{
  "schemaVersion": 2,
  "eyebrow": "Pulmonary Vascular Medicine",
  "title": "Pulmonary Hypertension",
  "summary": "Pulmonary hypertension requires invasive hemodynamic confirmation, separation of pre- from post-capillary physiology, and prompt identification of potentially curable chronic thromboembolic disease before PAH-targeted treatment is considered.",
  "seoDescription": "Physician guide to pulmonary hypertension hemodynamics, right-heart catheterization interpretation, provocative testing, and chronic thromboembolic treatment selection.",
  "clinicalQuestion": "How should clinicians confirm, classify, and direct initial management of pulmonary hypertension?",
  "specialty": "Pulmonology and Cardiology",
  "audience": "U.S. physicians and medical trainees",
  "tags": [
    "pulmonary hypertension",
    "right heart catheterization",
    "pulmonary arterial hypertension",
    "pulmonary hypertension due to left heart disease",
    "chronic thromboembolic pulmonary hypertension",
    "pulmonary endarterectomy",
    "balloon pulmonary angioplasty"
  ],
  "keyTakeaways": [
    "Confirm pulmonary hypertension with right-heart catheterization: resting mean pulmonary artery pressure greater than 20 mm Hg defines PH. [4][8]",
    "Classify hemodynamics with pulmonary arterial wedge pressure, cardiac output, and pulmonary vascular resistance; PAWP and PVR prevent mislabeling left-heart disease or high-flow states as PAH. [6][8]",
    "A resting PAWP of 15 mm Hg or less with PVR greater than 2 Wood units supports pre-capillary PH; CTEPH additionally requires chronic thromboembolic disease. [4][14]",
    "For suspected occult post-capillary PH despite PAWP 15 mm Hg or less, exercise, passive leg raise, or fluid challenge may uncover PAWP greater than 18 mm Hg, but reclassification varies substantially by maneuver. [23]",
    "Refer confirmed or strongly suspected CTEPH for multidisciplinary assessment of pulmonary endarterectomy, balloon pulmonary angioplasty, and PH-directed therapy; expert-center peri-interventional mortality is reported below 3% for endarterectomy and below 1% for BPA. [20][22]"
  ],
  "sections": [
    {
      "id": "confirm-and-stabilize",
      "eyebrow": "First Decision",
      "heading": "Confirm pulmonary hypertension with complete invasive hemodynamics",
      "intro": "Do not assign PH subtype or initiate subtype-specific therapy from echocardiographic estimates alone.",
      "paragraphs": [
        "Use right-heart catheterization (RHC) to establish the diagnosis and obtain mean pulmonary artery pressure (mPAP), pulmonary arterial wedge pressure (PAWP), cardiac output (CO), and pulmonary vascular resistance (PVR). Resting PH is defined by mPAP greater than 20 mm Hg; contemporary classification then depends on PAWP and PVR rather than mPAP alone. [4][8]",
        "Obtain CO during the diagnostic RHC and calculate PVR. Incorporating PVR distinguishes pulmonary vascular disease from high-flow states with normal resistance, while PAWP or left-ventricular end-diastolic pressure measurement reduces inappropriate labeling of left-heart disease as PAH. [6]",
        "In patients with established PH, assess right-ventricular adaptation rather than relying only on pulmonary pressure. Progressive right-ventricular dilation signals loss of ventricular-arterial coupling and is a key follow-up parameter. [9]"
      ],
      "bullets": [
        "Record PAWP, CO, and calculated PVR during the index RHC; an RHC without CO cannot reliably classify PAH physiology. [6]",
        "If mPAP is greater than 20 mm Hg, proceed immediately to hemodynamic subtype assignment and etiologic evaluation rather than treating the pressure value as a diagnosis. [4][8]"
      ],
      "subsections": [],
      "table": {
        "caption": "Hemodynamic classification directs the next diagnostic branch. [4][8][14]",
        "columns": [
          "Hemodynamic pattern",
          "RHC findings",
          "Interpretation and next action"
        ],
        "rows": [
          [
            "Pulmonary hypertension",
            "mPAP >20 mm Hg. [4][8]",
            "Confirm PAWP, CO, and PVR to distinguish pre- from post-capillary physiology. [6][8]"
          ],
          [
            "Pre-capillary PH",
