Predicting Future Directions in Pulmonary Hypertension

The future of the diagnosis and treatment of pulmonary arterial hypertension (PAH) is uncertain, but it is much more promising than it was a decade ago. Intravenous prostacyclin has changed the course of this disease, and now one oral agent is approved for use and clearly has an impact on PAH.

Our experts took aim in this issue at what may come to be—in terms of understanding the pathobiology, possible advances in therapy, and new thinking on end points. So much of the effort driving new approaches to therapy stems from the hope that a yet-to-be discovered agent could unlock the secret of reversing the disease process, addressing the core issue of cell proliferation. How convenient it would be if we could identify switches that might be turned off, thereby directing the vasculature to reverse proliferation as we solve the riddle of restoring vessel architecture and lung function. These topics and much more are addressed in the Roundtable discussion.

I wish to thank two esteemed colleagues who served as guest editors, Sean Gaine, MD, and Richard N. Channick, MD, not only for organizing the Roundtable but for recruiting the experts who contributed their articles as well. Many of the advances foreseen by our experts are still theoretical, yet some are tantalizingly imminent. We need translational research to turn them into clinical applications. Although work is progressing swiftly to find a cure for PAH, this issue of Advances in Pulmonary Hypertension seeks to “freeze” the moving target, at least for the moment, or for as long as is required to read these pages. After that, the elusive target will move on, as will our relentless effort to find and hit it.