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Int J Cardiol. 2018 Dec 1;272S:11-19. doi: 10.1016/j.ijcard.2018.08.083. Epub 2018 Aug 27.

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

Author information

1
Department of Internal Medicine, Division of Pulmonology, Medical University of Graz and Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria. Electronic address: gabor.kovacs@medunigraz.at.
2
Clinic III for Internal Medicine, Heart Center, University of Cologne, Germany.
3
Hospital & Sanatorium Dr. Barner, Braunlage, Germany.
4
Department of Internal Medicine III, Cardiology, Angiology and Pneumology, University Clinic Heidelberg, Germany.
5
Center for Pulmonary Hypertension, Thoracic Clinic at the University Clinic Heidelberg, Germany.
6
Clinic for Pediatric Cardiology and Congenital Heart Diseases, German Heart Center, Munich, Germany.
7
Clinic for Pulmonology, Department Internal Medicine, University Clinic Freiburg, Germany.
8
Clinic for Pediatric Cardiology, University Heart Center Hamburg GmbH, University Clinic Eppendorf, Hamburg, Germany.
9
Cardio Centrum Ludwigsburg Bietigheim, Ludwigsburg, Germany.
10
Pediatric Cardiology, University Clinic Münster, Germany.
11
Clinic for Pulmonology, St. Franziskus Hospital, Mönchengladbach, Germany.
12
Clinic for Pulmonology, Gastroenterology and Intensive Care, Klinikum Harlaching, Germany.
13
Medical Clinic II, Department of Pneumology, University Hospital Bonn, Germany.
14
Department of Respiratory Medicine; University of Leipzig, Germany.
15
University Heart Center Hamburg, Clinic for General and Interventional Cardiology, Hamburg, Germany.
16
Clinic for Pulmonology, St.-Josef Hospital, RkK-Klinikum, Freiburg, Germany.
17
Clinic Löwenstein, Medical Clinic I, Löwenstein, Germany.
18
Clinic for Internal Medicine V, Pulmonology University Clinic of Saarland, Homburg, Germany.
19
Center for Pulmonary Hypertension and Lung Vascular Diseases, Department of Internal Medicine, Missionsklinik Würzburg, Germany.

Abstract

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.

KEYWORDS:

Classification; Definition; Diagnosis; Pulmonary hypertension

PMID:
30219257
DOI:
10.1016/j.ijcard.2018.08.083
[Indexed for MEDLINE]

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