group (least-squares mean difference, 46 m; 95% confidence interval [CI], 25 to 67; P<0.001). Pulmonary vascular resistance decreased by 226 dyn · sec · cm –5 in the riociguat group and increased by 23 dyn · sec · cm –5 in the placebo group (least-squares mean difference, –246 dyn · sec · cm –5 ; 95% CI, –303 to –190; P<0.001). Riociguat was also associated with significant improvements in the NT-proBNP level (P<0.001) and WHO functional class (P = 0.003). The most common serious adverse events were right ventricular failure (in 3% of patients in each group) and syncope (in 2% of the riociguat group and in 3% of the placebo group). CONCLUSIONS Riociguat significantly improved exercise capacity and pulmonary vascular re sistance in patients with chronic thromboembolic pulmonary hypertension. (Funded by Bayer HealthCare; CHEST-1 and CHEST-2 ClinicalTrials.gov numbers, NCT00855465 and NCT00910429, respectively.)read more
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2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint 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: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT).
Nazzareno Galiè,Marc Humbert,Jean-Luc Vachiery,Simon Gibbs,Irene Lang,Adam Torbicki,Gérald Simonneau,Andrew Peacock,Anton Vonk Noordegraaf,Maurice Beghetti,Ardeschir Ghofrani,Miguel Angel Gomez Sanchez,Georg Hansmann,Walter Klepetko,Patrizio Lancellotti,Marco Matucci,Theresa McDonagh,Luc Pierard,Pedro T. Trindade,Maurizio Zompatori,Marius M. Hoeper +20 more
TL;DR: In this paper, the authors defined the following terms: ALAT, alanine aminotransferase, ASAT, aspartate AMINOTE, and APAH, associated pulmonary arterial hypertension.
Journal ArticleDOI
Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel Report
Clive Kearon,Elie A. Akl,Elie A. Akl,Joseph Ornelas,Allen J. Blaivas,David Jiménez,Henri Bounameaux,Menno V. Huisman,Christopher S. King,Timothy A. Morris,Namita Sood,Scott M. Stevens,Janine R.E. Vintch,Philip S. Wells,Scott C. Woller,Lisa K. Moores +15 more
TL;DR: Recommendations on 12 topics that were in the 9th edition of these guidelines are updated, and 3 new topics are addressed.
Journal ArticleDOI
Special article2015 ESC/ERS Guidelines for the Diagnosis and Treatment of Pulmonary Hypertension
Nazzareno Galiè,Marc Humbert,Jean-Luc Vachiery,Simon Gibbs,Irene Lang,Adam Torbicki,Gérald Simonneau,Andrew J. Peacock,Anton Vonk Noordegraaf,Maurice Beghetti,Ardeschir Ghofrani,Miguel Angel Gomez Sanchez,Georg Hansmann,Walter Klepetko,Patrizio Lancellotti,Marco Matucci,Theresa McDonagh,Luc Pierard,Marius M. Hoeper +18 more
TL;DR: This article is being published concurrently in the European Heart Journal and the European Respiratory Journal and is identical except for minor stylistic and spelling differences in keeping with each journal’s style.
Journal ArticleDOI
[2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension].
Nazzareno Galiè,Marc Humbert,Jean-Luc Vachiery,Simon Gibbs,Irene Lang,Adam Torbicki,Gérald Simonneau,Andrew J. Peacock,Anton Vonk Noordegraaf,Maurice Beghetti,Ardeschir Ghofrani,Miguel Angel Gomez Sanchez,Georg Hansmann,Walter Klepetko,Patrizio Lancellotti,Marco Matucci,Theresa McDonagh,Luc Pierard,Pedro T. Trindade,Maurizio Zompatori,Marius M. Hoeper +20 more
TL;DR: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS) is constituted.
Journal ArticleDOI
2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism
Stavros Konstantinides,Adam Torbicki,David Fitzmaurice,Simón J,R. Gibbs,Menno V. Huisman,Marc Humbert,John Lekakis,Nicolas Meneveau,Lars Hvilsted Rasmussen,Thomas H. Schindler,Anton Vonk Noordegraaf,José Luis Zamorano,Maurizio Zompatori +13 more
TL;DR: Guidelines summarize and evaluate all available evidence at the time of the writing process, on a particular issue with the aim of assisting health professionals in selecting the best management strategies for an individual patient, with a given condition, taking into account the impact on outcome.
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 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
TL;DR: 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.
Journal ArticleDOI
Guidelines for the diagnosis and treatment of pulmonary hypertension
Marius M. Hoeper,Marc Humbert,Adam Torbicki,Jean-Luc Vachiery,Joan Albert Barberà,Maurice Beghetti,Paul A. Corris,Sean Gaine,J. Simon R. Gibbs,Miguel Ángel Gómez-Sánchez,Guillaume Jondeau,Walter Klepetko,Andrew J. Peacock,Lewis J. Rubin,Michael J. Zellweger,Gérald Simonneau,Angelo Auricchio,Jeroen J. Bax,Claudio Ceconi,Veronica Dean,Gerasimos Filippatos,Christian Funck-Brentano,Richard J. Hobbs,Peter Kearney,Theresa McDonagh,Keith McGregor,Bogdan A. Popescu,Zeljko Reiner,Udo Sechtem,Michal Tendera,Panos E. Vardas,Petr Widimsky,Felicita Andreotti,Michael Aschermann,Riccardo Asteggiano,Ray Benza,Rolf M. F. Berger,Damien Bonnet,Marion Delcroix,Luke Howard,Anastasia Kitsiou,Irene Lang,Aldo P. Maggioni,Jens Erik Nielsen-Kudsk,Myung H. Park,Pasquale Perrone-Filardi,Maria Teresa Subirana Domenech,Anton Vonk-Noordegraaf,José Luis Zamorano +48 more
TL;DR: Guidelines and Expert Consensus Documents summarise 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.
Journal ArticleDOI
Long-Term Intravenous Epoprostenol Infusion in Primary Pulmonary Hypertension Prognostic Factors and Survival
Olivier Sitbon,Marc Humbert,Hilario Nunes,Florence Parent,Gilles Garcia,Philippe Hervé,Maurizio Rainisio,G.érald Simonneau +7 more
TL;DR: It is suggested that lung transplantation should be considered in a subset of patients who remain in NYHA functional class III or IV or in those who cannot achieve a significant hemodynamic improvement after three months of epoprostenol therapy, or both.
Journal ArticleDOI
Reduced Expression of Endothelial Nitric Oxide Synthase in the Lungs of Patients with Pulmonary Hypertension
Adel Giaid,Dina Saleh +1 more
TL;DR: It is possible that decreased expression of nitric oxide synthase may contribute to pulmonary vasoconstriction and to the excessive growth of the tunica media observed in this disease.
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