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Predicting Survival in Pulmonary Arterial Hypertension: Time to Combine Markers

Marc Humbert, MD, PhD; David Montani, MD, PhD; Rogério Souza, MD, PhD
Author and Funding Information

From AP-HP (Drs Humbert, Montani, and Souza), Centre National de Référence de l’Hypertension Pulmonaire Sévère, Service de Pneumologie et Réanimation Respiratoire, Hôpital Antoine Béclère; the University of Paris-Sud (Drs Humbert, Montani, and Souza), Faculté de medicine, Kremlin-Bicêtre, France; INSERM U999 (Drs Humbert, Montani, and Souza), Hypertension Artérielle Pulmonaire: Physiopathologie et Innovation Thérapeutique, Centre Chirurgical Marie-Lannelongue, Le Plessis-Robinson, France; and Pulmonary Department (Dr Souza), University of São Paulo Medical School, São Paulo, Brazil.

Correspondence to: Marc Humbert, MD, PhD, Service de Pneumologie, Hôpital Antoine Béclère, 157 rue de la Porte de Trivaux, 92140 Clamart, France; e-mail: marc.humbert@abc.aphp.fr


Financial/nonfinancial disclosures: The authors have reported to CHEST the following conflicts of interest: Dr Humbert has received consultancy and advisory board fees from Actelion and Novartis, and has received lecture fees from Actelion, BayerSchering, GlaxoSmithKline, Pfizer Inc, and United Therapeutics. Drs Montani and Souza have reported that no potential conflicts of interest exit with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;139(6):1263-1264. doi:10.1378/chest.10-2868
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In recent years, we have witnessed the use of a growing number of surrogate markers in pulmonary arterial hypertension (PAH) to evaluate novel therapeutic options.1,2 From the first, large, multicenter study cohort derived from the 1980s National Institutes of Health Registry3 to the contemporary data of the French Registry and the US REVEAL (Registry to Evaluate Early and Long-term Pulmonary Arterial Hypertension Disease Management),4-6 several prognostic markers have been described that are now commonly used to test response to PAH therapy. These markers include functional assessment, exercise capacity, biomarkers quantification, echocardiographic measurements, MRI, and hemodynamic parameters measured by right-sided heart catheterization. Because these measurements reflect different aspects of PAH pathophysiology, their integration in composite scores seems reasonable and even necessary.

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