The new 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension (PH) are authored by the Joint Task Force of the ESC and of the European Respiratory Society (ERS) and endorsed by the European Paediatric and Congenital Cardiology, the International Society for Heart and Lung Transplantation, the European League Against Rheumatism, and the European Society of Radiology.
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PH is defined as an increase in mean pulmonary arterial pressure (PAPm) ≥25 mmHg at rest as assessed by right heart catheterisation. It is a pathophysiological disorder which may involve multiple clinical conditions and complicate the majority of cardiovascular and respiratory diseases.
This latest edition follows the two previous ESC/ERS guidelines of 2004 and 2009 and is based on systematic literature review to identify new studies published since 2009.
The new clinical classification of PH includes five major types:
The main changes from the previous 2009 guidelines are:
Specifically, in what concerns therapy for PH, there are several recommended approaches:
A treatment algorithm is also included and the diagnosis and treatment of PH complications are presented. Finally, end-of-life care and ethical issues are discussed. This same approach is followed for specific PH subsets (paediatric, left heart disease or lung diseases/hypoxia, from chronic thromboembolic pulmonary hypertension, etc).
At the end there is a definition of a PH referral centre and a complete online addenda with extra tables, figures and text with the pathology and pathobiology of PH, a proposal for a screening programme and a set of quality of life measurements.
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