Definition und Klassifikation der pulmonalen Hypertonie

Douschan P, Kaemmerer-Suleiman AS, Egenlauf B, Seyfarth HJ, Zeder K, Mayer L, Wissmüller M, Heberling M, Huntgeburth M, Barnikel M, Xanthouli P, Sorichter S, John T, Ulrich S, Kovacs G (2025)

Publication Type: Journal article, Review article

Publication year: 2025

Journal

Pneumologie Georg Thieme Verlag

Book Volume: 79

Pages Range: 723-731

Journal Issue: 10

DOI: 10.1055/a-2625-4769

Abstract

Pulmonary Hypertension (PH) is characterized as a hemodynamic disorder defined by a mean pulmonary arterial pressure (mPAP) exceeding 20 mmHg at rest. Classification into distinct subtypes is guided by measurements of pulmonary arterial wedge pressure (PAWP) and pulmonary vascular resistance (PVR): Precapillary PH: PAWP ≤ 15 mmHg accompanied by PVR > 2 Wood Units (WU), isolated Postcapillary PH: PAWP > 15 mmHg with PVR ≤ 2 WU and combined Pre- and Postcapillary PH: PAWP > 15 mmHg with PVR > 2 WU.Exercise-Induced PH refers to a pathophysiological condition in which resting mPAP is within normal limits but exhibits an exaggerated rise during physical exertion. This is quantified by a slope of mPAP relative to cardiac output exceeding 3 mmHg per liter per minute between rest and activity.The foundational framework for the clinical classification of PH, comprising five principal groups, remains unchanged. Nevertheless, several updates have been introduced: Reintegration of long-term responders to calcium channel blockers as a distinct subset within idiopathic pulmonary arterial hypertension (IPAH), Inclusion of new subcategories under Group 2 PH, which encompasses PH associated with left heart disease and Revision of Group 3 PH to categorize patients based on underlying pulmonary pathology rather than solely functional impairment.Additionally, Mitomycin-C and Carfilzomib have been recognized as pharmacologic agents with a confirmed causal relationship to the development of pulmonary arterial hypertension (PAH) and have thus been added to the list of definitively associated drugs.

Authors with CRIS profile

Ann-Sophie Kaemmerer-Suleiman Department of Cardiac Surgery

Involved external institutions

Universitätsspital Zürich (USZ) CH Switzerland (CH) Universitätsklinikum Carl Gustav Carus Dresden DE Germany (DE) Medizinische Universität Graz AT Austria (AT) Universitätsklinikum Heidelberg DE Germany (DE) Klinikum der Universität München (LMU Klinikum) DE Germany (DE) Universitätsklinikum Köln DE Germany (DE)

How to cite

APA:

Douschan, P., Kaemmerer-Suleiman, A.-S., Egenlauf, B., Seyfarth, H.J., Zeder, K., Mayer, L.,... Kovacs, G. (2025). Definition und Klassifikation der pulmonalen Hypertonie. Pneumologie, 79(10), 723-731. https://doi.org/10.1055/a-2625-4769

MLA:

Douschan, Philipp, et al. "Definition und Klassifikation der pulmonalen Hypertonie." Pneumologie 79.10 (2025): 723-731.

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