Diagnostic and Management Dilemmas in Pulmonary Hypertension Webinar Series

Diagnostic and Management Dilemmas in Pulmonary Hypertension Webinar Series is organized by European Respiratory Society (ERS).

Dates:
7 February 2024 – 4 December 2024

Description:
The proposed webinar series “Diagnostic and management dilemmas in pulmonary hypertension”, highlights current important challenges in the diagnostic work-up and management of patients with pulmonary hypertension (PH).

The recent 2022 ERS/ESC PH guidelines highlight a number of theses dilemmas including patients diagnosed with idiopathic pulmonary arterial hypertension (IPAH) in the presence of respiratory and cardiovascular comorbidities.

Other health issues facing society, such as the obesity pandemic, present unique challenges in characterizing PH adequately in relation to technical issues at right heart catheterization and the presence of associated comorbidities including alveolar hypoventilation. We believe that a webinar series focusing on forms of PH which present diagnostic and management dilemmas will be of significant interest.

Educational Aims:
Current important challenges in the diagnostic work-up and management of patients with pulmonary hypertension (PH) will be explored using an interactive case-based approach. Speakers will present background data and illustrative cases which will then be further discussed by the chairs and external expert. Following the webinars, participants will have increased understanding regarding the diagnosis and management of more complex an rarer forms of PH.

Learning Outcomes:
Following this webinar, participants will be able to:

• Recognise important pitfalls in the diagnostic work-up of patients with pulmonary hypertension.
• Use and understand the most appropriate imaging techniques in the diagnostic work-up of patients with pulmonary hypertension depending on the differential diagnosis.
• Recognise the most prevalent congenital vascular abnormalities leading to pulmonary arterial hypertension.
• Recognise the pitfalls and understand the important technical aspects when performing right heart catheterization including in obese patients with pulmonary hypertension of different origin.
• Appreciate diagnostic uncertainty in patients with PAH with cardiopulmonary comorbidities.
• To recognise the right ventricle phenotype in post-capillary pulmonary hypertension.

Topics and Schedule:

• Session 1: PAH with cardiopulmonary comorbidities (7 February, 2024)
• Session 2: Go with the flow: pulmonary hypertension with high cardiac output (3 April, 2024)
• Session 3: Post-capillary pulmonary hypertension (5 June, 2024)
• Session 4: CTEPH mimics (2 October, 2024)
• Session 5: Obesity and pulmonary hypertension (6 November, 2024)
• Session 6: Group 5 pulmonary hypertension; the unanswered questions (4 December, 2024)

Session 1: (I)PAH with cardiopulmonary comorbidities

7 February, 2024
18:00–19:00 CET

Learning objectives: 

• Understand the effect of cardiac and pulmonary comorbidities on outcomes in patients diagnosed with IPAH
• Appreciate clinical, PFT, echocardiographic and radiological features
• Understand the evidence for response or lack of response to PAH therapies

Topics: 

• Cases demonstrating pulmonary and cardiovascular phenotypes.
• Focus on PFTs, (HR)CT and echocardiography in the diagnostic work-up.
• Evidence for response or lack of response to PAH therapies.

Session 2: Go with the flow: pulmonary hypertension with high cardiac output

3 April, 2024
18:00–19:00 CEST

Learning objectives: 

• Understand the different causes of PH with a high cardiac output (eg PAPVR/ASD, acquired and congenital AVMs, thyrotoxicosis, liver disease, Paget’s disease etc.)
• Appreciate radiological features of L-R shunt due to CHD including PAPVD
• Understand importance of systematic diagnostic approach in identifying the correct cause

Topics:

• Cases demonstrating unsuspected congenital heart disease (eg PAPVR/ASD), acquired and congenital AVMs, thyrotoxicosis, liver disease, Paget’s disease etc.
• Focus on systematic evaluation of CTPA and MRI, comprehensive RHC evaluation and laboratory tests in the diagnostic work-up.

Session 3: Post-capillary pulmonary hypertension

5 June, 2024
18:00–19:00 CEST

Learning objectives: 

• Understand the differences between isolated post-capillary and combined pre- and post-capillary PH
• Understand the importance of echocardiography in diagnosis
• Appreciate the data for PAH therapies

Topics:

• Cases demonstrating isolated post-capillary PH and combined pre-and post-capillary PH with significant RV impairment.
• Focus on echocardiography in the diagnostic work-up.
• Discussion regarding optimal therapeutic management.

Session 4: CTEPH mimics

2 October, 2024
18:00–19:00 CEST

Learning objectives: 

• Understand conditions which can mimic CTEPH (eg sarcoma, vasculitis, pulmonary vein obstruction, tumor-related PH)
• Appreciate different imaging techniques in the diagnostic work-up in CTEPH, e.g. CTPA, dual energy CT, V/Q scan, plus PET

Topics:

• Cases demonstrating sarcoma, vasculitis, pulmonary vein obstruction, tumor-related PH.
• Focus on different imaging techniques in the diagnostic work-up in CTEPH, e.g. CTPA, dual energy CT, V/Q scan, plus PET.
• Pitfalls in CTEPH diagnosis.

Session 5: Obesity and pulmonary hypertension

6 November, 2024
18:00–19:00 CET

Learning objectives: 

• Understand different PH phenotypes seen in patients with obesity including PH with obesity hypoventilation syndrome, post-capillary PH, high-output PH.
• Appreciate the importance of RHC assessment including assessment of PAWP.
• Explore outcomes in obese patients with different forms of PH.

Topics:

• Cases demonstrating different PH phenotypes seen in patients with obesity including PH with obesity hypoventilation syndrome, post-capillary PH, high-output PH.
• Focus on RHC assessment including assessment of PAWP.
• Review of outcomes in obese patients with different forms of PH.

Session 6: Group 5 pulmonary hypertension; the unanswered questions

4 December, 2024
18:00–19:00 CET

Learning objectives: 

• Understand the different forms of group 5 disease
• Appreciate different possible nature of PH in these conditions (e.g. Sarcoidosis – granulomatous vasculopathy v lung disease v compression; Myeloproliferative disease – group 5 versus CTEPH. LCH. NFM.
• Appreciate the evidence for optimal treatment in these groups

Topics:

• Cases demonstrating uncertainty in patients with various forms of group 5 disease: Sarcoidosis – granulomatous vasculopathy v lung disease v compression. Myeloproliferative disease – group 5 versus CTEPH. LCH. NFM.