Updated Treatment Algorithm of Pulmonary Arterial Hypertension
Identifieur interne : 004B69 ( Main/Exploration ); précédent : 004B68; suivant : 004B70Updated Treatment Algorithm of Pulmonary Arterial Hypertension
Auteurs : Nazzareno Galie [Italie] ; Paul A. Corris [Royaume-Uni] ; Adaani Frost [États-Unis] ; Reda E. Girgis [États-Unis] ; John Granton [Canada] ; ZHI CHENG JING [République populaire de Chine] ; Walter Klepetko [Autriche] ; Michael D. Mcgoon [États-Unis] ; Vallerie V. Mclaughlin [États-Unis] ; Ioana R. Preston [États-Unis] ; Lewis J. Rubin [États-Unis] ; Julio Sandoval [Mexique] ; Werner Seeger [Allemagne] ; Anne Keogh [Australie]Source :
- Journal of the American College of Cardiology [ 0735-1097 ] ; 2013.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
The demands on a pulmonary arterial hypertension (PAH) treatment algorithm are multiple and in some ways conflicting. The treatment algorithm usually includes different types of recommendations with varying degrees of scientific evidence. In addition, the algorithm is required to be comprehensive but not too complex, informative yet simple and straightforward. The type of information in the treatment algorithm are heterogeneous including clinical, hemodynamic, medical, interventional, pharmacological and regulatory recommendations. Stakeholders (or users) including physicians from various specialties and with variable expertise in PAH, nurses, patients and patients' associations, healthcare providers, regulatory agencies and industry are often interested in the PAH treatment algorithm for different reasons. These are the considerable challenges faced when proposing appropriate updates to the current evidence-based treatment algorithm. The current treatment algorithm may be divided into 3 main areas: 1) general measures, supportive therapy, referral strategy, acute vasoreactivity testing and chronic treatment with calcium channel blockers; 2) initial therapy with approved PAH drugs; and 3) clinical response to the initial therapy, combination therapy, balloon atrial septostomy, and lung transplantation. All three sections will be revisited highlighting information newly available in the past 5 years and proposing updates where appropriate. The European Society of Cardiology grades of recommendation and levels of evidence will be adopted to rank the proposed treatments.
Affiliations:
- Allemagne, Australie, Autriche, Canada, Italie, Mexique, Royaume-Uni, République populaire de Chine, États-Unis
- Californie, Massachusetts, Michigan, Minnesota, Nouvelle-Galles du Sud, Ontario, Texas, Vienne (Autriche)
- East Lansing, Pékin, Sydney, Toronto, Vienne (Autriche)
- Université d'État du Michigan, Université de Toronto
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Le document en format XML
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Corris</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Institute of Cellular Medicine Newcastle University and The Newcastle Hospitals NHS Foundation Trust</s1><s2>Newcastle</s2><s3>GBR</s3><sZ>2 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Institute of Cellular Medicine Newcastle University and The Newcastle Hospitals NHS Foundation Trust</wicri:noRegion></affiliation></author><author><name sortKey="Frost, Adaani" sort="Frost, Adaani" uniqKey="Frost A" first="Adaani" last="Frost">Adaani Frost</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Girgis, Reda E" sort="Girgis, Reda E" uniqKey="Girgis R" first="Reda E." last="Girgis">Reda E. Girgis</name><affiliation wicri:level="4"><inist:fA14 i1="04"><s1>Michigan State University, College of Human Medicine</s1><s2>Grand Rapids, Michigan</s2><s3>USA</s3><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region><settlement type="city">East Lansing</settlement></placeName><orgName type="university">Université d'État du Michigan</orgName></affiliation></author><author><name