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Winter 2004, Vol. 3, No. 4

Editor’s Memo   Under the Tent of the New ACCP Guidelines in PAH: Room for Debate, Comment, Analysis Publication of the new American College of Chest Physicians (ACCP) evidence-based clinical practice guidelines for pulmonary arterial hypertension (PAH) represents a major advance in understanding the diagnosis and management of the disease. For the target audience of cardiologists, pulmonologists, rheumatologists, internists, and other healthcare providers involved in such care, the guidelines are the first revision of an earlier document created 10 years ago. Lewis J. Rubin, MD, who chaired the consensus panel, and the international panel of 19 experts from five medical specialties, deserve our appreciation and praise for the extraordinary work they have done during the last 3 years. We applaud their efforts and commitment to the highest standards of medical care. If the guidelines cast a long shadow over our practice because of how large they loom in clinical decision-making, they also shed tremendous light on areas where we need more evidence-based information. Under the tent of the guidelines, however, there is plenty of room for debate and comment over how the new criteria should be applied in the myriad decisions we make every day. As clinicians, we must often make decisions in areas in which the evidence base is inadequate because of the need for more data. As our Editorial Board reviewed the guidelines, we wanted to explore various approaches taken by clinicians involved with PAH, especially in areas where the guidelines cannot (of necessity) make strong recommendations. The experts we have assembled for this issue are not debating the relative merits of the guidelines. Beginning on page 3, they are offering fresh and varied perspectives, whether it is on the use of echocardiography or the benefits of new agents still in phase 3 clinical trials. Gleaned from their own knowledge and practice-based experience, these comments, queries, and insights will, it is hoped, broaden our base of knowledge. Victor F. Tapson, MD Editor-in-Chief   Take it With You   Download this issue in PDF (4.42 MB)   Issue Sponsor Ads   Actelion (PDF) Accredo Therapeutics (PDF)	Articles   Advances in Pulmonary Hypertension, Winter 2004, Vol. 3, No. 4 cover close-up Click titles to read stories... Profiles in Pulmonary Hypertension: Lewis Rubin, MD: From ACCP Guidelines to Pharmacogenomics of PH, Lewis Rubin, MD, Stands Tall as a Prime Mover Lewis J. Rubin, MD, is one of a select group of physicians who have seen pulmonary hypertension from many different perspectives, one of a handful of clinicians worldwide whose experience spans more than 20 years in this clinical setting. Their experience covers a dramatic ... Pulmonary Arterial Hypertension: Diagnostic Considerations Echocardiography The Role of Electrocardiography Implantable Hemodynamic Monitoring Cardiopulmonary Exercise Testing Pulmonary Arterial Hypertension: Therapeutic Considerations Calcium-Channel Blockers Treating Class II PAH Patients Treating Class III PAH Patients Treatment for Class IV Patients Considering Sildenafil Relative Merits of Different Endothelin Antagonists Discontinuing Epoprostenol When to Use Treprostinil PAH Treatment in Germany Combination Therapy Treatment Options in Portopulmonary Hypertension Severe PH Associated with LVDD Examining the Use of Anticoagulants       PHA Announcements   PH Doctor (PDF) (HTML) PH Practice Guidelines from the ACCP (PDF) (HTML) Cardiovascular Medical Research and Education Fund (PDF) Program Announcement: Mentored Clinical Scientist Development Award (K08) & Mentored Patient-Oriented Research Career Development Award (K23) (PDF)
