Breathwork: Pulmonary Hypertension with Professor Sean Gaine (Part 2)

Irish Thoracic Society Podcast Productions

This week, we’re joined by Professor Seán Gaine, Ireland’s foremost expert in pulmonary hypertension. In this insightful episode, he shares his expert perspective on the diagnosis, classification, and clinical presentation of the condition, as well as the latest advances in treatment.

A must-listen for all healthcare professionals, Professor Gaine also discusses when to suspect pulmonary hypertension and highlights the nuances in the management of patients with pulmonary hypertension. Don’t miss this opportunity to learn from a global leader in the field.

Chapters

0:52 Rapid fire round on pulmonary hypertension

01:42 Definition of pulmonary hypertension

02:08 Signs and symptoms of pulmonary hypertension

02:56 Five groups of pulmonary hypertension

03:33 Group 1 pulmonary hypertension: Pulmonary arterial hypertension

04:34 Group 2 pulmonary hypertension: Left heart disease

05:23 Group 3 pulmonary hypertension: Chronic lung disease/hypoxia

05:58 Group 4 pulmonary hypertension: Pulmonary vascular obstruction

06:30 Group 5 pulmonary hypertension: Miscellaneous

07:25 Referral to the national pulmonary hypertension centre: right heart catheterisation

09:37 Work up in the pulmonary hypertension clinic

11:06 Risk stratification in pulmonary hypertension

12:06 Diagnostic criteria pulmonary hypertension

Dynamic testing right heart catheterisation: Cardiopulmonary exercise testing Reliability of right heart catheterisation

Treatment algorithm in pulmonary arterial hypertension Tripple therapy for high risk patients

Double combination therapy for non-high risk patients

Fourth treatment pathway, Quadruple therapy?: Sotatercept - an activin

scavenger Treatment options for groups 4 pulmonary hypertension: Balloon pulmonary angioplasty

Treatment options for groups 2, 3 and 5

Side effects of triple therapy

Lung transplant in pulmonary hypertension: Double or single lung transplant

Pitfalls in the acute management of patients with pulmonary hypertension

Interpretation of the B Natriuretic Peptide level

Medications contraindicated pulmonary hypertensions

Outcomes in pulmonary hypertension

Take home message on pulmonary hypertension

Show Notes

- https://lumen5.com/user/edofficer/sotatercept-emergin-d5jg6/

- Irish Thoracic Society Flashcard Pulmonary Hypertension

https://irishthoracicsociety.com/wp-content/uploads/2021/06/5.-Pulmonary-Hypertension.pdf

- Benza RL, Kanwar MK, Raina A, et al. Development and validation of an abridged version of the REVEAL 2.0 risk score calculator, REVEAL Lite 2, for use in patients with pulmonary arterial hypertension. Chest 2021; 159: 337–346.

- Humbert M, Kovacs G, Hoeper MM, Badagliacca R, Berger RMF, Brida M, et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. European Respiratory Journal. 2022:2200879.

DOI: https://doi.org/10.1183/13993003.00879-2022

- Chin KM, Gaine SP, Gerges C, Jing Z-C, Mathai SC, Tamura Y, et al. Treatment algorithm for pulmonary arterial hypertension. European Respiratory Journal. 2024;64(4):2401325. DOI: https://doi.org/10.1183/13993003.01325-2024

- Hoeper, M.M., Badesch, D.B., Ghofrani, H.A., Gibbs, J.S.R., GombergMaitland, M., McLaughlin, V.V. et al. (2023) ‘Phase 3 trial of sotatercept for treatment of pulmonary arterial hypertension’, New England Journal of Medicine, 388(17), pp. 1478–1490. Available at:

https://doi.org/10.1056/NEJMoa2213558

- Humbert M, McLaughlin VV, Badesch DB, Ghofrani HA, Gibbs JSR, Gomberg-Maitland M, et al. Sotatercept in Patients with Pulmonary Arterial Hypertension at High Risk for Death. N Engl J Med. 2025;392(20):1987-2000. DOI: 10.1056/NEJMoa2415160