Updated Clinical Classification of Pulmonary Hypertension

The aim of a clinical classification of pulmonary hypertension (PH) is to group together different manifestations of disease sharing similarities in pathophysiologic mechanisms, clinical presentation, and therapeutic approaches. In 2003, during the 3rd World Symposium on Pulmonary Hypertension, the...

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Published inJournal of the American College of Cardiology Vol. 54; no. 1; pp. S43 - S54
Main Authors Simonneau, Gérald, Robbins, Ivan M., Beghetti, Maurice, Channick, Richard N., Delcroix, Marion, Denton, Christopher P., Elliott, C. Gregory, Gaine, Sean P., Gladwin, Mark T., Jing, Zhi-Cheng, Krowka, Michael J., Langleben, David, Nakanishi, Norifumi, Souza, Rogério
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 30.06.2009
Elsevier Limited
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Abstract The aim of a clinical classification of pulmonary hypertension (PH) is to group together different manifestations of disease sharing similarities in pathophysiologic mechanisms, clinical presentation, and therapeutic approaches. In 2003, during the 3rd World Symposium on Pulmonary Hypertension, the clinical classification of PH initially adopted in 1998 during the 2nd World Symposium was slightly modified. During the 4th World Symposium held in 2008, it was decided to maintain the general architecture and philosophy of the previous clinical classifications. The modifications adopted during this meeting principally concern Group 1, pulmonary arterial hypertension (PAH). This subgroup includes patients with PAH with a family history or patients with idiopathic PAH with germline mutations (e.g., bone morphogenetic protein receptor-2, activin receptor-like kinase type 1, and endoglin). In the new classification, schistosomiasis and chronic hemolytic anemia appear as separate entities in the subgroup of PAH associated with identified diseases. Finally, it was decided to place pulmonary veno-occlusive disease and pulmonary capillary hemangiomatosis in a separate group, distinct from but very close to Group 1 (now called Group 1′). Thus, Group 1 of PAH is now more homogeneous.
AbstractList The aim of a clinical classification of pulmonary hypertension (PH) is to group together different manifestations of disease sharing similarities in pathophysiologic mechanisms, clinical presentation, and therapeutic approaches. In 2003, during the 3rd World Symposium on Pulmonary Hypertension, the clinical classification of PH initially adopted in 1998 during the 2nd World Symposium was slightly modified. During the 4th World Symposium held in 2008, it was decided to maintain the general architecture and philosophy of the previous clinical classifications. The modifications adopted during this meeting principally concern Group 1, pulmonary arterial hypertension (PAH). This subgroup includes patients with PAH with a family history or patients with idiopathic PAH with germline mutations (e.g., bone morphogenetic protein receptor-2, activin receptor-like kinase type 1, and endoglin). In the new classification, schistosomiasis and chronic hemolytic anemia appear as separate entities in the subgroup of PAH associated with identified diseases. Finally, it was decided to place pulmonary veno-occlusive disease and pulmonary capillary hemangiomatosis in a separate group, distinct from but very close to Group 1 (now called Group 1′). Thus, Group 1 of PAH is now more homogeneous.
The aim of a clinical classification of pulmonary hypertension (PH) is to group together different manifestations of disease sharing similarities in pathophysiologic mechanisms, clinical presentation, and therapeutic approaches. In 2003, during the 3rd World Symposium on Pulmonary Hypertension, the clinical classification of PH initially adopted in 1998 during the 2nd World Symposium was slightly modified. During the 4th World Symposium held in 2008, it was decided to maintain the general architecture and philosophy of the previous clinical classifications. The modifications adopted during this meeting principally concern Group 1, pulmonary arterial hypertension (PAH). This subgroup includes patients with PAH with a family history or patients with idiopathic PAH with germline mutations (e.g., bone morphogenetic protein receptor-2, activin receptor-like kinase type 1, and endoglin). In the new classification, schistosomiasis and chronic hemolytic anemia appear as separate entities in the subgroup of PAH associated with identified diseases. Finally, it was decided to place pulmonary veno-occlusive disease and pulmonary capillary hemangiomatosis in a separate group, distinct from but very close to Group 1 (now called Group 1'). Thus, Group 1 of PAH is now more homogeneous.The aim of a clinical classification of pulmonary hypertension (PH) is to group together different manifestations of disease sharing similarities in pathophysiologic mechanisms, clinical presentation, and therapeutic approaches. In 2003, during the 3rd World Symposium on Pulmonary Hypertension, the clinical classification of PH initially adopted in 1998 during the 2nd World Symposium was slightly modified. During the 4th World Symposium held in 2008, it was decided to maintain the general architecture and philosophy of the previous clinical classifications. The modifications adopted during this meeting principally concern Group 1, pulmonary arterial hypertension (PAH). This subgroup includes patients with PAH with a family history or patients with idiopathic PAH with germline mutations (e.g., bone morphogenetic protein receptor-2, activin receptor-like kinase type 1, and endoglin). In the new classification, schistosomiasis and chronic hemolytic anemia appear as separate entities in the subgroup of PAH associated with identified diseases. Finally, it was decided to place pulmonary veno-occlusive disease and pulmonary capillary hemangiomatosis in a separate group, distinct from but very close to Group 1 (now called Group 1'). Thus, Group 1 of PAH is now more homogeneous.
Author Beghetti, Maurice
Nakanishi, Norifumi
Robbins, Ivan M.