Notes   Editorial Advisory Board Editor-in-Chief Ronald J. Oudiz, MD Associate Professor of Medicine UCLA School of Medicine Director, Liu Center for Pulmonary Hypertension Division of Cardiology Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center Torrance, California Immediate Past Editor Vallerie V. McLaughlin, MD Associate Professor of Medicine Director, Pulmonary Hypertension Program University of Michigan Health System Ann Arbor, Michigan Editor-in-Chief Elect Richard Channick, MD Professor of Clinical Medicine Pulmonary and Critical Care Division University of California, San Diego Medical Center San Diego, California Associate Editors Erika Berman Rosenzweig, MD Assistant Professor of Pediatrics Department of Pediatrics Columbia College of Physicians and Surgeons New York, New York Robert Frantz, MD Consultant in Cardiovascular Diseases and Internal Medicine Assistant Professor of Medicine Mayo Clinic College of Medicine Rochester, Minnesota Srinivas Murali, MD, FACC Professor of Medicine Drexel University College of Medicine Director, Division of Cardiovascular Medicine Medical Director, Gerald McGinnis Cardiovascular Institute Allegheny General Hospital Pittsburgh, Pennsylvania Publisher Pulmonary Hypertension Association Jack Stibbs, Board Chair Rino Aldrighetti, President Donica Merhazion, Medical Services Associate Director Publishing Staff Stu Chapman, Executive Editor Susan Chapman, Managing Editor Heidi Green, Associate Editor Gloria Catalano, Production Director Michael McClain, Design Director PHA Office Pulmonary Hypertension Association 801 Roeder Road., St.e 400 Silver Spring, MD 20910 301-565-3004, 301-565-3994 (fax) www.PHAssociation.org Provided with an unrestricted educational grant from Actelion Pharmaceuticals, U.S., Inc. and Accredo Therapeuticss. © 2006 by Pulmonary Hypertension Association and DataMedica. All rights reserved. None of the contents may be reproduced in any form whatsoever without the written permission of PHA. Editorial Offices Advances in Pulmonary Hypertension DataMedica 424 Dune Road Westhampton Beach, NY 11978 Tel: 631-288-7733 Fax: 631- 288-7744 Advances in Pulmonary Hypertension is circulated to cardiologists, pulmonologists, rheumatologists and other selected physicians by the Pulmonary Hypertension Association . The contents of the articles are independently determined ly the Editor and the Editorial Advisory Board. PHA's Scientific Leadership Council Editorial Mission Advances in Pulmonary Hypertension is committed to help physicians in their clinical decision making by informing them of important trends affecting their practice. Analyzing the impact of new findings and covering current information in the peer-reviewed literature, Advances in Pulmonary Hypertension is published four times a year. Advances in Pulmonary Hypertension is the official journal of the Pulmonary Hypertension Association. Each article in this journal has been reviewed and approved by members of the Editorial Advisory Board.   Editorial Board Todd Bull, MD Division of Pulmonary Sciences and Critical Care Medicine University of Colorado Health Sciences Center Denver, Colorado Murali Chakinala, MD Director, Pulmonary Hypertension Clinic Washington University School of Medicine St. Louis, Missouri Kristin Highland, MD Assistant Professor Division of Pulmonary and Critical Care Director, Pulmonary Hypertension Clinic Medical University of South Carolina Charleston, South Carolina Jim Maloney, MD Associate Professor of Pulmonary and Critical Care Medicine University of Colorado Health Sciences Center Denver, Colorado Ioana Preston, MD Assistant Professor of Medicine Tufts - New England Medical Center Boston, Massachusetts Zeenat Safdar, MD Assistant Professor of Medicine Department of Medicine, Pulmonary & Critical Care Section Pulmonary Hypertension Center Baylor College of Medicine Houston, Texas Rajan Saggar, MD Assistant Professor Division of Pulmonary and Critical Care Medicine and Hospitalists David Geffen School of Medicine UCLA Los Angeles, California Robert Schilz, DO, PhD Medical Director of Lung Transplantation and Pulmonary Vascular Disease University Hospital of Cleveland Case Western Reserve University Cleveland, Ohio Francisco Soto, MD, MS Assistant Professor Director, Pulmonary Hypertension Program Medical College of Wisconsin Milwaukee, Wisconsin Roxana Sulica, MD Assistant Professor of Medicine Albert Einstein College of Medicine Director, Beth Israel Pulmonary Hypertension Program Beth Israel Medical Center New York, New York

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