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Semin Respir Crit Care Med 2023; 44(06): 721-727
DOI: 10.1055/s-0043-1770115
Review Article

Updated Hemodynamic Definition and Classification of Pulmonary Hypertension

Benoit Lechartier
1   Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bicêtre, Le Kremlin-Bicêtre, France
2   School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
3   INSERM UMR_S 999 “Pulmonary Hypertension: Pathophysiology and Novel Therapies,” Hôpital Marie Lannelongue, Le Plessis-Robinson, France
4   Respiratory Division, Lausanne University Hospital (CHUV), Lausanne, Switzerland
,
Mithum Kularatne
1   Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bicêtre, Le Kremlin-Bicêtre, France
2   School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
3   INSERM UMR_S 999 “Pulmonary Hypertension: Pathophysiology and Novel Therapies,” Hôpital Marie Lannelongue, Le Plessis-Robinson, France
5   Division of Respiratory Medicine, Department of Medicine, University of Calgary, Canada
,
Xavier Jaïs
1   Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bicêtre, Le Kremlin-Bicêtre, France
2   School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
3   INSERM UMR_S 999 “Pulmonary Hypertension: Pathophysiology and Novel Therapies,” Hôpital Marie Lannelongue, Le Plessis-Robinson, France
6   European Reference Network on Rare Pulmonary Diseases (ERN-LUNG), Germany
,
Marc Humbert
1   Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bicêtre, Le Kremlin-Bicêtre, France
2   School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
3   INSERM UMR_S 999 “Pulmonary Hypertension: Pathophysiology and Novel Therapies,” Hôpital Marie Lannelongue, Le Plessis-Robinson, France
6   European Reference Network on Rare Pulmonary Diseases (ERN-LUNG), Germany
,
David Montani
1   Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Center, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Bicêtre, Le Kremlin-Bicêtre, France
2   School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
3   INSERM UMR_S 999 “Pulmonary Hypertension: Pathophysiology and Novel Therapies,” Hôpital Marie Lannelongue, Le Plessis-Robinson, France
6   European Reference Network on Rare Pulmonary Diseases (ERN-LUNG), Germany
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Abstract

Pulmonary hypertension (PH) is a pathophysiological manifestation of a heterogeneous group of diseases characterized by abnormally elevated pulmonary arterial pressures diagnosed on right heart catheterization. The 2022 European Society of Cardiology (ESC) and European Respiratory Society (ERS) Guidelines for the diagnosis and treatment of PH provides a new hemodynamic definition to define PH by lowering the threshold of the mean pulmonary artery pressure (mPAP) to 20 mm Hg. Precapillary PH is thus now defined as a mPAP >20 mm Hg together with a normal pulmonary artery wedge pressure (<15 mm Hg) and an increased pulmonary vascular resistance (>2 Wood Units). The ESC/ERS 2022 Guidelines also introduce a revised clinical classification of PH while retaining its previous distinction between the five groups according to the underlying pathophysiology.

Keywords

pulmonary hypertension - definition - classification


Publication History

Article published online:
18 August 2023

© 2023. Thieme. All rights reserved.

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