Denton, Christopher P.
Langleben, David
Souza, Rogério
Channick, Richard N.
Elliott, C. Gregory
Gaine, Sean P.
Jing, Zhi-Cheng
Delcroix, Marion
Krowka, Michael J.
Gladwin, Mark T.
Simonneau, Gérald
Author_xml – sequence: 1
  givenname: Gérald
  surname: Simonneau
  fullname: Simonneau, Gérald
  email: gerald.simonneau@abc.aphp.fr
  organization: Centre National de Référence des Maladies Vasculaires Pulmonaires, Université Paris-Sud Hôpital Antoine Béclère, Clamart, France
– sequence: 2
  givenname: Ivan M.
  surname: Robbins
  fullname: Robbins, Ivan M.
  organization: Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
– sequence: 3
  givenname: Maurice
  surname: Beghetti
  fullname: Beghetti, Maurice
  organization: Pediatric Cardiology Unit, Hôpital des Enfants, University Hospital of Geneva, Geneva, Switzerland
– sequence: 4
  givenname: Richard N.
  surname: Channick
  fullname: Channick, Richard N.
  organization: Division of Pulmonary and Critical Care Medicine, UCSD Medical Center, La Jolla, California
– sequence: 5
  givenname: Marion
  surname: Delcroix
  fullname: Delcroix, Marion
  organization: Center for Pulmonary Vascular Disease, Department of Pneumology, Gasthuisberg University Hospital, Leuven, Belgium
– sequence: 6
  givenname: Christopher P.
  surname: Denton
  fullname: Denton, Christopher P.
  organization: Centre for Rheumatology, Royal Free Hospital, London, United Kingdom
– sequence: 7
  givenname: C. Gregory
  surname: Elliott
  fullname: Elliott, C. Gregory
  organization: Department of Medicine, Intermountain Medical Center, University of Utah, Salt Lake City, Utah
– sequence: 8
  givenname: Sean P.
  surname: Gaine
  fullname: Gaine, Sean P.
  organization: Department of Respiratory Medicine, Mater Misericordiae University Hospital, University College Dublin, Dublin, Ireland
– sequence: 9
  givenname: Mark T.
  surname: Gladwin
  fullname: Gladwin, Mark T.
  organization: Pulmonary, Allergy, and Critical Care Medicine, Hemostasis and Vascular Biology Research Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
– sequence: 10
  givenname: Zhi-Cheng
  surname: Jing
  fullname: Jing, Zhi-Cheng
  organization: Department of Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University, Shanghai, China
– sequence: 11
  givenname: Michael J.
  surname: Krowka
  fullname: Krowka, Michael J.
  organization: Department of Pulmonary and Critical Care Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
– sequence: 12
  givenname: David
  surname: Langleben
  fullname: Langleben, David
  organization: Center for Pulmonary Vascular Disease, Sir Mortimer B. Davis Jewish General Hospital, Montréal, Québec, Canada
– sequence: 13
  givenname: Norifumi
  surname: Nakanishi
  fullname: Nakanishi, Norifumi
  organization: Division of Cardiology and Pulmonary Circulation, Department of Internal Medicine National Cardiovascular Center, Osaka, Japan
– sequence: 14
  givenname: Rogério
  surname: Souza
  fullname: Souza, Rogério
  organization: Pulmonary Department, Heart Institute, University of São Paulo Medical School, São Paulo, Brazil
BackLink https://www.ncbi.nlm.nih.gov/pubmed/19555858$$D View this record in MEDLINE/PubMed
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Issue 1
Keywords ESRD
BMPR2
OR
pulmonary hypertension
PPH
IPAH
PVR
POPH
HIV
PCH
SCD
PAH
PH
clinical classification
TRV
CTEPH
pulmonary arterial hypertension
CHD
PAP
PVOD
odds ratio
pulmonary arterial pressure
primary pulmonary hypertension
sickle cell disease
congenital heart disease
bone morphogenetic protein receptor type 2
tricuspid regurgitation jet velocity
end-stage renal disease
idiopathic pulmonary arterial hypertension
chronic thromboembolic pulmonary hypertension
human immunodeficiency virus
pulmonary veno-occlusive disease
pulmonary vascular resistance
pulmonary capillary hemangiomatosis
portopulmonary hypertension
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Snippet The aim of a clinical classification of pulmonary hypertension (PH) is to group together different manifestations of disease sharing similarities in...
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SubjectTerms Algorithms
Anticoagulants - therapeutic use
Antihypertensive Agents - administration & dosage
Calcium Channel Blockers - therapeutic use
Cardiology
Cardiovascular
Cardiovascular disease
Classification
clinical classification
Clinical trials
Comorbidity
Defects
Drug therapy
Endothelin Receptor Antagonists
Epoprostenol - administration & dosage
Evidence-Based Medicine
Family medical history
Genetic counseling
Humans
Hypertension, Pulmonary - classification
Hypertension, Pulmonary - drug therapy
Hypertension, Pulmonary - epidemiology
Internal Medicine
Mutation
Prognosis
pulmonary arterial hypertension
Pulmonary hypertension
Randomized Controlled Trials as Topic
Scleroderma, Systemic - epidemiology
Surgery
Treatment Outcome
Title Updated Clinical Classification of Pulmonary Hypertension
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https://dx.doi.org/10.1016/j.jacc.2009.04.012
https://www.ncbi.nlm.nih.gov/pubmed/19555858
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Volume 54
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