Definition, clinical classification and initial diagnosis of pulmonary hypertension: Updated recommendations from the Cologne Consensus Conference 2018

TY - JOUR

T1 - Definition, clinical classification and initial diagnosis of pulmonary hypertension: Updated recommendations from the Cologne Consensus Conference 2018

AU - Kovacs, Gabor

AU - Dumitrescu, Daniel

AU - Barner, Andreas

AU - Greiner, Sebastian

AU - Grünig, Ekkehard

AU - Hager, Alfred

AU - Köhler, Thomas

AU - Kozlik-Feldmann, Rainer

AU - Kruck, Irmtraut

AU - Lammers, Astrid E

AU - Mereles, Derliz

AU - Meyer, Andreas

AU - Meyer, Joachim

AU - Pabst, Stefan

AU - Seyfarth, Hans-Jürgen

AU - Sinning, Christoph

AU - Sorichter, Stephan

AU - Stähler, Gerd

AU - Wilkens, Heinrike

AU - Held, Matthias

N1 - Leitlinienäquivalent

PY - 2018/12/1

Y1 - 2018/12/1

N2 - In the summer of 2016, delegates from the German Society of Cardiology (DGK), the German Respiratory Society (DGP), and the German Society of Pediatric Cardiology (DGPK) met in Cologne, Germany, to define consensus-based practice recommendations for the management of patients with pulmonary hypertension (PH). These recommendations were built on the 2015 European Pulmonary Hypertension guidelines, aiming at their practical implementation, considering country-specific issues, and including new evidence, where available. To this end, a number of working groups was initiated, one of which was specifically dedicated to the definition, clinical classification and initial diagnosis of PH. While the European guidelines provide a detailed clinical classification and a structured approach for diagnostic testing, their application in routine care may be challenging, particularly given the changing phenotype of PH patients who are nowadays often elderly and may present with multiple potential causes of PH, as well as comorbid conditions. Specifically, the working group addresses the thoroughness of diagnostic testing, and the roles of echocardiography, exercise testing, and genetic testing in diagnosing PH. Furthermore, challenges in the diagnostic work-up of patients with various causes of PH including "PAH with comorbidities", CTEPH and coexisting conditions are highlighted, and a modified diagnostic algorithm is provided. The detailed results and recommendations of the working group on definition, clinical classification and initial diagnosis of PH, which were last updated in the spring of 2018, are summarized in this article.

AB - In the summer of 2016, delegates from the German Society of Cardiology (DGK), the German Respiratory Society (DGP), and the German Society of Pediatric Cardiology (DGPK) met in Cologne, Germany, to define consensus-based practice recommendations for the management of patients with pulmonary hypertension (PH). These recommendations were built on the 2015 European Pulmonary Hypertension guidelines, aiming at their practical implementation, considering country-specific issues, and including new evidence, where available. To this end, a number of working groups was initiated, one of which was specifically dedicated to the definition, clinical classification and initial diagnosis of PH. While the European guidelines provide a detailed clinical classification and a structured approach for diagnostic testing, their application in routine care may be challenging, particularly given the changing phenotype of PH patients who are nowadays often elderly and may present with multiple potential causes of PH, as well as comorbid conditions. Specifically, the working group addresses the thoroughness of diagnostic testing, and the roles of echocardiography, exercise testing, and genetic testing in diagnosing PH. Furthermore, challenges in the diagnostic work-up of patients with various causes of PH including "PAH with comorbidities", CTEPH and coexisting conditions are highlighted, and a modified diagnostic algorithm is provided. The detailed results and recommendations of the working group on definition, clinical classification and initial diagnosis of PH, which were last updated in the spring of 2018, are summarized in this article.

KW - Consensus Development Conferences as Topic

KW - Exercise Test/methods

KW - Germany/epidemiology

KW - Hemodynamics/physiology

KW - Humans

KW - Hypertension, Pulmonary/classification

KW - Practice Guidelines as Topic/standards

U2 - 10.1016/j.ijcard.2018.08.083

DO - 10.1016/j.ijcard.2018.08.083

M3 - Other (editorial matter etc.)

C2 - 30219257

VL - 272S

SP - 11

EP - 19

JO - INT J CARDIOL

JF - INT J CARDIOL

SN - 0167-5273

ER -