RT Journal Article
SR Electronic
T1 Diagnosis and management of pulmonary hypertension related to chronic respiratory disease
JF Breathe
JO Breathe
FD European Respiratory Society
SP 220205
DO 10.1183/20734735.0205-2022
VO 18
IS 4
A1 Anastasia Krompa
A1 Philip Marino
YR 2022
UL http://breathe.ersjournals.com/content/18/4/220205.abstract
AB Pulmonary hypertension (PH) is a recognised and significant complication of chronic lung disease (CLD) and hypoxia (referred to as group 3 PH) that is associated with increased morbidity, decreased quality of life and worse survival. The prevalence and severity of group 3 PH varies within the current literature, with the majority of CLD-PH patients tending to have non-severe disease. The aetiology of this condition is multifactorial and complex, while the prevailing pathogenetic mechanisms include hypoxic vasoconstriction, parenchymal lung (and vascular bed) destruction, vascular remodelling and inflammation. Comorbidities such as left heart dysfunction and thromboembolic disease can further confound the clinical picture. Noninvasive assessment is initially undertaken in suspected cases (e.g. cardiac biomarkers, lung function, echocardiogram), while haemodynamic evaluation with right heart catheterisation remains the diagnostic gold standard. For patients with suspected severe PH, those with a pulmonary vascular phenotype or when there is uncertainty regarding further management, referral to specialist PH centres for further investigation and definitive management is mandated. No disease-specific therapy is currently available for group 3 PH and the focus of management remains optimisation of the underlying lung therapy, along with treating hypoventilation syndromes as indicated.Pulmonary hypertension is a recognised complication of chronic respiratory disease that is associated with significant mortality and morbidity. Treatment of the underlying lung disease and associated comorbidities is essential. https://bit.ly/3O4eoFh