Management and Therapy for Pulmonary Hypertension: 2016 Update
Simone K. Visser 1, Marc Humbert 2, Edmund M. Lau 1
1 University of Sydney, Sydney Medical School, Department of Respiratory Medicine, Royal Prince Alfred Hospital, Camperdown, Australia; 2 University Paris-Sud, Faculté de Médecine and AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, France; UMR_S 999, University Paris-Sud; INSERM; Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
*Correspondence: Edmund M. Lau, Email not available
Abstract
Pulmonary hypertension encompasses a range of conditions that lead through varying mechanisms to an elevated mean pulmonary artery pressure of ≥ 25 mmHg at right heart catheterization. This update on pulmonary hypertension management will focus on those areas in which major recent developments have occurred, specifically pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. An increasing repertoire of approved targeted medical therapies and data supporting the efficacy of combination therapy have transformed the management algorithm for pulmonary arterial hypertension, which has recently been updated in the 2015 European Society of Cardiology/European Respiratory Society guidelines. For patients with chronic thromboembolic pulmonary hypertension, pulmonary endarterectomy remains the treatment of choice. However, treatment options for those with adjudicated inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension have expanded. Riociguat has demonstrated efficacy and is approved for these patients, and balloon pulmonary angioplasty is being offered at an increasing number of expert centres worldwide.
