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Background <p>At the 7th World Symposium on Pulmonary Hypertension (WSPH) in 2024 one working group addressed risk stratification and treatment goals for patients with pulmonary arterial hypertension (PAH) and another group focused on lung transplantation and bridging measures.</p> Objective <p>This paper concisely summarizes the respective results.</p> Material and methods <p>The original publications of WSPH working groups&#xa0;7 and&#xa0;8 have been translated into German and shortened.</p> Results <p>Risk stratifications are employed to predict disease progression and guide treatment for PAH patients. Most models include the three noninvasive parameters WHO functional class, 6‑min walking distance and natriuretic peptides. Additional parameters such as invasive hemodynamic parameters or those from cardiac imaging could improve the predictive power. In high-risk patients despite maximum treatment, lung transplantation should be considered. The topic should therefore be discussed with patients early on to enable evaluation and, if necessary, listing. Right ventricular support technologies such as venoarterial extracorporeal membrane oxygenation can bridge the waiting time for a&#xa0;suitable organ preoperatively and enable a&#xa0;better cardiac adaptation postoperatively.</p> Conclusion <p>Risk stratification has been continuously refined using various models to provide the best possible prediction; however, not all patient populations are sufficiently represented and further optimization is required. Invasive bridging measures until lung transplantation are also being continuously improved at expert centers to prevent death while being on the waiting list for organ transplantation.</p>

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Risikostratifizierung der pulmonalarteriellen Hypertonie und Lungentransplantation sowie überbrückende Maßnahmen

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月5日

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  • Ekkehard Grünig,
  • Nicola Benjamin,
  • Benjamin Egenlauf,
  • Satenik Harutyunova,
  • Vera Hess,
  • Panagiota Xanthouli,
  • Christina A. Eichstaedt

摘要

Background

At the 7th World Symposium on Pulmonary Hypertension (WSPH) in 2024 one working group addressed risk stratification and treatment goals for patients with pulmonary arterial hypertension (PAH) and another group focused on lung transplantation and bridging measures.

Objective

This paper concisely summarizes the respective results.

Material and methods

The original publications of WSPH working groups 7 and 8 have been translated into German and shortened.

Results

Risk stratifications are employed to predict disease progression and guide treatment for PAH patients. Most models include the three noninvasive parameters WHO functional class, 6‑min walking distance and natriuretic peptides. Additional parameters such as invasive hemodynamic parameters or those from cardiac imaging could improve the predictive power. In high-risk patients despite maximum treatment, lung transplantation should be considered. The topic should therefore be discussed with patients early on to enable evaluation and, if necessary, listing. Right ventricular support technologies such as venoarterial extracorporeal membrane oxygenation can bridge the waiting time for a suitable organ preoperatively and enable a better cardiac adaptation postoperatively.

Conclusion

Risk stratification has been continuously refined using various models to provide the best possible prediction; however, not all patient populations are sufficiently represented and further optimization is required. Invasive bridging measures until lung transplantation are also being continuously improved at expert centers to prevent death while being on the waiting list for organ transplantation.