Challenges in Pulmonary Hypertension: Controversies in Treating the Tip of the Iceberg. A Joint National Institutes of Health Clinical Center and Pulmonary Hypertension Association Symposium Report

Jason M Elinoff¹, Richa Agarwal², Christopher F Barnett³, Raymond L Benza², Michael J Cuttica⁴, Ahmed M Gharib⁵, Michael P Gray⁶, Paul M Hassoun⁷, Anna R Hemnes⁸, Marc Humbert⁹, Todd M Kolb⁷, Tim Lahm^{10

11}, Jane A Leopold¹², Stephen C Mathai⁷, Vallerie V McLaughlin¹³, Ioana R Preston¹⁴, Erika B Rosenzweig¹⁵, Oksana A Shlobin¹⁶, Virginia D Steen¹⁷, Roham T Zamanian¹⁸, Michael A Solomon^{1

19}

Affiliations

¹ 1 Clinical Center.
² 2 Division of Cardiovascular Disease, Department of Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania.
³ 3 MedStar Washington Hospital Center, Washington, DC.
⁴ 4 Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
⁵ 5 National Institute of Diabetes, Digestive, and Kidney Diseases, and.
⁶ 6 Pulmonary Hypertension Association, Silver Spring, Maryland.
⁷ 7 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, Maryland.
⁸ 8 Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
⁹ 9 Service de Pneumologie, Hôpital Bicêtre (Assistance Publique-Hôpitaux de Paris), Institut National de la Santé et de la Recherche Médicale U999, University Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France.
¹⁰ 10 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Indiana University, Indianapolis, Indiana.
¹¹ 11 Richard L. Roudebush VA Medical Center, Indianapolis, Indiana.
¹² 12 Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
¹³ 13 Division of Cardiology, Department of Medicine, University of Michigan, Ann Arbor, Michigan.
¹⁴ 14 Department of Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
¹⁵ 15 Department of Medicine, Columbia School of Medicine, New York, New York.
¹⁶ 16 Pulmonary Vascular Disease Program, Inova Fairfax Hospital, Falls Church, Virginia.
¹⁷ 17 Rheumatology Division, Department of Medicine, Georgetown University, Washington, DC; and.
¹⁸ 18 Stanford University, Department of Medicine, Stanford, California.
¹⁹ 19 NHLBI, NIH, Bethesda, Maryland.

PMID: 29425462
PMCID: PMC6058980
DOI: 10.1164/rccm.201710-2093PP

Challenges in Pulmonary Hypertension: Controversies in Treating the Tip of the Iceberg. A Joint National Institutes of Health Clinical Center and Pulmonary Hypertension Association Symposium Report

Jason M Elinoff et al. Am J Respir Crit Care Med. 2018.

. 2018 Jul 15;198(2):166-174.

doi: 10.1164/rccm.201710-2093PP.

Authors

Affiliations

¹ 1 Clinical Center.
² 2 Division of Cardiovascular Disease, Department of Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania.
³ 3 MedStar Washington Hospital Center, Washington, DC.
⁴ 4 Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
⁵ 5 National Institute of Diabetes, Digestive, and Kidney Diseases, and.
⁶ 6 Pulmonary Hypertension Association, Silver Spring, Maryland.
⁷ 7 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Johns Hopkins University, Baltimore, Maryland.
⁸ 8 Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
⁹ 9 Service de Pneumologie, Hôpital Bicêtre (Assistance Publique-Hôpitaux de Paris), Institut National de la Santé et de la Recherche Médicale U999, University Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France.
¹⁰ 10 Division of Pulmonary and Critical Care Medicine, Department of Medicine, Indiana University, Indianapolis, Indiana.
¹¹ 11 Richard L. Roudebush VA Medical Center, Indianapolis, Indiana.
¹² 12 Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
¹³ 13 Division of Cardiology, Department of Medicine, University of Michigan, Ann Arbor, Michigan.
¹⁴ 14 Department of Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, Massachusetts.
¹⁵ 15 Department of Medicine, Columbia School of Medicine, New York, New York.
¹⁶ 16 Pulmonary Vascular Disease Program, Inova Fairfax Hospital, Falls Church, Virginia.
¹⁷ 17 Rheumatology Division, Department of Medicine, Georgetown University, Washington, DC; and.
¹⁸ 18 Stanford University, Department of Medicine, Stanford, California.
¹⁹ 19 NHLBI, NIH, Bethesda, Maryland.

