Pulmonary Hypertension, an issue of Clinics in Chest Medicine

1st Edition, Volume 42-1 - February 5, 2021
Editors: Aaron B Waxman, Inderjit Singh
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 7 3 4 0 1 - 1
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 7 3 4 0 2 - 8

This issue of Clinics in Chest Medicine, guest-edited by Dr. Aaron B Waxman and Dr. Inderjit Singh, is focused on Pulmonary Hypertension. Topics discussed in this issue include bu… Read more

Pulmonary Hypertension, an issue of Clinics in Chest Medicine

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This issue of Clinics in Chest Medicine, guest-edited by Dr. Aaron B Waxman and Dr. Inderjit Singh, is focused on Pulmonary Hypertension. Topics discussed in this issue include but are not limited to:　Integrative omics to characterize and classify pulmonary vascular disease, Contemporary Pharmacotherapeutic Approach in Pulmonary Arterial Hypertension, Personalized Medicine: The Future Management of Pulmonary Hypertension Requires A New Taxonomy, Sex differences in Pulmonary Hypertension and Pulmonary Hypertension in Pregnancy

Cover image
Title page
Table of Contents
Copyright
Contributors
Forthcoming Issues
Preface
Section I: Introduction
The Evolution in Nomenclature, Diagnosis, and Classification of Pulmonary Hypertension
Key points
Introduction
Cardiopulmonary circulation—an evolution of perspective
A true measure of pressure
The right heart catheterization
A disease with a name
Pulmonary hypertension symposiums
A revolution to come
Summary
Clinics care points
Section II: Different Pulmonary Hypertension Subtypes
Congenital Heart Disease-Associated Pulmonary Hypertension
Key points
Epidemiology and pathophysiology of pulmonary arterial hypertension associated with congenital heart disease
Anatomic and clinical classification
Pulmonary arterial hypertension associated with unrestricted shunts
Interpretation of hemodynamic data
Eisenmenger syndrome
Management strategies for Eisenmenger syndrome
Pulmonary hypertension in the univentricular heart: the failing fontan
Summary
Clinics care points
Pulmonary Arterial Hypertension Secondary to Drugs and Toxins
Key points
Introduction
Aminorex fumarate
Fenfluramine and dexfenfluramine
Benfluorex
Methamphetamine
Tyrosine kinase inhibitors
Toxic rapeseed oil
Cocaine
Phenylpropanolamine
l-Tryptophan
St John’s Wort
Interferons
Alkylating agents
Direct-acting antiviral agents
Leflunomide
Indirubin
Mazindol
Selective serotonin reuptake inhibitors
Trichloroethylene
Anagrelide
Carfilzomib
Clinics care points
Pulmonary Hypertension in Left Heart Disease
Key points
Introduction
Definition of pulmonary hypertension
Epidemiology
Components of mean pulmonary artery pressure
Etiologic causes of pulmonary hypertension in left heart disease
Pulmonary hypertension in heart failure with reduced ejection fraction
Pulmonary hypertension in heart failure with preserved ejection fraction
Pulmonary hypertension in valve disease
Pulmonary hypertension in other cardiomyopathies
High-output heart failure
Methods to identify pulmonary hypertension and pulmonary vascular load
Pathophysiologic contributors to out of proportion pulmonary hypertension in left heart disease
Treatment of pulmonary hypertension with left heart disease
Pulmonary vasoactive therapies in pulmonary hypertension with left heart disease
Future directions
Clinics care points
Group 3 Pulmonary Hypertension: A Review of Diagnostics and Clinical Trials
Key points
Introduction
Classification
Epidemiology
Diagnosis
Treatment
Idiopathic pulmonary fibrosis–associated pulmonary hypertension
Connective tissue disease–associated interstitial lung disease and pulmonary hypertension
Other interstitial lung diseases associated with pulmonary hypertension
Chronic obstructive pulmonary disease–associated pulmonary hypertension
Combined pulmonary fibrosis and emphysema–associated pulmonary hypertension
Hypoventilation and hypoxia–associated pulmonary hypertension
Summary
Pulmonary Vascular Diseases Associated with Infectious Disease—Schistosomiasis and Human Immunodeficiency Viruses
Key points
Introduction
Schistosomiasis
Human immunodeficiency virus
Polyparasitism and coinfections
Summary
Chronic Thromboembolic Disease and Chronic Thromboembolic Pulmonary Hypertension
Key points
