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Book: Pulmonary hypertension

Oudiz, Ronald J.

(Cardiology clinics ; volume 34, number 3 (August 2016))

2016

Author's details	editor Ronald J. Oudiz
Series title	Cardiology clinics ; volume 34, number 3 (August 2016)
Collection
Language	English
Size	ix Seiten, Seite 359-505, Illustrationen
Publisher	Elsevier
Publishing place	Philadelphia, Pennsylvania
Publishing country	United States
Document type	Book
HBZ-ID	HT019088010
ISBN	978-0-323-45959-4 ; 0-323-45959-5
Database	Catalogue ZB MED Medicine, Health

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Article ; Online: Pulmonary Hypertension.

Oudiz, Ronald J

Cardiology clinics

2016 Volume 34, Issue 3, Page(s) ix

MeSH term(s)	Cardiology ; Heart Failure/etiology ; Humans ; Hypertension, Pulmonary/complications ; Periodicals as Topic ; Ventricular Dysfunction, Right/complications
Language	English
Publishing date	2016-08
Publishing country	Netherlands
Document type	Editorial
ZDB-ID	1196385-2
ISSN	1558-2264 ; 0733-8651
ISSN (online)	1558-2264
ISSN	0733-8651
DOI	10.1016/j.ccl.2016.05.001
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Article ; Online: Classification of Pulmonary Hypertension.

Oudiz, Ronald J

Cardiology clinics

2016 Volume 34, Issue 3, Page(s) 359–361

Abstract: The classification of pulmonary hypertension (PH) is an attempt to define subtypes of PH based on clinical presentation, underlying physiology, and treatment implications. Five groups of PH have been defined, and the classification scheme has been ... ...

Abstract	The classification of pulmonary hypertension (PH) is an attempt to define subtypes of PH based on clinical presentation, underlying physiology, and treatment implications. Five groups of PH have been defined, and the classification scheme has been refined over the years to guide clinicians in the diagnosis and management of PH. Understanding the classification of PH is paramount before embarking on a work-up of patients with PH or suspected PH because treatment and outcome can vary greatly.
MeSH term(s)	Humans ; Hypertension, Pulmonary/classification ; Hypertension, Pulmonary/physiopathology ; Pulmonary Wedge Pressure ; World Health Organization
Language	English
Publishing date	2016-08
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	1196385-2
ISSN	1558-2264 ; 0733-8651
ISSN (online)	1558-2264
ISSN	0733-8651
DOI	10.1016/j.ccl.2016.04.009
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Article ; Online: Death in pulmonary arterial hypertension.

Oudiz, Ronald J

American journal of respiratory and critical care medicine

2013 Volume 188, Issue 3, Page(s) 269–270

MeSH term(s)	Cause of Death ; Death, Sudden/etiology ; Familial Primary Pulmonary Hypertension ; Female ; Heart Failure/etiology ; Humans ; Hypertension, Pulmonary/mortality ; Male ; Risk Assessment
Language	English
Publishing date	2013-08-01
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	1180953-x
ISSN	1535-4970 ; 0003-0805 ; 1073-449X
ISSN (online)	1535-4970
ISSN	0003-0805 ; 1073-449X
DOI	10.1164/rccm.201305-0898ED
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Article: Using a knowledge translation program to facilitate guideline- and evidence-based patient management: the PAH-QuERI Extension Program.

McLaughlin, Vallerie V / Channick, Richard N / Lynum, Karimah S Bell / Oudiz, Ronald J / Selej, Mona / Tapson, Victor F / Rubin, Lewis J

Pulmonary circulation

2022 Volume 12, Issue 3, Page(s) e12134

Abstract: The Pulmonary Arterial Hypertension-Quality Enhancement Research Initiative Extension Program was designed to support physicians' adherence to pulmonary arterial hypertension (PAH) guidelines. Guidelines were followed in >95% of patients with functional ... ...

Abstract	The Pulmonary Arterial Hypertension-Quality Enhancement Research Initiative Extension Program was designed to support physicians' adherence to pulmonary arterial hypertension (PAH) guidelines. Guidelines were followed in >95% of patients with functional class (FC) II/III, but for only 28.6% of FC IV patients (Month 36). Low adherence was driven by FC IV patients' preference to avoid parenteral treatment.
Language	English
Publishing date	2022-07-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2638089-4
ISSN	2045-8940 ; 2045-8932
ISSN (online)	2045-8940
ISSN	2045-8932
DOI	10.1002/pul2.12134
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Article ; Online: Parenteral treprostinil induction for rapid attainment of therapeutic doses of oral treprostinil.

