• Rafael E Conde, Mirta Diez, Rubén Dueñas, Guillermo Giacomi, Luis Lema, Adrián Lescano, Eduardo R Perna, Nayeli Zayas Hernández, Sergio V Perrone, and Grupo de Expertos Latinoamericanos en Hipertensión Arterial Pulmonar.
• Fundación Neumológica Colombiana, Fundación Cardioinfantil, Bogotá, Colombia. E-mail: rconde@neumologica.org.
• Medicina (B Aires). 2021 Jan 1; 81 (4): 624-636.

AbstractPulmonary arterial hypertension (PAH) requires structured processes of diagnosis and risk stratification, being the function of the right ventricle (RV) a hallmark prognosis determinant. The main therapeutic goals in PAH are to improve and try to revert RV dysfunction and maintaining a low risk. Currently, there are multiple treatments with different mechanisms of action, the combination of which in double or triple therapy has shown improved results compared to monotherapy. Recent clinical evidence shows the importance of early incorporation of parenteral prostanoids to the scheme, improving RV function and survival. In this review, we discuss the role of the RV function in the diagnosis, prognosis, and follow-up of PAH. We recommend the systematic and standardised evaluation of the RV as well as the early initiation of combined treatment in cases of intermediatehigh risk to try to reach and keep the patient with PAH at a low risk and / or avoid the progression of PAH.

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