Consensus Statement
Standards of Care in Pulmonary Hypertension*
Joan Albert Barberàa,**, Pilar Escribanob,**, Pilar Moralesc, Miguel Ángel Gómezb, Mikel Oribed, Ángel Martíneze, Antonio Románf, Javier Segoviag, Francisco Santosh, María Teresa Subiranai
a Servicio de Neumología, Hospital Clínic, Barcelona, Spain
b Servicio de Cardiología, Hospital 12 de Octubre, Madrid, Spain
c Unidad de Trasplante Pulmonar, Hospital La Fe, Valencia, Spain
d Servicio de Neumología, Hospital de Galdakao, Galdakao, Vizcaya, Spain
e Servicio de Cardiología, Hospital Virgen del Rocío, Sevilla, Spain
f Servicio de Neumología, Hospital Vall d'Hebron, Barcelona, Spain
g Servicio de Cardiología, Hospital Puerta de Hierro, Madrid, Spain
h Servicio de Neumología, Hospital Reina Sofía, Córdoba, Spain
i Servicio de Cardiología, Hospital de Sant Pau, Barcelona, Spain
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Rocío, Sevilla, Spain" "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff5" ] 5 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Vall d'Hebron, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">f</span>" "identificador" => "aff6" ] 6 => array:3 [ "entidad" => "Servicio de Cardiología, Hospital Puerta de Hierro, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">g</span>" "identificador" => "aff7" ] 7 => array:3 [ "entidad" => "Servicio de Neumología, Hospital Reina Sofía, Córdoba, Spain" "etiqueta" => "<span class="elsevierStyleSup">h</span>" "identificador" => "aff8" ] 8 => array:3 [ "entidad" => "Servicio de Cardiología, Hospital de Sant Pau, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">i</span>" "identificador" => "aff9" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec155163" "palabras" => array:4 [ 0 => "Pulmonary hypertension: diagnosis and therapy" 1 => "Antihypertensive agents" 2 => "Lung transplantation" 3 => "Clinical practice guidelines" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155162" "palabras" => array:5 [ 0 => "Hipertensión pulmonar" 1 => "diagnóstico y tratamiento" 2 => "Agentes antihipertensivos" 3 => "Trasplante pulmonar" 4 => "Guías de práctica clínica" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Substantial progress in the diagnosis and treatment of patients with pulmonary hypertension in recent years has led to significant improvement in survival. Evidence-based clinical practice guidelines issued by scientific societies reflect these new developments. However, certain clinically relevant issues have not been covered in consensus guidelines because of the lack of conclusive scientific evidence. Therefore, the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and the Spanish Society of Cardiology (SEC) have promoted the present consensus statement in order to define national standards of care in the evaluation and management of pulmonary hypertension in its various forms, as well as to outline a clinical pathway and the basic principles for organizing health care in this clinical setting, with special emphasis on the requirements for and functions of specialized referral units. To prepare the statement, SEPAR and SEC formed a task force composed of national experts in various aspects of pulmonary hypertension. The resulting consensus is based on international clinical guidelines, a review of available scientific evidence, and panel discussion among the task force members. The final statement, approved by all participants, underwent external review.