Miller, Chad E / Franco, Veronica / Smith, Jimmy S / Balasubramanian, Vijay / Kingrey, John / Zolty, Ronald / Melendres-Groves, Lana / Huston, Jessica / Elwing, Jean M / Ravichandran, Ashwin / Cella, Dana / Shen, Eric / Seaman, Scott / Thrasher, Claire M / Broderick, Meredith / Oudiz, Ronald J

Respiratory medicine

2023 Volume 218, Page(s) 107374

Abstract: Rationale: Oral treprostinil slows disease progression and improves exercise capacity in pulmonary arterial hypertension; however, titration can be prolonged. Published data suggests prostacyclin-naïve patients achieve total daily oral treprostinil ... ...

Abstract	Rationale: Oral treprostinil slows disease progression and improves exercise capacity in pulmonary arterial hypertension; however, titration can be prolonged. Published data suggests prostacyclin-naïve patients achieve total daily oral treprostinil doses of about 6 mg by Week 16, while those on prior parenteral treprostinil reach higher doses at the same timepoint. Objectives: EXPEDITE (NCT03497689), a single-arm, multicenter study, assessed the efficacy of rapid parenteral treprostinil induction to quickly reach higher doses of oral treprostinil for the treatment of pulmonary arterial hypertension. Methods: Parenteral treprostinil was titrated for 2-8 weeks, followed by cross-titration of oral treprostinil. The primary endpoint was percentage of patients reaching ≥12 mg daily of oral treprostinil at Week 16. Secondary endpoints included clinical changes from baseline to Week 16. Results: Twenty-nine prostacyclin-naïve patients were included in efficacy analyses. At Week 16, the mean daily oral treprostinil dose was 16.4 mg; 79% of patients met the primary endpoint. From baseline to Week 16, median REVEAL Lite 2 score improved (decreased) from 6 to 3.5 (p = 0.0006). Statistically significant improvements were also seen in World Health Organization Functional Class, N-terminal-pro brain natriuretic peptide levels, 6-minute walk distance, right atrial area, Borg Dyspnea Score, and emPHasis-10 score. Favorable trends were seen in risk stratification, echocardiography parameters, disease symptoms, and treatment satisfaction. Conclusion: Short-course parenteral treprostinil induction resulted in oral treprostinil doses over twice those reported in de novo initiations and may be a useful approach to quickly achieve the therapeutic benefits of oral treprostinil.
MeSH term(s)	Humans ; Antihypertensive Agents ; Epoprostenol ; Familial Primary Pulmonary Hypertension/drug therapy ; Hypertension, Pulmonary/drug therapy ; Pulmonary Arterial Hypertension/drug therapy ; Treatment Outcome
Chemical Substances	Antihypertensive Agents ; Epoprostenol (DCR9Z582X0) ; treprostinil (RUM6K67ESG)
Language	English
Publishing date	2023-08-01
Publishing country	England
Document type	Clinical Study ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	1003348-8
ISSN	1532-3064 ; 0954-6111
ISSN (online)	1532-3064
ISSN	0954-6111
DOI	10.1016/j.rmed.2023.107374
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Article: Implementing the EXPEDITE parenteral induction protocol: Rapid parenteral treprostinil titration and transition to oral treprostinil.

Kingrey, John F / Miller, Chad E / Franco, Veronica / Smith, Jimmy S / Zolty, Ronald / Oudiz, Ronald J / Elwing, Jean M / Huston, Jessica H / Melendres-Groves, Lana / Ravichandran, Ashwin / Balasubramanian, Vijay / Wu, Benjamin / Hwang, Stephanie / Seaman, Scott / Broderick, Meredith / Rahaghi, Franck F

Pulmonary circulation

2023 Volume 13, Issue 3, Page(s) e12255

Abstract: Treprostinil is a prostacyclin analogue that targets multiple cellular receptors to treat pulmonary arterial hypertension (PAH). In certain scenarios, patients may require aggressive treprostinil titration. Several studies have demonstrated that higher ... ...