PMID: 29425462
PMCID: PMC6058980
DOI: 10.1164/rccm.201710-2093PP

No abstract available

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Figures

**Figure 1.**
Iceberg models illustrating the substrates underlying pulmonary hypertension (PH) due to pulmonary arterial hypertension (PAH), heart failure with preserved ejection fraction (HFpEF), interstitial lung disease (ILD), and pulmonary veno-occlusive disease (PVOD). LV = left ventricular; RV = right ventricular. Illustration by Jacqueline Schaffer.

See this image and copyright information in PMC

Comment in

The Light at the End of the Long Pulmonary Hypertension Tunnel Brightens.
Voelkel NF, Newman JH. Voelkel NF, et al. Am J Respir Crit Care Med. 2018 Sep 15;198(6):818-820. doi: 10.1164/rccm.201802-0325LE. Am J Respir Crit Care Med. 2018. PMID: 29944843 No abstract available.
Reply to Voelkel and Newman: The Light at the End of the Long Pulmonary Hypertension Tunnel Brightens.
Elinoff JM, Humbert M, Solomon MA. Elinoff JM, et al. Am J Respir Crit Care Med. 2018 Sep 15;198(6):820-821. doi: 10.1164/rccm.201804-0792LE. Am J Respir Crit Care Med. 2018. PMID: 29944844 Free PMC article. No abstract available.

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Precision medicine: The future of diagnostic approach to pulmonary hypertension?
Kedzierski P, Torbicki A. Kedzierski P, et al. Anatol J Cardiol. 2019 Sep;22(4):168-171. doi: 10.14744/AnatolJCardiol.2019.97820. Anatol J Cardiol. 2019. PMID: 31584446 Free PMC article. Review.
Diagnosis of pulmonary hypertension.
Frost A, Badesch D, Gibbs JSR, Gopalan D, Khanna D, Manes A, Oudiz R, Satoh T, Torres F, Torbicki A. Frost A, et al. Eur Respir J. 2019 Jan 24;53(1):1801904. doi: 10.1183/13993003.01904-2018. Print 2019 Jan. Eur Respir J. 2019. PMID: 30545972 Free PMC article. Review.
Pulmonary Hypertension Caused by Interstitial Lung Disease: A New iNK(T)ling into Disease Pathobiology.
Hersi K, Elinoff JM. Hersi K, et al. Am J Respir Crit Care Med. 2022 Oct 15;206(8):930-932. doi: 10.1164/rccm.202206-1186ED. Am J Respir Crit Care Med. 2022. PMID: 35772120 Free PMC article. No abstract available.
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Dubroff J, Melendres L, Lin Y, Beene DR, Ketai L. Dubroff J, et al. Pulm Circ. 2020 Feb 4;10(1):2045894019894534. doi: 10.1177/2045894019894534. eCollection 2020 Jan-Mar. Pulm Circ. 2020. PMID: 32110384 Free PMC article.
Renin-Angiotensin-Aldosterone System Inhibitor Use and Mortality in Pulmonary Hypertension: Insights From the Veterans Affairs Clinical Assessment Reporting and Tracking Database.
Lahm T, Hess E, Barón AE, Maddox TM, Plomondon ME, Choudhary G, Maron BA, Zamanian RT, Leary PJ. Lahm T, et al. Chest. 2021 Apr;159(4):1586-1597. doi: 10.1016/j.chest.2020.09.258. Epub 2020 Oct 5. Chest. 2021. PMID: 33031831 Free PMC article.

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1. Simonneau G, Gatzoulis MA, Adatia I, Celermajer D, Denton C, Ghofrani A, et al. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol. 2013;62:D34–D41. - PubMed
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Challenges in Pulmonary Hypertension: Controversies in Treating the Tip of the Iceberg. A Joint National Institutes of Health Clinical Center and Pulmonary Hypertension Association Symposium Report

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Challenges in Pulmonary Hypertension: Controversies in Treating the Tip of the Iceberg. A Joint National Institutes of Health Clinical Center and Pulmonary Hypertension Association Symposium Report

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