Haemodynamic Partial Remission as a Prognostic Target in Pulmonary Arterial Hypertension

Extract Pulmonary arterial hypertension (PAH) is a chronic, progressive disease in which increased pulmonary vascular resistance (PVR) and elevated mean pulmonary arterial pressure (mPAP) lead to right ventricular (RV) dysfunction, the major determinant of mortality [1]. Although advances in targeted therapies have improved survival, pragmatic and clinically meaningful haemodynamic treatment goals remain needed [2]. Reductions in PVR and mPAP correlate with RV recovery and better long-term outcomes, as described after the initiation of pulmonary vasodilators and specially after lung transplant in PAH, and in the context of chronic thromboembolic pulmonary hypertension after successful interventional treatment [3, 4, 5]. The concept of haemodynamic partial remission (PR)—a profound reduction of afterload without full normalisation—has gained interest, but its prevalence and prognostic relevance have not been well defined [6]. This study evaluates PR in a large contemporary cohort of patients with PAH.