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Recommendations from the Association for European Paediatric and Congenital Cardiology for training in pulmonary hypertension

  • Hannes Sallmon (a1), Shahin Moledina (a2), Dimpna C. Albert (a3), Maurice Beghetti (a4), Rolf M. F. Berger (a5), Damien Bonnet (a6), Mila Bukova (a7), Martin Koestenberger (a8), Katharina Meinel (a8), Zdenka Reinhardt (a9), Robert M. R. Tulloh (a10), Daniel de Wolf (a11) and Georg Hansmann (a7)...

Abstract

Pulmonary hypertension is a complex and progressive condition that is either idiopathic or heritable, or associated with one or multiple health conditions, with or without congenital or acquired cardiovascular disease. Recent developments have tremendously increased the armamentarium of diagnostic and therapeutic approaches in children and young adults with pulmonary hypertension that is still associated with a high morbidity and mortality. These modalities include non-invasive imaging, pharmacotherapy, interventional and surgical procedures, and supportive measures. The optimal, tailored diagnostic and therapeutic strategies for pulmonary hypertension in the young are rapidly evolving but still face enormous challenges: Healthcare providers need to take the patient’s age, development, disease state, and family concerns into account when initiating advanced diagnostics and treatment. Therefore, there is a need for guidance on core and advanced medical training in paediatric pulmonary hypertension. The Association for European Paediatric and Congenital Cardiology working group “pulmonary hypertension, heart failure and transplantation” has produced this document as an expert consensus statement; however, all recommendations must be considered and applied in the context of the local and national infrastructure and legal regulations.

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Copyright

Corresponding author

Author for Correspondence: Prof. Dr Georg Hansmann, MD, PhD, FESC, FAHA, Department of Pediatric Cardiology and Critical Care, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Tel: + 49 511 532 9594; Fax: + 49 511 532 18533; E-mail: georg.hansmann@gmail.com

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On behalf of the Association for European Paediatric and Congenital Cardiology working group “Pulmonary Hypertension, Heart Failure, and Transplantation”.

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References

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1. Rosenzweig, EB, Abman, SH, Adatia, I, et al. Paediatric pulmonary arterial hypertension: updates on definition, classification, diagnostics and management. Eur Respir J 2019; 53: pii: 1801916.10.1183/13993003.01916-2018
2. Hansmann, G. Pulmonary hypertension in infants, children, and young adults. J Am Coll Cardiol 2017; 69: 25512569.
3. Ollivier, C, Sun, H, Amchin, W, et al. New strategies for the conduct of clinical trials in pediatric pulmonary arterial hypertension: Outcome of a multistakeholder meeting with patients, academia, industry, and regulators, held at the European Medicines Agency on Monday, June 12, 2017. J Am Heart Assoc 2019; 8: e011306.
4. Hansmann, G, Koestenberger, M, Alastalo, TP, et al. 2019 updated consensus statement on the diagnosis and treatment of pediatric pulmonary hypertension. The European Pediatric Pulmonary Vascular Disease Network (EPPVDN), endorsed by AEPC, ESPR and ISHLT. J Heart Lung Transplant. 2019; 38: 879901.
5. Hansmann, G, Apitz, C. Treatment of children with pulmonary hypertension. Expert consensus statement on the diagnosis and treatment of paediatric pulmonary hypertension. The European Paediatric Pulmonary Vascular Disease Network, endorsed by ISHLT and DGPK. Heart 2016; 102 Suppl 2: ii6785.
6. Abman, SH, Hansmann, G, Archer, SL, et al. Pediatric pulmonary hypertension: Guidelines from the American Heart Association and American Thoracic Society. Circulation 2015; 132: 2037–99.
7. Galiè, N, Humbert, M, Vachiery, JL, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J 2016; 37: 67119.
8. Hansmann, G, Apitz, C, Abdul-Khaliq, H, et al. Executive summary. Expert consensus statement on the diagnosis and treatment of paediatric pulmonary hypertension. The European Paediatric Pulmonary Vascular Disease Network, endorsed by ISHLT and DGPK. Heart 2016; 102 Suppl 2: ii86100.
9. Fukuda, K, Date, H, Doi, S, et al. Guidelines for the treatment of pulmonary hypertension (JCS 2017/JPCPHS 2017). Circ J 2019; 83: 842945.
10. Webber, SA, Pahl, E, Hsu, DT, et al. Task force 7: Paediatric cardiology fellowship training in pulmonary hypertension, advanced heart failure and transplantation. J Am Coll Cardiol 2015; 66: 732739.
11. Ross, RD, Brook, M, Koenig, P, et al. 2015 SPCTPD/ACC/AAP/AHA Training Guidelines for Pediatric Cardiology Fellowship Programs (Revision of the 2005 Training Guidelines for Pediatric Cardiology Fellowship Programs): Introduction. J Am Coll Cardiol 2015; 66: 672676.
12. Reinhardt, Z, Hansmann, G, O’Sullivan, J, et al. Recommendations from the Association for European Paediatric and Congenital Cardiology for clinical training in paediatric heart failure and transplantation. Cardiol Young 2018; 28: 12951298.

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Recommendations from the Association for European Paediatric and Congenital Cardiology for training in pulmonary hypertension

  • Hannes Sallmon (a1), Shahin Moledina (a2), Dimpna C. Albert (a3), Maurice Beghetti (a4), Rolf M. F. Berger (a5), Damien Bonnet (a6), Mila Bukova (a7), Martin Koestenberger (a8), Katharina Meinel (a8), Zdenka Reinhardt (a9), Robert M. R. Tulloh (a10), Daniel de Wolf (a11) and Georg Hansmann (a7)...

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