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Review
. 2011 Dec;20(122):236-42.
doi: 10.1183/09059180.00006711.

Prognostic factors in pulmonary arterial hypertension: assessing the course of the disease

L S Howard  1
Affiliations
Review

Prognostic factors in pulmonary arterial hypertension: assessing the course of the disease

L S Howard. Eur Respir Rev. 2011 Dec.

Abstract

The practical management of pulmonary arterial hypertension (PAH) requires an accurate assessment of disease severity and prognosis. A number of prognostic indicators are known to be associated with patient outcome, and recent treatment guidelines advocate using such parameters to guide management decisions. Although PAH is characterised by the presence of pulmonary vasculopathy, it is the response of the right ventricle to an increased afterload that is the greatest determinant of a patient's symptoms and survival; thus, measurements that capture right ventricular function provide the best potential to assess PAH severity. One challenge is to understand how the tests we use in everyday clinical practice relate to right heart function in PAH patients, and how current measures can be improved and developed to optimise assessment of disease status and progress. Future research in the field of PAH should focus on how best to assess right heart function, and which measures or combination of measures provide the most relevant information for the individual patient.

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Conflict of interest statement

Statement of Interest

L.S. Howard has received honoraria for speaking and acting on advisory boards from Actelion, Pfizer, GSK and Bayer. He has received research grants from Pfizer and Bayer, and funds for a member of staff from Actelion. Travel and conference fees have been provided by Actelion, GSK and Pfizer.

Figures

Figure 1.
Figure 1.
Schematic representation of changes in haemodynamic parameters over the course of pulmonary arterial hypertension. Ppa: pulmonary arterial pressure; PVR: pulmonary vascular resistance.
See this image and copyright information in PMC

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MeSH terms