title: [Pulmonary hypertension: definition, diagnostic and new classification].
abstract: Pulmonary hypertension (PH): mean pulmonary arterial pressure (mPAP) ≥ 25 mm Hg on right heart catheterization at rest. Pulmonary arterial hypertension (PAH): mPAP ≥ 25 mm Hg, pulmonary capillary wedge pressure (PCWP) ≤ 15 mm Hg and pulmonary vascular resistances (PVR) >3 Wood units. Patients with compatible symptoms (exertional dyspnea, syncopes, signes of right heart failure) can show signs of PH on cardiac echography and therefore need to be investigated in search of the cause of PH. After ruling out the frequent causes of PH (left heart and chronic respiratory diseases), the V/Q lung scan is used to screen for patients with post-embolic PH, that need to be further investigated hemodynamically and radiologically in order to decide operability. For the rest of the patients, only right heart catheterization can identify patients with precapillary PH and these patients must be further evaluated (clinically, by blood samples and by imaging techniques) in order to be classified in one the PH groups of the classification. For the future the discovery of novel risk factors and understanding the mechanism involved with the already known ones represent two major points of research.
authors.affiliation: Université Paris-Sud, faculté de médecine, 94276 Le Kremlin-Bicêtre, France; AP-HP, hôpital Bicêtre, DHU Torino, centre de référence de l'hypertension pulmonaire sévère, service de pneumologie et réanimation respiratoire, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France; Inserm UMR-S 999, LabEx Lermit, hypertension artérielle pulmonaire, physiopathologie et innovation thérapeutique, centre chirurgical Marie-Lannelongue, 92350 Le Plessis-Robinson, France. Electronic address: andrei.seferian@bct.aphp.fr.
authors.forename: Andrei
authors.initials: A
authors.lastname: Seferian
authors.affiliation: Université Paris-Sud, faculté de médecine, 94276 Le Kremlin-Bicêtre, France; AP-HP, hôpital Bicêtre, DHU Torino, centre de référence de l'hypertension pulmonaire sévère, service de pneumologie et réanimation respiratoire, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France; Inserm UMR-S 999, LabEx Lermit, hypertension artérielle pulmonaire, physiopathologie et innovation thérapeutique, centre chirurgical Marie-Lannelongue, 92350 Le Plessis-Robinson, France.
authors.forename: Gérald
authors.initials: G
authors.lastname: Simonneau
mesh_terms: D006328:Cardiac Catheterization; D002908:Chronic Disease; D003240:Connective Tissue Diseases / Q000150:complications; D064420:Drug-Related Side Effects and Adverse Reactions; D020022:Genetic Predisposition to Disease; D015658:HIV Infections / Q000150:complications; D006330:Heart Defects, Congenital / Q000150:complications; D006391:Hemangioma / Q000150:complications; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications; D006976:Hypertension, Pulmonary / Q000145:classification / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D008171:Lung Diseases / Q000150:complications; D011655:Pulmonary Embolism / Q000150:complications; D011668:Pulmonary Veno-Occlusive Disease / Q000150:complications; D012552:Schistosomiasis / Q000150:complications; D018487:Ventricular Dysfunction, Left / Q000150:complications