            "mPAP >20 mm Hg, PAWP ≤15 mm Hg, PVR >2 WU. [4][14]",
            "Evaluate for PAH, chronic thromboembolic disease, lung disease/hypoxia, and other pre-capillary causes. [4][14]"
          ],
          [
            "Post-capillary physiology",
            "PAWP >15 mm Hg in a patient with PH. [7][8]",
            "Prioritize left-heart disease assessment; do not presume group 1 PAH. [6][8]"
          ],
          [
            "Combined post- and pre-capillary physiology",
            "Post-capillary PH with elevated PVR identifies a combined phenotype. [7][8]",
            "Recognize higher pulmonary vascular burden in PH due to left-heart disease and reassess left-sided filling pressure management and phenotype. [7][8]"
          ],
          [
            "CTEPH",
            "mPAP >20 mm Hg, PAWP ≤15 mm Hg, PVR >2 WU plus chronic thromboembolic disease. [14]",
            "Refer to an experienced CTEPH program for operability and multimodal treatment assessment. [20][22]"
          ]
        ]
      }
    },
    {
      "id": "separate-major-etiologies",
      "eyebrow": "Etiologic Branching",
      "heading": "Use wedge pressure and thromboembolic assessment to direct the workup",
      "intro": "The initial diagnostic fork is pre-capillary versus left-heart-associated PH.",
      "paragraphs": [
        "When PAWP exceeds 15 mm Hg, manage the case as PH associated with left-heart disease until proven otherwise. In HFpEF cohorts, PH due to left-heart disease has been defined by mPAP at least 25 mm Hg with PAWP greater than 15 mm Hg, and PVR, transpulmonary gradient, and diastolic pressure gradient have been used to identify a combined pulmonary vascular component. [7][8]",
        "When PAWP is 15 mm Hg or less and PVR is elevated, pursue pre-capillary etiologies. The current classification framework separates PAH, chronic thromboembolic disease, PH associated with chronic lung disease, and other PH groups; chronic lung disease-associated PH is classified as World Symposium group 3. [4][12][14]",
        "Actively identify chronic thromboembolic disease because it changes treatment from medical management alone to potential mechanical intervention. Detection of peripheral chronic thromboembolic lesions helps distinguish CTEPH from other PH causes and determines whether lesions are surgically accessible or better suited to balloon pulmonary angioplasty. [21]"
      ],
      "bullets": [
        "Pre-capillary physiology plus chronic thromboembolic lesions should trigger CTEPH-center referral rather than empiric classification as idiopathic PAH. [14][21]",
        "Post-capillary physiology should redirect evaluation toward left-heart disease, even when PVR is also elevated. [7][8]",
        "In suspected PAH, evaluate competing group 2, group 3, and chronic thromboembolic mechanisms before selecting PAH-specific therapy. [4][12][21]"
      ],
      "subsections": [
        {
          "heading": "Borderline resting wedge pressure or unexplained exertional limitation",
          "paragraphs": [
            "A resting PAWP of 15 mm Hg or less does not exclude latent post-capillary PH. During exercise, a PAWP/CO slope greater than 2 WU has been used to define post-capillary PH with provocation; after fluid challenge or passive leg raise, mPAP greater than 20 mm Hg with PAWP greater than 18 mm Hg has been used for reclassification. [23]",
            "Interpret provocative testing cautiously. Across maneuvers and classification criteria, 11% to 48% of patients were reclassified as post-capillary PH with provocation and 3% to 50% as exercise PH, demonstrating that the chosen maneuver can materially change classification. [23]"
          ],
          "bullets": [
            "Use provocative RHC when the resting study conflicts with the clinical likelihood of left-heart disease; document the maneuver and the threshold used. [23]",
            "Exercise PH is defined by an mPAP/CO slope greater than 3 mm Hg/L/min from rest to peak exercise. [14]"
          ]
        }
      ],
      "table": {
        "caption": "Practical etiologic branches after RHC confirmation. [4][7][12][14][21][23]",
        "columns": [
          "Branch",
          "Discriminator",
          "Next clinical action"
        ],
        "rows": [
