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1.
Rev Mal Respir ; 40(9-10): 838-852, 2023.
Artigo em Francês | MEDLINE | ID: mdl-37923650

RESUMO

Pulmonary arterial hypertension (PAH) is a rare disease that can be caused by (likely) pathogenic germline genomic variants. In addition to the most prevalent disease gene, BMPR2 (bone morphogenetic protein receptor 2), several genes, some belonging to distinct functional classes, are also now known to predispose to the development of PAH. As a consequence, specialist and non-specialist clinicians and healthcare professionals are increasingly faced with a range of questions regarding the need for, approaches to and benefits/risks of genetic testing for PAH patients and/or related family members. We provide a consensus-based approach to recommendations for genetic counselling and assessment of current best practice for disease gene testing. We provide a framework and the type of information to be provided to patients and relatives through the process of genetic counselling, and describe the presently known disease causal genes to be analysed. Benefits of including molecular genetic testing within the management protocol of patients with PAH include the identification of individuals misclassified by other diagnostic approaches, the optimisation of phenotypic characterisation for aggregation of outcome data, including in clinical trials, and importantly through cascade screening, the detection of healthy causal variant carriers, to whom regular assessment should be offered.


Assuntos
Hipertensão Pulmonar , Hipertensão Arterial Pulmonar , Humanos , Aconselhamento Genético/métodos , Hipertensão Arterial Pulmonar/genética , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/genética , Hipertensão Pulmonar/terapia , Mutação , Hipertensão Pulmonar Primária Familiar/diagnóstico , Hipertensão Pulmonar Primária Familiar/genética , Testes Genéticos/métodos , Predisposição Genética para Doença
2.
Dtsch Med Wochenschr ; 141(S 01): S4-S9, 2016 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-27760444

RESUMO

The 2015 European Guidelines on Diagnosis and Treatment of Pulmonary Hypertension (PH) are also valid for Germany. While the guidelines contain detailed recommendations regarding clinical aspects of pulmonary arterial hypertension (PAH) and other forms of PH, they contain only a relatively short paragraph on novel findings on the pathobiology, pathology, and genetics. However, these are of great importance for our understanding of this complex disease both from a clinical and scientific point of view, and they are essential for the development of novel treatment strategies. To this end, a number of current data are relevant, prompting a detailed commentary to the guidelines, and the consideration of new scientific data. In June 2016, a Consensus Conference organized by the PH working groups of the German Society of Cardiology (DGK), the German Society of Respiratory Medicine (DGP) and the German Society of Pediatric Cardiology (DGPK) was held in Cologne, Germany. This conference aimed to solve practical and controversial issues surrounding the implementation of the European Guidelines in Germany. To this end, a number of working groups was initiated, one of which was specifically dedicated to the pathobiology, pathology and genetics of PH. This article summarizes the results and recommendations of this working group.


Assuntos
Cardiologia/normas , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/terapia , Guias de Prática Clínica como Assunto , Pneumologia/normas , Anti-Hipertensivos/uso terapêutico , Terapia Combinada/normas , Endarterectomia/normas , Alemanha , Humanos , Hipertensão Pulmonar/genética
3.
Herz ; 40(3): 457-68; quiz 469-70, 2015 May.
Artigo em Alemão | MEDLINE | ID: mdl-25963173

RESUMO

Pulmonary hypertension (PH) is a severe disease, which is usually only recognized at a late stage. It is characterized by dyspnea and right heart insufficiency. In some forms of pulmonary hypertension, such as the rare pulmonary arterial hypertension (PAH) and PAH associated with congenital heart defects, genetic factors have been identified. This article summarizes the general and supportive therapies for PH, targeted pharmaceutical treatment for PAH and non-operable chronic thromboembolic pulmonary hypertension. To achieve acceptable survival rates, it is essential to transfer patients to an expert center at an early stage for further differential diagnostics and therapy.


Assuntos
Anticoagulantes/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Terapia por Exercício , Predisposição Genética para Doença/genética , Hipertensão Pulmonar/genética , Hipertensão Pulmonar/terapia , Medicina Baseada em Evidências , Humanos , Hipertensão Pulmonar/diagnóstico , Resultado do Tratamento
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