[Revised definition and classification of pulmonary hypertension].

Abstract

REVISED DEFINITION AND CLASSIFICATION OF PULMONARY HYPERTENSION. Pulmonary hypertension (PH) is a manifestation of a diverse group of diseases characterised by elevated mean pulmonary artery pressure (mPAP), measured by right heart catheterisation. The European Society of Cardiology (ESC) and European Respiratory Society (ERS) guidelines for the diagnosis and treatment of pulmonary hypertension, published in 2022, propose a new haemodynamic definition of PH by lowering the threshold for mPAP to 20 mmHg. Precapillary PH is now defined as mPAP > 20 mmHg associated with normal pulmonary artery wedge pressure (≤ 15 mmHg) and increased pulmonary vascular resistance (> 2 Wood units). These criteria were endorsed during the 7th World Symposium on Pulmonary Hypertension in 2024. The 2022 ESC/ERS guidelines also include a revision of the clinical classification of PH, maintaining the distinction between five entities based on the underlying pathophysiology.