          [
            "Left-heart-associated PH",
            "PH with PAWP >15 mm Hg. [7][8]",
            "Assess the left-heart phenotype and distinguish isolated from combined post- and pre-capillary physiology using PVR. [7][8]"
          ],
          [
            "Occult post-capillary PH",
            "Resting PAWP ≤15 mm Hg but PAWP/CO slope >2 WU during exercise or PAWP >18 mm Hg after provocation. [23]",
            "Interpret within the specific provocative protocol; avoid reclassifying solely from an uncontextualized resting wedge pressure. [23]"
          ],
          [
            "Chronic thromboembolic PH",
            "Pre-capillary hemodynamics plus chronic thromboembolic disease. [14][21]",
            "Determine lesion distribution and refer for PEA/BPA/medical-therapy planning. [20][21][22]"
          ],
          [
            "Chronic lung disease-associated PH",
            "Clinical classification as group 3 PH in the setting of chronic lung disease. [12]",
            "Treat the underlying lung-disease and hypoxia pathway while confirming that another PH mechanism is not dominant. [12]"
          ],
          [
            "PAH phenotype",
            "Pre-capillary PH after exclusion of left-heart, chronic thromboembolic, and lung-disease mechanisms. [4][6][12]",
            "Use specialist-directed PAH risk assessment and therapy selection after complete phenotyping. [4][17]"
          ]
        ]
      }
    },
    {
      "id": "right-heart-catheterization",
      "eyebrow": "Invasive Assessment",
      "heading": "Perform RHC as a classification procedure, not a pressure-only test",
      "intro": "Measurement quality determines whether the patient is assigned to the correct treatment pathway.",
      "paragraphs": [
        "At diagnostic RHC, measure mPAP, PAWP, and CO under standardized conditions and derive PVR. Contemporary hemodynamic assessment emphasizes meticulous RHC because the same mPAP elevation has different diagnostic, prognostic, and therapeutic implications when PAWP or PVR differs. [6][8]",
        "Use acute vasoreactivity testing selectively in PAH phenotyping rather than as a general test for all PH. In PAH associated with congenital heart disease, inhaled iloprost during RHC improved hemodynamic parameters and was well tolerated in the reported pediatric cohort; acute changes in PVR are also used when considering reversibility before defect correction in selected congenital-shunt patients. [16]",
        "Do not extrapolate a single provocative maneuver across all phenotypes. Exercise, passive leg raise, and fluid challenge correlate only moderately to strongly in practice, and their variable reclassification rates require integration with the patient’s left-heart phenotype and the entire invasive dataset. [23]"
      ],
      "bullets": [
        "Calculate PVR only after documenting CO; PVR is central to excluding high-flow causes of elevated pulmonary pressure. [6]",
        "For congenital heart disease with elevated PVR, incorporate acute vasoreactivity into defect-correction planning rather than treating it as a standalone prognostic result. [16]",
        "For exercise testing, an mPAP/CO slope greater than 3 mm Hg/L/min meets the cited exercise-PH definition. [14]"
      ],
      "subsections": [],
      "table": {
        "caption": "RHC data elements and their management implications. [6][8][14][16][23]",
        "columns": [
          "Measurement",
          "Decision use",
          "Threshold or interpretation"
        ],
        "rows": [
          [
            "mPAP",
            "Establishes resting PH.",
            ">20 mm Hg defines PH. [4][8]"
          ],
          [
            "PAWP",
            "Separates resting pre- from post-capillary physiology.",
            "≤15 mm Hg supports pre-capillary physiology; >15 mm Hg supports post-capillary physiology. [7][14]"
          ],
          [
            "CO and PVR",
            "Distinguish pulmonary vascular disease from high flow and refine subtype.",
            "PVR >2 WU is part of contemporary pre-capillary PH and CTEPH definitions. [4][14]"
          ],
          [
            "Exercise PAWP/CO slope",
            "Assesses latent post-capillary physiology.",