</p>" ] "es" => array:1 [ "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">En los últimos años se han producido importantes avances en el diagnóstico y tratamiento de la hipertensión pulmonar que han logrado una mejoría significativa en la supervivencia de esta enfermedad. Estas innovaciones se han recogido en guías de práctica clínica basadas en la evidencia elaboradas por las sociedades científicas. Sin embargo, no se incluyen en ellas, por falta de evidencia científica concluyente, algunos aspectos que inciden en la práctica asistencial. Conscientes de ello, la Sociedad Española de Neumología y Cirugía Torácica (SEPAR) y la Sociedad Española de Cardiología (SEC) han promovido la elaboración de un documento de consenso para definir en nuestro medio los estándares de calidad adecuados para el diagnóstico y tratamiento de la hipertensión pulmonar en sus diversas formas de presentación, así como la vía clínica y las directrices básicas de la organización asistencial del cuidado de estos pacientes, haciendo especial hincapié en los requisitos y funciones de las unidades de referencia. Para su redacción la SEPAR y la SEC designaron a un grupo de trabajo formado por expertos en los distintos aspectos de la enfermedad. Para la elaboración del documento se han utilizado las guías clínicas internacionales existentes, la revisión de la evidencia científica disponible y el debate en panel entre los expertos. El documento final, aprobado por todos los participantes, ha sido evaluado por revisores externos.</p>" ] ] "NotaPie" => array:3 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">The work leading to this consensus statement was funded by unrestricted grants received by the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and the Spanish Society of Cardiology (SEC) from the following companies: Actelion Pharmaceuticals España, Ferrer Grupo, GlaxoSmithKline, Pfizer, and Schering España.</p>" ] 1 => array:2 [ "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara">The original Spanish article was published simultaneously in Rev Esp Cardiol. 2008;161(2): 170–84.</p>" ] 2 => array:2 [ "etiqueta" => "**" "nota" => "<p class="elsevierStyleNotepara">Coordinators</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:19 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guías de práctica clínica sobre el diagnóstico y tratamiento de la hipertensión pulmonar" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N Galie" 1 => "A Torbicki" 2 => "R Barst" 3 => "P Dartevelle" 4 => "S Haworth" 5 => "T Higenbottam" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Esp Cardiol" "fecha" => "2005" "volumen" => "58" "paginaInicial" => "523" "paginaFinal" => "566" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15899198" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis and management of pulmonary arterial hypertension: ACCP evidence-based clinical practice guidelines" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "American College of Chest Physicians" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Chest" "fecha" => "2004" "volumen" => "126" "paginaInicial" => "S1" "paginaFinal" => "S92" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Medical therapy for pulmonary arterial hypertension. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 7 | 9 | 16 |
| 2024 October | 32 | 10 | 42 |
| 2024 September | 39 | 12 | 51 |
| 2024 August | 49 | 31 | 80 |
| 2024 July | 26 | 21 | 47 |
| 2024 June | 53 | 19 | 72 |
| 2024 May | 54 | 29 | 83 |
| 2024 April | 23 | 24 | 47 |