sortKey="Granton, John" sort="Granton, John" uniqKey="Granton J" first="John" last="Granton">John Granton</name><affiliation wicri:level="4"><inist:fA14 i1="05"><s1>Division of Respirology, University of Toronto</s1><s2>Toronto</s2><s3>CAN</s3><sZ>5 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Zhi Cheng Jing" sort="Zhi Cheng Jing" uniqKey="Zhi Cheng Jing" last="Zhi Cheng Jing">ZHI CHENG JING</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Fu Wai Hospital & National Center for Cardiovascular Disease Peking Union Medical College and Chinese Academy of Medical Science</s1><s2>Beijing</s2><s3>CHN</s3><sZ>6 aut.</sZ></inist:fA14><country>République populaire de Chine</country><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Klepetko, Walter" sort="Klepetko, Walter" uniqKey="Klepetko W" first="Walter" last="Klepetko">Walter Klepetko</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Department of Thoracic Surgery, Medical University Vienna/Vienna General Hospital</s1><s2>Vienna</s2><s3>AUT</s3><sZ>7 aut.</sZ></inist:fA14><country>Autriche</country><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author><author><name sortKey="Mcgoon, Michael D" sort="Mcgoon, Michael D" uniqKey="Mcgoon M" first="Michael D." last="Mcgoon">Michael D. Mcgoon</name><affiliation wicri:level="2"><inist:fA14 i1="08"><s1>Cardiovascular Diseases, Mayo Clinic</s1><s2>Rochester, Minnesota</s2><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Minnesota</region></placeName></affiliation></author><author><name sortKey="Mclaughlin, Vallerie V" sort="Mclaughlin, Vallerie V" uniqKey="Mclaughlin V" first="Vallerie V." last="Mclaughlin">Vallerie V. Mclaughlin</name><affiliation wicri:level="2"><inist:fA14 i1="09"><s1>Cardiovascular Medicine, The University of Michigan</s1><s2>Ann Arbor, Michigan</s2><s3>USA</s3><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Preston, Ioana R" sort="Preston, Ioana R" uniqKey="Preston I" first="Ioana R." last="Preston">Ioana R. Preston</name><affiliation wicri:level="2"><inist:fA14 i1="10"><s1>Pulmonary, Critical Care and Sleep Division, Tufts Medical Center, Tufts University School of Medicine</s1><s2>Boston, Massachusetts</s2><s3>USA</s3><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Rubin, Lewis J" sort="Rubin, Lewis J" uniqKey="Rubin L" first="Lewis J." last="Rubin">Lewis J. Rubin</name><affiliation wicri:level="2"><inist:fA14 i1="11"><s1>Medical School, University of California, San Diego</s1><s2>La Jolla, California</s2><s3>USA</s3><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Sandoval, Julio" sort="Sandoval, Julio" uniqKey="Sandoval J" first="Julio" last="Sandoval">Julio Sandoval</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Clinical Research, National Institute of Cardiology of Mexico</s1><s2>Mexico City</s2><s3>MEX</s3><sZ>12 aut.</sZ></inist:fA14><country>Mexique</country><wicri:noRegion>Mexico City</wicri:noRegion></affiliation></author><author><name sortKey="Seeger, Werner" sort="Seeger, Werner" uniqKey="Seeger W" first="Werner" last="Seeger">Werner Seeger</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Max Planck Institute for Heart and Lung Research, Universities of Giessen and Marburg Lung Center</s1><s2>Giessen/Bad Nauheim</s2><s3>DEU</s3><sZ>13 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Giessen/Bad Nauheim</wicri:noRegion><wicri:noRegion>Universities of Giessen and Marburg Lung Center</wicri:noRegion><wicri:noRegion>Giessen/Bad Nauheim</wicri:noRegion></affiliation></author><author><name sortKey="Keogh, Anne" sort="Keogh, Anne" uniqKey="Keogh A" first="Anne" last="Keogh">Anne Keogh</name><affiliation wicri:level="3"><inist:fA14 i1="14"><s1>Heart Transplant Unit, St Vincent's Hospital</s1><s2>Sydney</s2><s3>AUS</s3><sZ>14 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">14-0036896</idno><date when="2013">2013</date><idno type="stanalyst">PASCAL 14-0036896 INIST</idno><idno