            ">2 WU has been used to define post-capillary PH during exercise. [23]"
          ],
          [
            "Exercise mPAP/CO slope",
            "Assesses exercise PH.",
            ">3 mm Hg/L/min from rest to peak exercise defines exercise PH. [14]"
          ]
        ]
      }
    },
    {
      "id": "ctepH-treatment-selection",
      "eyebrow": "Curable Branch",
      "heading": "Refer CTEPH for mechanical-treatment assessment",
      "intro": "CTEPH management is defined by lesion accessibility, operative risk, and residual disease.",
      "paragraphs": [
        "Pulmonary endarterectomy (PEA) is first-line treatment for operable CTEPH. Surgical candidacy depends on whether chronic thromboembolic lesions are technically accessible, making anatomic evaluation at an experienced CTEPH center essential before concluding that disease is inoperable. [20][21]",
        "Use balloon pulmonary angioplasty (BPA) for selected patients with technically inoperable distal disease, prohibitive surgical risk, or recurrent PH after PEA. BPA has emerged as a therapeutic option for these groups, whereas PEA remains preferred when operable disease is present. [20][21]",
        "PH-directed medical therapy is a third established CTEPH treatment modality and may be combined with mechanical therapy. In a systematic review of five studies, riociguat followed by combination therapy with BPA was associated with larger gains in WHO functional class, PVR, CO, and 6-minute walk distance than either therapy alone; the pooled evidence base was limited and should not replace individualized multidisciplinary selection. [19][22]",
        "Discuss treatment at an expert center because modern procedural risk is center-dependent. Reported peri-interventional mortality is below 3% for PEA and below 1% for BPA in expert centers. [22]"
      ],
      "bullets": [
        "Operable CTEPH: evaluate for PEA first. [20]",
        "Inoperable distal disease, prohibitive surgical risk, or residual/recurrent PH after PEA: evaluate for BPA. [20][21]",
        "Residual disease may require a multimodal plan incorporating BPA and PH-directed medical therapy. [19][22]"
      ],
      "subsections": [],
      "table": {
        "caption": "CTEPH treatment selection requires multidisciplinary assessment of anatomy and procedural candidacy. [19][20][21][22]",
        "columns": [
          "Clinical situation",
          "Preferred strategy",
          "Key tradeoff"
        ],
        "rows": [
          [
            "Operable chronic thromboembolic lesions",
            "Pulmonary endarterectomy is first-line. [20]",
            "Requires technically accessible disease and expert surgical assessment. [20][21]"
          ],
          [
            "Technically inoperable distal disease",
            "Balloon pulmonary angioplasty. [20][21]",
            "Requires staged catheter-based treatment in an experienced program. [20][22]"
          ],
          [
            "Prohibitive surgical risk",
            "Balloon pulmonary angioplasty may be a viable option. [20]",
            "Selection depends on anatomy and center expertise. [20][21]"
          ],
          [
            "Residual or recurrent PH after PEA",
            "Evaluate BPA and PH-directed medical therapy. [20][21][22]",
            "Combination approaches may improve hemodynamics and functional outcomes relative to monotherapy in limited comparative evidence. [19]"
          ],
          [
            "Procedure-risk counseling",
            "Expert-center PEA or BPA assessment. [22]",
            "Reported peri-interventional mortality is <3% for PEA and <1% for BPA. [22]"
          ]
        ]
      }
    },
    {
      "id": "monitoring-and-escalation",
      "eyebrow": "Follow-up",
      "heading": "Monitor ventricular response and re-evaluate discordant physiology",
      "intro": "Serial follow-up should detect right-ventricular failure, residual thromboembolic burden, or misclassified filling-pressure disease.",
      "paragraphs": [
        "Track right-ventricular size and function longitudinally. Right-ventricular hypertrophy can maintain coupling early in PH, whereas progressive dilation indicates late failure of adaptation and should prompt reassessment of hemodynamics, disease mechanism, and treatment strategy. [9]",