Abstract	Treprostinil is a prostacyclin analogue that targets multiple cellular receptors to treat pulmonary arterial hypertension (PAH). In certain scenarios, patients may require aggressive treprostinil titration. Several studies have demonstrated that higher doses of treprostinil lead to greater clinical benefit. Data supports successful transitions from parenteral to oral treprostinil; however, administration routes, transition duration, and transition setting vary in the real-world. The EXPEDITE clinical trial (NCT03497689) prospectively studied whether rapid parenteral treprostinil induction can be used to achieve high doses of oral treprostinil (total daily dose: ≥12 mg) in prostacyclin naïve PAH patients. Parenteral prostacyclin induction may be more appropriate for patients who need to reach therapeutic dosing more urgently than longer titration durations reported with conventional de novo oral treprostinil initiation. This summary provides strategies utilized in EXPEDITE. Parenteral treprostinil was initiated at 2 ng/kg/min intravenously or subcutaneously; clinicians determined the frequency and dose increment of up-titration. Two distinct transition schedules from parenteral to oral treprostinil were employed: rapid cross-titration in an inpatient setting (median: 2 days) or gradual cross-titration in an outpatient setting (median: 5 days). Patient status was closely monitored after transition; oral treprostinil dose was titrated to clinical effect and tolerability. Factors considered when individualizing dosing strategies included parenteral and oral treprostinil target doses, nursing support, patient education, medication counseling and adverse events management. EXPEDITE demonstrated the time to a therapeutic dose of oral treprostinil is significantly shorter when utilizing a short-term parenteral induction strategy and may be suitable for patients requiring aggressive titration of oral treprostinil.
Language	English
Publishing date	2023-07-25
Publishing country	United States
Document type	Journal Article
ZDB-ID	2638089-4
ISSN	2045-8940 ; 2045-8932
ISSN (online)	2045-8940
ISSN	2045-8932
DOI	10.1002/pul2.12255
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Article: Pulmonary hypertension associated with left-sided heart disease.

Oudiz, Ronald J

Clinics in chest medicine

2007 Volume 28, Issue 1, Page(s) 233–41, x

Abstract: Pulmonary hypertension (PH) denotes a poor prognosis in patients with left-sided heart disease. No study has demonstrated long-term benefit from PH drugs such as prostanoids, endothelin antagonists, and phosphodiesterase-5 inhibitors. In some cases, ... ...

Abstract	Pulmonary hypertension (PH) denotes a poor prognosis in patients with left-sided heart disease. No study has demonstrated long-term benefit from PH drugs such as prostanoids, endothelin antagonists, and phosphodiesterase-5 inhibitors. In some cases, cautious use of PH drugs may be indicated. However, theoretic and practical concerns limit any formal recommendations.
MeSH term(s)	Antihypertensive Agents/therapeutic use ; Comorbidity ; Exercise Test ; Heart Diseases/epidemiology ; Heart Diseases/surgery ; Heart Transplantation ; Humans ; Hypertension, Pulmonary/classification ; Hypertension, Pulmonary/diagnosis ; Hypertension, Pulmonary/epidemiology ; Hypertension, Pulmonary/physiopathology ; Prognosis ; Ventricular Function, Left
Chemical Substances	Antihypertensive Agents
Language	English
Publishing date	2007-03
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	447455-7
ISSN	1557-8216 ; 0272-5231
ISSN (online)	1557-8216
ISSN	0272-5231
DOI	10.1016/j.ccm.2006.12.001
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Article ; Online: The ALPHA phase 1 study: pulmonary ArteriaL hypertension treated with CardiosPHere-Derived allogeneic stem cells.

Lewis, Michael I / Shapiro, Shelley / Oudiz, Ronald J / Nakamura, Mamoo / Geft, Dael / Matusov, Yuri / Hage, Antoine / Tapson, Victor F / Henry, Timothy D / Azizad, Parisa / Saggar, Rajan / Mirocha, James / Karpov, Oleg A / Van Eyk, Jennifer E / Marbán, Eduardo

EBioMedicine

2023 Volume 100, Page(s) 104900

Abstract: Background: Pulmonary Arterial Hypertension (PAH) is a progressive condition with no cure. Even with pharmacologic advances, survival remains poor. Lung pathology on PAH therapies still shows impressive occlusive arteriolar remodelling and plexiform ... ...