type="RBID">Pascal:14-0036896</idno><idno type="wicri:Area/PascalFrancis/Corpus">000580</idno><idno type="wicri:Area/PascalFrancis/Curation">005877</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000520</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000520</idno><idno type="wicri:doubleKey">0735-1097:2013:Galie N:updated:treatment:algorithm</idno><idno type="wicri:Area/Main/Merge">004C94</idno><idno type="wicri:Area/Main/Curation">004B69</idno><idno type="wicri:Area/Main/Exploration">004B69</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Updated Treatment Algorithm of Pulmonary Arterial Hypertension</title><author><name sortKey="Galie, Nazzareno" sort="Galie, Nazzareno" uniqKey="Galie N" first="Nazzareno" last="Galie">Nazzareno Galie</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Bologna University Hospital</s1><s2>Bologna</s2><s3>ITA</s3><sZ>1 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Bologna</wicri:noRegion></affiliation></author><author><name sortKey="Corris, Paul A" sort="Corris, Paul A" uniqKey="Corris P" first="Paul A." last="Corris">Paul A. Corris</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Institute of Cellular Medicine Newcastle University and The Newcastle Hospitals NHS Foundation Trust</s1><s2>Newcastle</s2><s3>GBR</s3><sZ>2 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Institute of Cellular Medicine Newcastle University and The Newcastle Hospitals NHS Foundation Trust</wicri:noRegion></affiliation></author><author><name sortKey="Frost, Adaani" sort="Frost, Adaani" uniqKey="Frost A" first="Adaani" last="Frost">Adaani Frost</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>3 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Girgis, Reda E" sort="Girgis, Reda E" uniqKey="Girgis R" first="Reda E." last="Girgis">Reda E. Girgis</name><affiliation wicri:level="4"><inist:fA14 i1="04"><s1>Michigan State University, College of Human Medicine</s1><s2>Grand Rapids, Michigan</s2><s3>USA</s3><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region><settlement type="city">East Lansing</settlement></placeName><orgName type="university">Université d'État du Michigan</orgName></affiliation></author><author><name sortKey="Granton, John" sort="Granton, John" uniqKey="Granton J" first="John" last="Granton">John Granton</name><affiliation wicri:level="4"><inist:fA14 i1="05"><s1>Division of Respirology, University of Toronto</s1><s2>Toronto</s2><s3>CAN</s3><sZ>5 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Zhi Cheng Jing" sort="Zhi Cheng Jing" uniqKey="Zhi Cheng Jing" last="Zhi Cheng Jing">ZHI CHENG JING</name><affiliation wicri:level="3"><inist:fA14 i1="06"><s1>Fu Wai Hospital & National Center for Cardiovascular Disease Peking Union Medical College and Chinese Academy of Medical Science</s1><s2>Beijing</s2><s3>CHN</s3><sZ>6 aut.</sZ></inist:fA14><country>République populaire de Chine</country><placeName><settlement type="city">Pékin</settlement></placeName></affiliation></author><author><name sortKey="Klepetko, Walter" sort="Klepetko, Walter" uniqKey="Klepetko W" first="Walter" last="Klepetko">Walter Klepetko</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Department of Thoracic Surgery, Medical University Vienna/Vienna General Hospital</s1><s2>Vienna</s2><s3>AUT</s3><sZ>7 aut.</sZ></inist:fA14><country>Autriche</country><placeName><settlement type="city">Vienne (Autriche)</settlement><region nuts="2" type="province">Vienne (Autriche)</region></placeName></affiliation></author><author><name sortKey="Mcgoon, Michael D" sort="Mcgoon, Michael D" uniqKey="Mcgoon M" first="Michael D." last="Mcgoon">Michael D. Mcgoon</name><affiliation wicri:level="2"><inist:fA14 i1="08"><s1>Cardiovascular Diseases, Mayo Clinic</s1><s2>Rochester, Minnesota</s2><s3>USA</s3><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Minnesota</region></placeName></affiliation></author><author><name sortKey="Mclaughlin, Vallerie