        "In PH due to left-heart disease, an elevated PVR identifies a greater pulmonary vascular burden than isolated post-capillary PH. Reconsider occult or undertreated elevation in left-sided filling pressure when symptoms, PAWP, and PVR are discordant, and use protocolized provocative RHC selectively rather than assuming a fixed PAH phenotype. [7][8][23]",
        "After CTEPH intervention, evaluate persistent or recurrent PH for residual proximal or distal obstruction and reassess whether BPA, medical therapy, or an additional multimodal approach is appropriate. Both PEA and BPA may be considered in chronic thromboembolic pulmonary disease even without resting PH in selected patients, underscoring the importance of symptom and anatomic reassessment rather than mPAP alone. [22]"
      ],
      "bullets": [
        "Progressive RV dilation is a clinically meaningful escalation signal. [9]",
        "Persistent symptoms after apparently non-post-capillary resting RHC may justify exercise or fluid/leg-raise hemodynamic reassessment when left-heart disease remains plausible. [23]",
        "Residual or recurrent PH after PEA should trigger CTEPH-center review for BPA and/or medical therapy. [20][21][22]"
      ],
      "subsections": [],
      "table": {
        "caption": "Follow-up findings that should change management. [7][9][20][21][22][23]",
        "columns": [
          "Follow-up finding",
          "Interpretation",
          "Next step"
        ],
        "rows": [
          [
            "Progressive RV dilation",
            "Suggests deteriorating RV-pulmonary arterial coupling. [9]",
            "Reassess hemodynamics and treatment adequacy. [9]"
          ],
          [
            "PAWP ≤15 mm Hg at rest but strong left-heart phenotype",
            "Latent post-capillary PH remains possible. [23]",
            "Consider protocolized exercise, fluid-challenge, or passive-leg-raise RHC. [23]"
          ],
          [
            "Persistent PH after PEA",
            "May reflect residual or recurrent chronic thromboembolic obstruction. [20][21]",
            "Refer for BPA and medical-therapy reassessment. [20][21][22]"
          ],
          [
            "Elevated PVR in PH due to left-heart disease",
            "Supports combined post- and pre-capillary physiology. [7][8]",
            "Reassess phenotype and left-sided filling-pressure management; avoid automatic PAH labeling. [6][8]"
          ]
        ]
      }
    }
  ],
  "faq": [],
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  "editorialNote": "Prepared from cited clinical literature using Astra's research workflow. Verify recommendations against current guidance and patient-specific factors.",
  "citations": [
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      "authors": "thorax.bmj.com",
      "host": "thorax.bmj.com",
      "snippet": "## \n\n## 1. FOREWORD\n\nI am delighted to write the foreword for this consensus statement which updates the “Recommendations on the management of pulmonary hypertension in clinical practice” of 2001. The consensus statement reflects contemporary practice in the management of this uncommon, deadly but n",
      "score": 0.23965217
    },
    {
      "number": 2,
      "title": "Diagnostic MicroRNA Signatures to Support Classification ...",
      "detail": "www.ahajournals.org",
      "url": "https://www.ahajournals.org/doi/10.1161/CIRCGEN.124.004862",
      "authors": "www.ahajournals.org",
      "host": "www.ahajournals.org",
      "snippet": "by N Errington · 2025 · Cited by 10 — World Symposium on Pulmonary Hypertension (WSPH) Group 1: pulmonary arterial hypertension (PAH); 2022 ESC/ERS guidelines for the diagnosis and",
      "score": 0.67269784
    },
    {
      "number": 3,
      "title": "Classification and Predictors of Right Ventricular ...",
      "detail": "www.ahajournals.org",
      "url": "https://www.ahajournals.org/doi/pdf/10.1161/CIRCHEARTFAILURE.123.010555",
      "authors": "www.ahajournals.org",
      "host": "www.ahajournals.org",
      "snippet": "by FP Rischard · 2023 · Cited by 17 — ... ESC/ERS Sci- entific Document Group. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2022;43:3618–3731. doi",
      "score": 0.6701125
    },
