Volume 13: Issue 1

Robyn J. Barst, MD

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“Stars of the first magnitude are rare, but that such a one will arise among women physicians, I have not the slightest doubt.”
William Osler, MD

The Fifth World Symposium (5th WSPH) on Pulmonary Hypertension was held in Nice, France, from February 27 to March 1, 2013, almost 40 years after the first symposium was convened to develop an understanding of a rare disorder made visible by an epidemic of primary pulmonary hypertension (PH) caused by the prescription of Aminorex.

Nazzareno Galiè, MD, and Gerald Simonneau, MD, organizers of the 5th WSPH,

Classification of pulmonary hypertension groups patients with similar pathological findings, hemodynamic profiles, and management strategies. Minor modifications have been made to the current classification system, particularly within Group 1 pulmonary arterial hypertension. This article summarizes the published conclusions of the Fifth World Symposium of Pulmonary Hypertension task force that addressed the updated clinical classification of pulmonary hypertension.

Registries of pulmonary arterial hypertension (PAH) are important means by which to characterize the presentation and outcome of patients and to provide a basis for predicting the course of the disease. This article summarizes the published conclusions of the World Symposium of Pulmonary Hypertension task force that addressed registries and epidemiology of PAH.

During the Fifth World Symposium on Pulmonary Hypertension, the working group on diagnosis and assessment was charged with evaluating the definition of pulmonary arterial hypertension (PAH) as it was established at the Fourth World Symposium. The group also covered related topics such as “borderline PAH,” exercise-induced PAH, and issues surrounding the measurement of pulmonary capillary wedge pressure (PCWP). The working group's discussion specifically addressed the following questions:

Should pulmonary hypertension (PH) continue to be defined by a resting mean pulmonary artery pressure (MPAP) ≥25 mm Hg, and should the term “borderline PH” be introduced?
Should exercise-induced PH be included as a subset of PH?
Should pulmonary vascular resistance (PVR) be reintroduced in the definition of PAH?
Is pulmonary artery wedge pressure (PAWP) of 15 mm Hg adequate to distinguish between pre- and post-capillary PH, and how should it be measured?
Should fluid or exercise challenge be used to distinguish patients with PAH from pulmonary venous hypertension (PVH)?
Should exercise hemodynamics be used to unmask left sided heart failure?

Memos

Editor's Memo

The Fifth World Symposium on Pulmonary Hypertension and Robyn J. Barst, MD

Classification of Pulmonary Hypertension

Pulmonary Arterial Hypertension: Epidemiology and Registries

Insights From the Fifth World Health Organization Symposium Working Group: Definitions and Diagnosis of Pulmonary Hypertension

A Treatment Algorithm for Pulmonary Arterial Hypertension

Ask the Expert: How Might Adherence to the Treatment Recommendations of the 2013 Fifth World Symposium on Pulmonary Hypertension Improve Long-Term Outcomes?

Implementation of the PHA Pulmonary Hypertension Care Center Accreditation Program

PHPN: The Many Faces of the PH Professional Network

Racial and Ethnic Equity in Pulmonary Arterial Hypertension Clinical Trials

Multiomics Integration for Identifying Treatment Targets, Drug Development, and Diagnostic Designs in PAH

Tyrosine Kinase Inhibitors for Treatment of Pulmonary Arterial Hypertension

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Editor’s Memo