Contemporary issues in pulmonary hypertension

Abstract

In recent years, important contributions to the understanding of pulmonary hypertension (PH) have been published in core clinical journals [1]. Relevant and thought-provoking studies evidencing the high quality of research in the PH field have been carried out by specialists worldwide. We have decided to focus on special issues we believe to be, on the one hand, pertinent to the understanding of what has happened hitherto and, on the other hand, useful to lay the new foundations on which future research will be based. Amongst the articles published in the last couple of years, we believe that the following groups of interest deserve special attention: the summary of the fourth World Symposium on PH; the guidelines on PH (both the American and the European); and the studies that shed new light on the discussion of survival in PH. In June 2009, the results of the discussion of working groups on specific issues of PH were published in 11 articles and one editorial in the Journal of the American College of Cardiology [2–13]. The articles covered a vast array of topics on PH, from basic research (comprising development, pathology, inflammation, genetics, and cellular and molecular basis of PH) to clinical issues, such as classification, diagnosis, the role of surgery and medical treatment in pulmonary arterial hypertension (PAH). Interestingly, there were also papers on end-points and clinical trials, and on future perspectives for the treatment of PAH. The article entitled “Updated clinical classification of pulmonary hypertension” [3] aimed at grouping together different PH manifestations with similar pathophysiological mechanisms, clinical presentation and therapeutic options. In spite of the maintenance of the general architecture of the classification compared to the previous classifications (Second and Third World Symposium on Pulmonary Hypertension in 1998 (Evian, France) and 2003 …