    {
      "number": 4,
      "title": "Evaluation and Management of Pulmonary Hypertension in Noncardiac Surgery: A Scientific Statement From the American Heart Association | Circulation",
      "detail": "www.ahajournals.org",
      "url": "https://www.ahajournals.org/doi/10.1161/CIR.0000000000001136",
      "authors": "www.ahajournals.org",
      "host": "www.ahajournals.org",
      "snippet": "Crossref\n\nPubMed\n\nGoogle Scholar\n\n10.\n\nHumbert M, Kovacs G, Hoeper MM, Badagliacca R, Berger RMF, Brida M, Carlsen J, Coats AJS, Escribano-Subias P, Ferrari P, et al; ESC/ERS Scientific Document Group. 2022 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension. _Eur Heart J_. ",
      "score": 0.65676886
    },
    {
      "number": 5,
      "title": "Elevated Pulmonary Artery Wedge Pressure in Group 1 ...",
      "detail": "www.ahajournals.org",
      "url": "https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.077606",
      "authors": "www.ahajournals.org",
      "host": "www.ahajournals.org",
      "snippet": "by YNV Reddy · 2026 · Cited by 4 — 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. classification and diagnosis of pulmonary hypertension.",
      "score": 0.64585793
    },
    {
      "number": 6,
      "title": "Definitions and Diagnosis of Pulmonary Hypertension | JACC",
      "detail": "www.jacc.org",
      "url": "https://www.jacc.org/doi/10.1016/j.jacc.2013.10.032",
      "authors": "www.jacc.org",
      "host": "www.jacc.org",
      "snippet": "Title: Definitions and Diagnosis of Pulmonary Hypertension | JACC\nThe term pulmonary arterial hypertension (PAH) describes a subpopulation of patients with PH characterized hemodynamically by the presence of pre-capillary PH including an end-expiratory pulmonary artery wedge pressure (PAWP) ≤15 mm H",
      "score": 0.783542
    },
    {
      "number": 7,
      "title": "Pulmonary Arterial Capacitance Is an Important Predictor of Mortality in Heart Failure With a Preserved Ejection Fraction | JACC: Heart Failure",
      "detail": "www.jacc.org",
      "url": "https://www.jacc.org/doi/10.1016/j.jchf.2015.01.013",
      "authors": "www.jacc.org",
      "host": "www.jacc.org",
      "snippet": "Title: Pulmonary Arterial Capacitance Is an Important Predictor of Mortality in Heart Failure With a Preserved Ejection Fraction | JACC: Heart Failure\nThe purpose of this study was to determine the predictors of mortality in patients with pulmonary hypertension (PH) associated with heart failure wit",
      "score": 0.77751994
    },
    {
      "number": 8,
      "title": "Cardiopulmonary Hemodynamics in Pulmonary Hypertension and Heart Failure: \nJACC Review Topic of the Week",
      "detail": "www.jacc.org",
      "url": "https://www.jacc.org/doi/10.1016/j.jacc.2020.10.007",
      "authors": "www.jacc.org",
      "host": "www.jacc.org",
      "snippet": "The hemodynamic definition of PH has been revised to mPAP >20 mm Hg, which is based on clinically relevant data and emphasizes early diagnosis in at-risk populations. Patients with elevated mPAP are classified further into pre-capillary PH, IpcPH, or CpCPH subtypes based on PVR and PAWP levels. This",
      "score": 0.7657514
    },
    {
      "number": 9,
      "title": "The Relationship Between the Right Ventricle and its Load in Pulmonary Hypertension | JACC",
      "detail": "www.jacc.org",
      "url": "https://www.jacc.org/doi/10.1016/j.jacc.2016.10.047",
      "authors": "www.jacc.org",
      "host": "www.jacc.org",
      "snippet": "Title: The Relationship Between the Right Ventricle and its Load in Pulmonary Hypertension | JACC\nBecause coupling is maintained by hypertrophy until the end stage of the disease, when progressive dilation begins, right ventricular volume is the essential parameter to measure in follow-up of patient",
      "score": 0.6479992
    },
    {
      "number": 10,
      "title": "Challenges and Strategies in Managing Pulmonary Arterial ...",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/10.1002/pul2.70311",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "Clinical classification should follow standard World Symposium ... Clinical classification of pulmonary hypertension. Group, Description",
      "score": 0.5164741
    },
    {
      "number": 11,
