Pulmonary Hypertension (Canada) Top 10

1. What are the specific mechanisms that lead to development of Pulmonary Arterial Hypertension?
2. How can PH be reversed or put into remission and how can we measure disease modification or reversal, clinically?
3. How can we predict which treatment or combination will work best for an individual PH patient (e.g. personalized medicine)?
4. What are the mechanisms of right heart adaptation to PH and right heart failure?
5. Which interventions or treatment strategies result in the best outcomes for patients with PH?
6. What is the role of the immune system and auto-immunity in the development of pulmonary arterial hypertension (PAH) and can treatments directed at the immune system help with PAH?
7. What are the best tools to predict progression of pulmonary hypertension and how fast the disease will progress?
8. What is the most effective and safe amount of exercise training for PH patients?
9. Are there biomarkers that allow early detection of PH?
10. Are stem cell therapies effective and safe for treating PH?

The following questions were also discussed and put in order of priority at the workshop: 

11. What is the underlying cause of idiopathic pulmonary arterial hypertension?
12. What are the mechanisms by which cardiac function continues to deteriorate despite an improvement in symptoms?
13. When a PH patient needs surgery what are the best anesthetic approaches and if general anesthesia is required, which anesthetics are safest?
14. How can we detect when the disease process  (pulmonary hypertension) starts and how long does it take for symptoms to develop after it starts?
15. What are the long-term consequences and complications in PH patients who are long term survivors?
16. How can the delay to diagnosis of PH be reduced?
17. For how long is PH treatment effective and will the effect wear off with time?
18. Is there a relationship between iron deficiency and the development or progression of pulmonary arterial hypertension and if so, does treatment of iron deficiency improve outcomes?
19. Can exercise testing be used to identify early PH and predict the risk of developing PH in the future?
20. How can the side effects of pulmonary hypertension therapies be managed or reduced?
21. What is the most accurate method to classify the severity or risk of a patient with PH?
22. Are there any harmful longterm effects of medications used for PH?
23. How can universal coverage for all PH medications be ensured in Canada?
24. Can educational interventions targeted at clinicians in-training, primary care and second line  (e.g. specialist) clinicians improve awareness of PH and lead to earlier diagnosis of PH?
25. How do COVID-19 and COVID-19 vaccinations affect people with PH?

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For full details of all of the questions identified by this PSP, please see the document below.