V" sort="Mclaughlin, Vallerie V" uniqKey="Mclaughlin V" first="Vallerie V." last="Mclaughlin">Vallerie V. Mclaughlin</name><affiliation wicri:level="2"><inist:fA14 i1="09"><s1>Cardiovascular Medicine, The University of Michigan</s1><s2>Ann Arbor, Michigan</s2><s3>USA</s3><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Michigan</region></placeName></affiliation></author><author><name sortKey="Preston, Ioana R" sort="Preston, Ioana R" uniqKey="Preston I" first="Ioana R." last="Preston">Ioana R. Preston</name><affiliation wicri:level="2"><inist:fA14 i1="10"><s1>Pulmonary, Critical Care and Sleep Division, Tufts Medical Center, Tufts University School of Medicine</s1><s2>Boston, Massachusetts</s2><s3>USA</s3><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Rubin, Lewis J" sort="Rubin, Lewis J" uniqKey="Rubin L" first="Lewis J." last="Rubin">Lewis J. Rubin</name><affiliation wicri:level="2"><inist:fA14 i1="11"><s1>Medical School, University of California, San Diego</s1><s2>La Jolla, California</s2><s3>USA</s3><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Sandoval, Julio" sort="Sandoval, Julio" uniqKey="Sandoval J" first="Julio" last="Sandoval">Julio Sandoval</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Clinical Research, National Institute of Cardiology of Mexico</s1><s2>Mexico City</s2><s3>MEX</s3><sZ>12 aut.</sZ></inist:fA14><country>Mexique</country><wicri:noRegion>Mexico City</wicri:noRegion></affiliation></author><author><name sortKey="Seeger, Werner" sort="Seeger, Werner" uniqKey="Seeger W" first="Werner" last="Seeger">Werner Seeger</name><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Max Planck Institute for Heart and Lung Research, Universities of Giessen and Marburg Lung Center</s1><s2>Giessen/Bad Nauheim</s2><s3>DEU</s3><sZ>13 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Giessen/Bad Nauheim</wicri:noRegion><wicri:noRegion>Universities of Giessen and Marburg Lung Center</wicri:noRegion><wicri:noRegion>Giessen/Bad Nauheim</wicri:noRegion></affiliation></author><author><name sortKey="Keogh, Anne" sort="Keogh, Anne" uniqKey="Keogh A" first="Anne" last="Keogh">Anne Keogh</name><affiliation wicri:level="3"><inist:fA14 i1="14"><s1>Heart Transplant Unit, St Vincent's Hospital</s1><s2>Sydney</s2><s3>AUS</s3><sZ>14 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Journal of the American College of Cardiology</title><title level="j" type="abbreviated">J. Am. Coll. Cardiol.</title><idno type="ISSN">0735-1097</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Journal of the American College of Cardiology</title><title level="j" type="abbreviated">J. Am. Coll. Cardiol.</title><idno type="ISSN">0735-1097</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Algorithm</term><term>Artery</term><term>Cardiology</term><term>Cardiovascular disease</term><term>Circulatory system</term><term>Decision tree</term><term>Pulmonary hypertension</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Hypertension artérielle pulmonaire</term><term>Pathologie de l'appareil circulatoire</term><term>Traitement</term><term>Algorithme</term><term>Arbre décision</term><term>Artère</term><term>Appareil circulatoire</term><term>Cardiologie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The demands on a pulmonary arterial hypertension (PAH) treatment algorithm are multiple and in some ways conflicting. The treatment algorithm usually includes different types of recommendations with varying degrees of scientific evidence. In addition, the algorithm is required to be comprehensive but not too complex, informative yet simple and straightforward. The type of information in the treatment algorithm are heterogeneous including clinical, hemodynamic, medical, interventional, pharmacological and regulatory recommendations. Stakeholders (or users) including physicians from various specialties and with variable expertise in PAH, nurses, patients and