      "title": "American Lung Association Pulmonary Hypertension ...",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/10.1002/pul2.70200",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "Recommendations are given for proper diagnosis and clinical classifications of the various forms of PH. World Symposium on Pulmonary",
      "score": 0.4562407
    },
    {
      "number": 12,
      "title": "Abstracts from the 17th International Neonatal and ...",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/10.1002/pul2.12369",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "Pulmonary hypertension (PH) associated with chronic lung disease is categorized as Group 3 PH by the World Symposium on Pulmonary Hypertension",
      "score": 0.44680908
    },
    {
      "number": 13,
      "title": "Performance of DETECT Pulmonary Arterial Hypertension ...",
      "detail": "acrjournals.onlinelibrary.wiley.com",
      "url": "https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/art.42791",
      "authors": "acrjournals.onlinelibrary.wiley.com",
      "host": "acrjournals.onlinelibrary.wiley.com",
      "snippet": "Patients were classified as non-PH, World Health Organization (WHO) Group 1 PH (PAH), WHO Group 2 PH, or WHO Group 3 PH. For the main analysis,",
      "score": 0.34601128
    },
    {
      "number": 14,
      "title": "Exercise pulmonary hypertension in chronic thromboembolic pulmonary disease: A right heart catheterization study - Dhayyat - 2024 - Pulmonary Circulation - Wiley Online Library",
      "detail": "onlinelibrary.wiley.com",
      "url": "https://onlinelibrary.wiley.com/doi/full/10.1002/pul2.70018",
      "authors": "onlinelibrary.wiley.com",
      "host": "onlinelibrary.wiley.com",
      "snippet": "All patients underwent exercise right heart catheterization before being classified into the following groups: (1) CTEPD without ePH; comprising patients with normal mean pulmonary artery pressure (mPAP) of ≤20 mmHg, but with mPAP/cardiac output (CO) slope of ≤3 mmHg/L/min, (2) CTEPD with ePH (CTEPD",
      "score": 0.72698855
    },
    {
      "number": 15,
      "title": "Ventilatory power, a cardiopulmonary exercise testing parameter for the prediction of pulmonary hypertension at right heart catheterization - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/pii/S2352906720300889",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Title: Ventilatory power, a cardiopulmonary exercise testing parameter for the prediction of pulmonary hypertension at right heart catheterization - ScienceDirect\n## IJC Heart & Vasculature. Volume 28, June 2020, 100513. # Ventilatory power, a cardiopulmonary exercise testing parameter for the predi",
      "score": 0.64478505
    },
    {
      "number": 16,
      "title": "Invasive Hemodynamic and Vasoreactivity Testing with... : Cardiology Discovery",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/cd/fulltext/2023/12000/invasive_hemodynamic_and_vasoreactivity_testing.2.aspx",
      "authors": "journals.lww.com",
      "host": "journals.lww.com",
      "snippet": "A positive PVRI response and higher pulmonary arterial oxygen saturation after iloprost inhalation, lower baseline brain natriuretic peptide, and PAH-targeted therapy at follow-up were significantly associated with a favorable clinical outcome. * In children with pulmonary arterial hypertension (PAH",
      "score": 0.6030211
    },
    {
      "number": 17,
      "title": "Current management of pulmonary arterial hypertension",
      "detail": "wchh.onlinelibrary.wiley.com",
      "url": "https://wchh.onlinelibrary.wiley.com/doi/pdf/10.1002/psb.1548",
      "authors": "wchh.onlinelibrary.wiley.com",
      "host": "wchh.onlinelibrary.wiley.com",
      "snippet": "by C Ricketts · 2017 · Cited by 1 — The evidence-based treatment algorithm for PAH patients from the European Society of Cardiology (ESC) and the 2015. European Respiratory Society (ERS)",
      "score": 0.6747586
    },
    {
      "number": 18,
      "title": "The Evolving Landscape of Pulmonary Hypertension Treatment",
      "detail": "ascpt.onlinelibrary.wiley.com",
      "url": "https://ascpt.onlinelibrary.wiley.com/doi/pdf/10.1111/cts.70685",
      "authors": "ascpt.onlinelibrary.wiley.com",
      "host": "ascpt.onlinelibrary.wiley.com",