Introduction and definitions
Epidemiology and natural history
Pathophysiology
Clinical presentation and diagnosis
Treatments
Sources of funding
Clinics care points
Pulmonary Hypertension in Pregnancy
Key points
Introduction
Normal physiologic changes of pregnancy
Effects of pregnancy on cardiopulmonary circulation in pulmonary hypertension
Management of the pregnant pulmonary hypertension patient
Role of pulmonary arterial hypertension–specific therapies during pregnancy and delivery
Use of assisted reproductive strategy in patients with pulmonary hypertension
Role of advanced mechanical circulatory support
Section III: Advanced Diagnostics
Advanced Imaging in Pulmonary Vascular Disease
Key points
Introduction
Imaging the lung parenchyma and vasculature
Imaging of proximal arteries and right ventricle–pulmonary artery coupling
Imaging of the heart
Summary and future directions
Clinics care points
The Role of Exercise Testing in Pulmonary Vascular Disease: Diagnosis and Management
Key points
Introduction
Basic notions
Pulmonary arterial hypertension
Predictive value of exercise testing in pulmonary arterial hypertension
Perspective
Clinics care points
Section IV: Management of the Pulmonary Hypertension Patient
Contemporary Pharmacotherapeutic Approach in Pulmonary Arterial Hypertension
Key points
Introduction
Early treatment options
Monotherapy approach
Combination therapy: goal-oriented approach
Combination therapy: sequential approach
Combination therapy: upfront dual therapy
Clinical trials: short-term versus long-term outcome measures
Combination therapy: triple therapy
Novel approaches to delivery of therapy
Summary
Preoperative Assessment and Perioperative Management of the Patient with Pulmonary Vascular Disease
Key points
Background
Perioperative impact
Preoperative assessment
Perioperative management
Summary
Clinics care points
Advanced Surgical and Percutaneous Approaches to Pulmonary Vascular Disease
Key points
Introduction
Interventions for chronic thromboembolic pulmonary hypertension
Interventions for rescue or bridging to transplantation
Transplantation
Summary
Clinics care points
Critical Care Management of the Patient with Pulmonary Hypertension
Key points
Introduction
Normal right ventricular function
Right ventricular failure
Management of right ventricular failure
Summary
Section V: Advanced Topics
Pulmonary Vascular Disease as a Systemic and Multisystem Disease
Key points
Introduction
Chronic heart failure syndrome
Skeletal and respiratory muscle
Systemic circulation
Systemic inflammation and infection
Endocrine and metabolic changes
Liver and gut axis
Sleep
Neurologic complications
Skin
Iron metabolism
Summary
Adaptation and Maladaptation of the Right Ventricle in Pulmonary Vascular Diseases
Key points
Introduction
The right ventricle
Early adaptive mechanisms of the right ventricle
Prolonged adaptation results in the maladaptive right ventricle
Clinical care points
Integrative Omics to Characterize and Classify Pulmonary Vascular Disease
Key points
Genomics and pulmonary vascular disease
Transcriptomics to understand pulmonary vascular disease
Proteomic profiling of pulmonary vascular disease
Metabolomics as a snapshot of pulmonary vascular disease and right ventricular dysfunction
Multi-omics phenotyping, big data, and novel methodologies for integrating data
Summary
Personalized Medicine for Pulmonary Hypertension:: The Future Management of Pulmonary Hypertension Requires a New Taxonomy
Key points
Introduction
First, the problem with averages
The limitations of the current clinical classification
And then there is the histology
Insights from genetics
Big data to the rescue
Toward mechanism-based therapeutics
The future of pulmonary hypertension treatment
Sex Differences in Pulmonary Hypertension
Key points
Introduction
The sex paradox in pulmonary arterial hypertension
Sex hormone synthesis and metabolism
Sex differences and bone morphogenetic protein receptor type II
Aromatase and estrogen synthesis in pulmonary hypertension
Estrogen metabolism in pulmonary arterial hypertension
16α-Hydroxyestrogens
2-Hydroxylation/methylation estrogen metabolites
Serotonin and sex in pulmonary hypertension
Influence of sex hormones on right ventricular function in the clinic
Clinical assays for quantification of endogenous estrogen
Summary