Pulmonary Hypertension Clinical Trial
Official title:
Evaluation of Prognostic Factors and Therapeutic Targets in Pulmonary Arterial Hypertension
The objective of this clinical research is to analyze the survival of a cohort of patients newly diagnosed (incident cases) with idiopathic PAH, familial or associated with the use of anorectics (isolated pulmonary vascular disease without comorbidity) and identify prognostic factors using a dynamic model for predicting survival, including prognostic factors evaluated repeatedly at pre-specified periods during follow-up. In a second step, the investigators define using this model combinations of parameters to better define the therapeutic goals in PAH (functional class, exercise testing, hemodynamic, echocardiographic variables, biological parameters).
Pulmonary arterial hypertension (PAH) is a rare disease characterized by an intense
proliferation of pulmonary arterial wall causing increased progressive pulmonary vascular
resistance, leading to right heart failure and death. Established prognostic factors at
diagnosis were identified 20 years ago at a time when there is no specific treatment for
describing the natural history of disease.
Over the last 10 years, new therapeutic classes (similar to prostacyclin, antagonists of
endothelin receptors, inhibitors of phosphodiesterase 5) have been developed and improved
symptoms, exercise capacity, and hemodynamics in patients with PAH. With the availability of
these new molecules, the clinician is now faced with difficult treatment decisions regarding
the choice of initial treatment and the need for road treatments combined during evolution.
Therapeutic purpose and effect of these different therapeutic strategies on the long-term
survival remain poorly understood.
If it has been clearly demonstrated that clinical parameters (NYHA functional class),
functional (test 6-minute walk) and hemodynamic (cardiac output and pulmonary vascular
resistance) measured before initiation of treatment have a major role in determining the
prognosis, with the contribution of new molecules is important to evaluate the prognostic
value of changes in these factors during follow-up under specific treatment. At the baseline
assessment, including repeat cardiac catheterization rights, it is also important to
evaluate other prognostic criteria substitution, including methods of noninvasive evaluation
(echocardiography, biomarkers).
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Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Prevention
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