      "snippet": "by S Ayalasomayajula · 2026 — ABSTRACT. Pulmonary hypertension (PH) is a complex disorder associated with significant morbidity and mortality. PH is characterized.",
      "score": 0.3031234
    },
    {
      "number": 19,
      "title": "Balloon pulmonary angioplasty and riociguat in the management of chronic thromboembolic pulmonary hypertension: a systematic review - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S0954611125002161",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Title: Balloon pulmonary angioplasty and riociguat in the management of chronic thromboembolic pulmonary hypertension: a systematic review - ScienceDirect\n# Balloon pulmonary angioplasty and riociguat in the management of chronic thromboembolic pulmonary hypertension: a systematic review. No systema",
      "score": 0.8055255
    },
    {
      "number": 20,
      "title": "Chronic thromboembolic pulmonary hypertension and balloon pulmonary angioplasty – Where are we in 2024? - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S0146280624001208",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Title: Chronic thromboembolic pulmonary hypertension and balloon pulmonary angioplasty – Where are we in 2024? - ScienceDirect\n# Chronic thromboembolic pulmonary hypertension and balloon pulmonary angioplasty – Where are we in 2024? Pulmonary endarterectomy (PEA) is the first-line treatment for pati",
      "score": 0.76279575
    },
    {
      "number": 21,
      "title": "Chronic thromboembolic pulmonary hypertension anno 2021 : Current Opinion in Cardiology",
      "detail": "journals.lww.com",
      "url": "https://journals.lww.com/co-cardiology/fulltext/2021/11000/chronic_thromboembolic_pulmonary_hypertension_anno.6.aspx",
      "authors": "journals.lww.com",
      "host": "journals.lww.com",
      "snippet": "Title: Chronic thromboembolic pulmonary hypertension anno 2021 : Current Opinion in Cardiology\nNext to the pulmonary endarterectomy, the newly introduced technique percutaneous pulmonary balloon angioplasty and/or P(A)H-targeted medical therapy has been shown to be beneficial in selected patients wi",
      "score": 0.7407191
    },
    {
      "number": 22,
      "title": "Management of chronic thromboembolic pulmonary hypertension - ScienceDirect",
      "detail": "www.sciencedirect.com",
      "url": "https://www.sciencedirect.com/science/article/abs/pii/S1053249825017735",
      "authors": "www.sciencedirect.com",
      "host": "www.sciencedirect.com",
      "snippet": "Title: Management of chronic thromboembolic pulmonary hypertension - ScienceDirect\nChronic thromboembolic pulmonary hypertension (CTEPH) is a severe and progressive disease. Three treatment modalities are available: pulmonary endarterectomy, balloon pulmonary angioplasty, and pulmonary hypertension ",
      "score": 0.73891455
    },
    {
      "number": 23,
      "title": "Hemodynamic Responses to Provocative Maneuvers during Right Heart Catheterization | Annals of the American Thoracic Society",
      "detail": "www.atsjournals.org",
      "url": "https://www.atsjournals.org/doi/10.1513/AnnalsATS.202201-077OC",
      "authors": "www.atsjournals.org",
      "host": "www.atsjournals.org",
      "snippet": "We also assessed whether provocative maneuvers led to hemodynamic reclassification of the patient to either postcapillary pulmonary hypertension with provocation or exercise pulmonary hypertension. Depending on provocative maneuver and classification criteria, there was significant variation in the ",
      "score": 0.72184175
    },
    {
      "number": 24,
      "title": "Pulmonary hypertension in sickle cell disease: diagnosis and ...",
      "detail": "ashpublications.org",
      "url": "https://ashpublications.org/hematology/article/2014/1/425/20525/Pulmonary-hypertension-in-sickle-cell-disease",
      "authors": "ashpublications.org",
      "host": "ashpublications.org",
      "snippet": "It is defined as a resting mean pulmonary arterial pressure (mPAP) ≥25 mmHg by right heart catheterization (RHC).22",
      "score": 0.70871735
    }
  ],
  "publishedAt": "2026-08-24T16:24:59.515201+00:00",
  "updatedAt": "2026-08-24T16:24:59.515201+00:00",
  "readingMinutes": 6,
  "slug": "pulmonary-hypertension"
}