patients' associations, healthcare providers, regulatory agencies and industry are often interested in the PAH treatment algorithm for different reasons. These are the considerable challenges faced when proposing appropriate updates to the current evidence-based treatment algorithm. The current treatment algorithm may be divided into 3 main areas: 1) general measures, supportive therapy, referral strategy, acute vasoreactivity testing and chronic treatment with calcium channel blockers; 2) initial therapy with approved PAH drugs; and 3) clinical response to the initial therapy, combination therapy, balloon atrial septostomy, and lung transplantation. All three sections will be revisited highlighting information newly available in the past 5 years and proposing updates where appropriate. The European Society of Cardiology grades of recommendation and levels of evidence will be adopted to rank the proposed treatments.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Autriche</li><li>Canada</li><li>Italie</li><li>Mexique</li><li>Royaume-Uni</li><li>République populaire de Chine</li><li>États-Unis</li></country><region><li>Californie</li><li>Massachusetts</li><li>Michigan</li><li>Minnesota</li><li>Nouvelle-Galles du Sud</li><li>Ontario</li><li>Texas</li><li>Vienne (Autriche)</li></region><settlement><li>East Lansing</li><li>Pékin</li><li>Sydney</li><li>Toronto</li><li>Vienne (Autriche)</li></settlement><orgName><li>Université d'État du Michigan</li><li>Université de Toronto</li></orgName></list><tree><country name="Italie"><noRegion><name sortKey="Galie, Nazzareno" sort="Galie, Nazzareno" uniqKey="Galie N" first="Nazzareno" last="Galie">Nazzareno Galie</name></noRegion></country><country name="Royaume-Uni"><noRegion><name sortKey="Corris, Paul A" sort="Corris, Paul A" uniqKey="Corris P" first="Paul A." last="Corris">Paul A. Corris</name></noRegion></country><country name="États-Unis"><region name="Texas"><name sortKey="Frost, Adaani" sort="Frost, Adaani" uniqKey="Frost A" first="Adaani" last="Frost">Adaani Frost</name></region><name sortKey="Girgis, Reda E" sort="Girgis, Reda E" uniqKey="Girgis R" first="Reda E." last="Girgis">Reda E. Girgis</name><name sortKey="Mcgoon, Michael D" sort="Mcgoon, Michael D" uniqKey="Mcgoon M" first="Michael D." last="Mcgoon">Michael D. Mcgoon</name><name sortKey="Mclaughlin, Vallerie V" sort="Mclaughlin, Vallerie V" uniqKey="Mclaughlin V" first="Vallerie V." last="Mclaughlin">Vallerie V. Mclaughlin</name><name sortKey="Preston, Ioana R" sort="Preston, Ioana R" uniqKey="Preston I" first="Ioana R." last="Preston">Ioana R. Preston</name><name sortKey="Rubin, Lewis J" sort="Rubin, Lewis J" uniqKey="Rubin L" first="Lewis J." last="Rubin">Lewis J. Rubin</name></country><country name="Canada"><region name="Ontario"><name sortKey="Granton, John" sort="Granton, John" uniqKey="Granton J" first="John" last="Granton">John Granton</name></region></country><country name="République populaire de Chine"><noRegion><name sortKey="Zhi Cheng Jing" sort="Zhi Cheng Jing" uniqKey="Zhi Cheng Jing" last="Zhi Cheng Jing">ZHI CHENG JING</name></noRegion></country><country name="Autriche"><region name="Vienne (Autriche)"><name sortKey="Klepetko, Walter" sort="Klepetko, Walter" uniqKey="Klepetko W" first="Walter" last="Klepetko">Walter Klepetko</name></region></country><country name="Mexique"><noRegion><name sortKey="Sandoval, Julio" sort="Sandoval, Julio" uniqKey="Sandoval J" first="Julio" last="Sandoval">Julio Sandoval</name></noRegion></country><country name="Allemagne"><noRegion><name sortKey="Seeger, Werner" sort="Seeger, Werner" uniqKey="Seeger W" first="Werner" last="Seeger">Werner Seeger</name></noRegion></country><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Keogh, Anne" sort="Keogh, Anne" uniqKey="Keogh A" first="Anne" last="Keogh">Anne Keogh</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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