Risk Stratification and Treatment Goals in Pulmonary Arterial Hypertension

Overview

Journal Eur Respir J

Specialty Pulmonary Medicine

Date 2024 Aug 29

PMID 39209472

Authors

Fabio Dardi

Athenais Boucly

Raymond Benza

Robert Frantz

Valentina Mercurio

Horst Olschewski

Goran Radegran

Lewis J Rubin

Marius M Hoeper

Affiliations

Soon will be listed here.

Abstract

Risk stratification has gained an increasing role in predicting outcomes and guiding the treatment of patients with pulmonary arterial hypertension (PAH). The most predictive prognostic factors are three noninvasive parameters (World Health Organization functional class, 6-min walk distance and natriuretic peptides) that are included in all currently validated risk stratification tools. However, suffering from limitations mainly related to reduced specificity of PAH severity, these variables may not always be adequate in isolation for guiding individualised treatment decisions. Moreover, with effective combination treatment regimens and emerging PAH therapies, markers associated with pulmonary vascular remodelling are expected to become of increasing relevance in guiding the treatment of patients with PAH. While reaching a low mortality risk, assessed with a validated risk tool, remains an important treatment goal, preliminary data suggest that invasive haemodynamics and cardiac imaging may add incremental value in guiding treatment decisions.

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