CHEST 2023 On Demand Pass-Applicability of the New ESC/ERS PAH Guidelines in the US: A Pro-Con Debate

Video Transcription

Video Summary

In this pro-con debate, Lana Melendez-Groves and Chris Mullins argue in favor of the new European diagnostic criteria for pulmonary hypertension (PH) while Frank Rahaghi and Harrison Farber argue against it. Melendez-Groves and Mullins believe that the new criteria, which lowers the pulmonary vascular resistance (PVR) threshold from 3 to 2, should be applicable in the US. They argue that the new criteria reflect a more scientifically accurate definition of normal and allow for earlier identification of at-risk patients. They also argue that the criteria do not force treatment but provide an opportunity to appropriately classify and potentially treat patients who may benefit from pulmonary vasodilators. On the other hand, Rahaghi and Farber argue that the new criteria lack sufficient evidence and may lead to harm. They raise concerns about the validity of using derived metrics such as PVR, which depends on the wedge pressure. They question the normal range of wedge pressure and argue that factors such as obesity, hypertension, hyperlipidemia, and diabetes can affect wedge pressure and consequently the PVR. They also note that there is no data on the efficacy of pulmonary hypertension therapies for patients meeting the new criteria. Ultimately, they caution against treating patients without evidence and call for more research in this area.

Meta Tag

Category Pulmonary Vascular Disease

Session ID 1084

Speaker Harrison Farber

Speaker Christopher King

Speaker Lana Melendres-Groves

Speaker Christopher Mullin

Speaker Franck Rahaghi

Track Pulmonary Vascular Disease

Keywords

pro-con debate

European diagnostic criteria

pulmonary hypertension

PVR threshold

scientifically accurate definition

at-risk patients

pulmonary vasodilators

sufficient evidence

harm

PH