| 2024 March | 30 | 17 | 47 |
| 2024 February | 25 | 17 | 42 |
| 2023 March | 2 | 3 | 5 |
| 2023 February | 17 | 14 | 31 |
| 2023 January | 20 | 24 | 44 |
| 2022 December | 23 | 25 | 48 |
| 2022 November | 15 | 17 | 32 |
| 2022 October | 25 | 27 | 52 |
| 2022 September | 19 | 28 | 47 |
| 2022 August | 17 | 40 | 57 |
| 2022 July | 20 | 37 | 57 |
| 2022 June | 22 | 29 | 51 |
| 2022 May | 19 | 32 | 51 |
| 2022 April | 21 | 25 | 46 |
| 2022 March | 17 | 29 | 46 |
| 2022 February | 14 | 25 | 39 |
| 2022 January | 20 | 28 | 48 |
| 2021 December | 21 | 55 | 76 |
| 2021 November | 18 | 55 | 73 |
| 2021 October | 29 | 44 | 73 |
| 2021 September | 35 | 56 | 91 |
| 2021 August | 18 | 37 | 55 |
| 2021 July | 13 | 18 | 31 |
| 2021 June | 12 | 19 | 31 |
| 2021 May | 23 | 21 | 44 |
| 2021 April | 50 | 35 | 85 |
| 2021 March | 14 | 21 | 35 |
| 2021 February | 9 | 19 | 28 |
| 2021 January | 14 | 12 | 26 |
| 2020 December | 9 | 8 | 17 |
| 2020 November | 15 | 12 | 27 |
| 2020 October | 13 | 6 | 19 |
| 2020 September | 10 | 4 | 14 |
| 2020 August | 66 | 6 | 72 |
| 2020 July | 35 | 15 | 50 |
| 2020 June | 10 | 6 | 16 |
| 2020 May | 25 | 11 | 36 |
| 2020 April | 43 | 17 | 60 |
| 2020 March | 11 | 5 | 16 |
| 2020 February | 17 | 13 | 30 |
| 2020 January | 22 | 10 | 32 |
| 2019 December | 29 | 11 | 40 |
| 2019 November | 9 | 5 | 14 |
| 2019 October | 4 | 4 | 8 |
| 2019 September | 10 | 9 | 19 |
| 2019 August | 9 | 4 | 13 |
| 2019 July | 18 | 20 | 38 |
| 2019 June | 7 | 4 | 11 |
| 2019 May | 6 | 14 | 20 |
| 2019 April | 20 | 15 | 35 |
| 2019 March | 9 | 14 | 23 |
| 2019 February | 9 | 9 | 18 |
| 2019 January | 7 | 6 | 13 |
| 2018 December | 8 | 10 | 18 |
| 2018 November | 15 | 14 | 29 |
| 2018 October | 42 | 18 | 60 |
| 2018 September | 22 | 6 | 28 |
| 2018 May | 8 | 0 | 8 |
| 2018 April | 8 | 8 | 16 |
| 2018 March | 2 | 4 | 6 |
| 2018 February | 7 | 7 | 14 |
| 2018 January | 7 | 5 | 12 |
| 2017 December | 6 | 5 | 11 |
| 2017 November | 5 | 5 | 10 |
| 2017 October | 4 | 6 | 10 |
| 2017 September | 8 | 5 | 13 |
| 2017 August | 11 | 11 | 22 |
| 2017 July | 15 | 10 | 25 |
| 2017 June | 24 | 12 | 36 |
| 2017 May | 9 | 6 | 15 |
| 2017 April | 8 | 4 | 12 |
| 2017 March | 6 | 3 | 9 |
| 2017 February | 7 | 3 | 10 |
| 2017 January | 3 | 3 | 6 |
| 2016 December | 4 | 4 | 8 |
| 2016 November | 13 | 5 | 18 |
| 2016 October | 12 | 4 | 16 |
| 2016 September | 4 | 2 | 6 |
| 2016 August | 8 | 6 | 14 |
| 2016 July | 6 | 0 | 6 |
| 2016 March | 2 | 0 | 2 |
| 2015 December | 3 | 0 | 3 |
| 2015 October | 55 | 12 | 67 |
| 2015 September | 67 | 10 | 77 |
| 2015 August | 50 | 15 | 65 |
| 2015 July | 96 | 11 | 107 |
| 2015 June | 54 | 11 | 65 |
| 2015 May | 62 | 24 | 86 |
| 2015 April | 56 | 10 | 66 |
| 2015 March | 58 | 7 | 65 |
| 2015 February | 38 | 5 | 43 |
| 2015 January | 41 | 5 | 46 |
| 2014 December | 48 | 4 | 52 |
| 2014 November | 60 | 9 | 69 |
| 2014 October | 71 | 9 | 80 |
| 2014 September | 49 | 8 | 57 |
| 2014 August | 59 | 18 | 77 |
| 2014 July | 59 | 10 | 69 |
| 2014 June | 73 | 12 | 85 |
| 2014 May | 71 | 18 | 89 |
| 2014 April | 79 | 13 | 92 |
| 2014 March | 69 | 12 | 81 |
| 2014 February | 60 | 10 | 70 |
| 2014 January | 48 | 13 | 61 |
| 2013 December | 53 | 11 | 64 |
| 2013 November | 55 | 12 | 67 |
| 2013 October | 63 | 16 | 79 |
| 2013 September | 55 | 9 | 64 |
| 2013 August | 59 | 16 | 75 |
| 2013 July | 62 | 23 | 85 |
| 2013 June | 51 | 15 | 66 |
| 2013 May | 55 | 8 | 63 |
| 2013 April | 44 | 8 | 52 |
| 2013 March | 10 | 4 | 14 |
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