Abstract	Background: Pulmonary Arterial Hypertension (PAH) is a progressive condition with no cure. Even with pharmacologic advances, survival remains poor. Lung pathology on PAH therapies still shows impressive occlusive arteriolar remodelling and plexiform lesions. Cardiosphere-derived cells (CDCs) are heart-derived progenitor cells exhibiting anti-inflammatory and immunomodulatory effects, are anti -fibrotic, anti-oxidative and anti-apoptotic to potentially impact several aspects of PAH pathobiology. In preclinical trials CDCs reduced right ventricular (RV) systolic pressure, RV hypertrophy, pulmonary arteriolar wall thickness and inflammation. Methods: The ALPHA study was a Phase 1a/b study in which CDCs were infused into patients with Idiopathic (I)PAH, Heritable (H) HPAH, PAH-connective tissue disease (CTD) and PAH-human immunodeficiency virus (HIV). The study was IRB approved and DSMB monitored. Phase 1a, was an open label study (n = 6). Phase 1b was a double-blind placebo-controlled study (n = 20) in which half received 100 million CDCs (the maximum feasible dose from manufacturing perspective) and half placebo (PLAC) infusions. Right heart catheterization (RHC) and cardiac MR imaging (cMR) were performed at baseline and at 4 months post infusion. Patients were followed over a year. Findings: No short-term clinical safety adverse events (AE) were related to the IP, the primary outcome measure. There were no adverse hemodynamic, gas exchange, rhythm or other clinical events following infusion and in the 1st 23 h monitored in hospital. There were no long-term AEs over 12 months noted, including unrelated limited hospitalizations. No immunologic short or long-term AEs were noted. We examined exploratory outcomes across multiple domains to determine encouraging signals to motivate future advanced phase testing. Phase 1a data showed encouraging observations for both 50 and 100 million CDC doses. Several encouraging findings favouring CDCs (n = 16) compared to placebo (n = 10) were noted. On cMR, the RV end diastolic volume (RVEDV) and index (RVEDVI) decreased with CDCs with a rise in the PLAC group. The 6-min walk distance was increased 2 months post infusion in the CDC group compared with PLAC. With PLAC, diffusing capacity (DLCO) decreased at 4 months but was unchanged with CDCs. Serum creatinine decreased with CDCs at 4 months. Encouraging observations favouring CDCs were also noted for RV fractional area change on echo and RV ejection fraction (RVEF) on cMR at 4 months. No differences were observed for mean pulmonary artery pressures or pulmonary vascular resistance. Review of long-term data to 12 months showed continued decline in DLCO for the PLAC cohort at 6 months with no change through 12 months. By contrast, CDC subjects showed an unchanged DLCO over 12-months. For parameters exhibiting early encouraging exploratory findings in CDC subjects, no further improvement was noted in long-term follow up through 12 months. Interpretation: Intravenous CDCs were safe in both the short and long term in PAH subjects and thus may be safe in larger cohorts, in line with our extensive track record of safety in clinical trials for other conditions. Further, CDCs exhibited encouraging exploratory findings across several domains. Repeat dosing (quarterly, over one year) of intravenous CDCs has been reported to yield highly significant sustained disease-modifying bioactivity in subjects with advanced Duchenne muscular dystrophy. Because only single CDC doses were used here, the findings represent a lower limit estimate of CDC's potential in PAH. Upcoming phase 2 studies would logically use a repeat dosing paradigm. Funding: California Institute for Regenerative Medicine (CIRM). Project Number: CLIN2-09444.
MeSH term(s)	Humans ; Pulmonary Arterial Hypertension ; Heart ; Stroke Volume ; Hematopoietic Stem Cell Transplantation
Language	English
Publishing date	2023-12-12
Publishing country	Netherlands
Document type	Randomized Controlled Trial ; Clinical Trial, Phase I ; Journal Article
ZDB-ID	2851331-9
ISSN	2352-3964
ISSN (online)	2352-3964
DOI	10.1016/j.ebiom.2023.104900
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Article: Care of patients with pulmonary arterial hypertension during the coronavirus (COVID-19) pandemic.

Ryan, John J / Melendres-Groves, Lana / Zamanian, Roham T / Oudiz, Ronald J / Chakinala, Murali / Rosenzweig, Erika B / Gomberg-Maitland, Mardi

Pulmonary circulation

2020 Volume 10, Issue 2, Page(s) 2045894020920153

Abstract: The COVID-19 pandemic presents many unique challenges when caring for patients with pulmonary hypertension. The COVID-19 pandemic has altered routine standard of care practice and the acute management particularly for those patients with pulmonary ... ...

Abstract	The COVID-19 pandemic presents many unique challenges when caring for patients with pulmonary hypertension. The COVID-19 pandemic has altered routine standard of care practice and the acute management particularly for those patients with pulmonary arterial hypertension, where pulmonary arterial hypertension-specific treatments are used. It is important to balance the ongoing care and evaluation of pulmonary arterial hypertension patients with "exposure risk" to COVID-19 for patients coming to clinic or the hospital. If there is a morbidity and mortality benefit from starting pulmonary arterial hypertension therapies, for example in a patient with high-likelihood of pulmonary arterial hypertension, then it remains important to complete the thorough evaluation. However, the COVID-19 outbreak may also represent a unique time when pulmonary hypertension experts have to weigh the risks and benefits of the diagnostic work-up including potential exposure to COVID-19 versus initiating targeted pulmonary arterial hypertension therapy in a select high-risk, high likelihood World Symposium Pulmonary Hypertension Group 1 pulmonary arterial hypertension patients. This document will highlight some of the issues facing providers, patients, and the pulmonary arterial hypertension community in real-time as the COVID-19 pandemic is evolving and is intended to share expected common clinical scenarios and best clinical practices to help the community at-large.
Keywords	covid19
Language	English
Publishing date	2020-04-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	2638089-4
ISSN	2045-8940 ; 2045-8932
ISSN (online)	2045-8940
ISSN	2045-8932
DOI	10.1177/2045894020920153
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