A Definitive Guide to New Applications in Diagnosis

This issue of the journal focuses on current diagnostic modalities used to diagnose and manage patients with pulmonary hypertension (PH) and especially the more complex and severe form, pulmonary arterial hypertension (PAH). Thanks to the impressive evolution of this field in recent years, physicians who take care of patients with PH are being faced with a very diverse population in whom PH etiology is frequently multifactorial. While potentially life saving, the cost and complexity of some of the treatments available for PAH mandate that clinicians perform a comprehensive evaluation of patients to confirm or exclude its presence. Likewise, given the high risk for rapid deterioration—especially in patients with PAH—we must use a variety of tests to closely monitor treatment response.

In the first half of this issue, the authors discuss new applications and selective information obtained from the more established diagnostic tests such as echocardiography and right heart catheterization. Potential applications of newer diagnostic tests such as magnetic resonance of the heart and continuous hemodynamic monitoring through implantable devices are also discussed. Some areas of this issue will also shed light on complex case-scenarios that clinicians who treat PH currently face: exercise-induced PH and pulmonary vascular response in patients with nonsystolic heart failure (ie, diastolic dysfunction).

Given the amount of unanswered questions in this field and the significant complexity of the many cases we evaluate, correctly diagnosing and managing PH has truly become an art. The authors who participated in this issue sincerely hope that the information contained in these pages will give the PH-treating community additional tools to establish a more accurate diagnosis and promptly identify signs of disease progression that require therapeutic interventions.