Towards the 7th World Symposium: Highlights of the annual meeting of Pulmonary Hypertension Bologna, November 29-30, 2019 – An interview with Prof. Nazzareno Galié

Professor Galié, the annual meeting of Pulmonary Hypertension Bologna has just concluded. What was the goal of the meeting?

We have concluded the annual meeting of “Pulmonary Hypertension Bologna 2019”, and in two half days we have reviewed all the topics related to Pulmonary Hypertension.

The meeting was structured into different sessions. What was the main topic of discussion and the outcome of each session?

The first session was dedicated to classification and how to move forward from the proceedings of the 6th World Meeting. We concluded that, while the new definition is more logical, it is not affecting  the majority of patients. Another important topic to be discussed at the next World Meeting is the definition of a normal pulmonary capillary wedge pressure: Two definitions have been proposed, 12 mm Hg or 15 mm Hg, and it is time to reach a consensus on which definition is more appropriate.

The second session evaluated Pulmonary Hypertension in left heart disease and lung disease: these are the big two, since almost 90% of patients with Pulmonary Hypertension will have one (or both) of these two underlying conditions. Unfortunately, we have yet to develop efficacious treatment for these patients. It is likely that we need to move away from the drugs approved for PAH and explore other treatment options for these two other forms of Pulmonary Hypertension.

The third session was dedicated to PAH, during which we discussed risk stratification and treatment strategies. The potential for new medications was also explored and the development  programs for new drugs was discussed at length.

The fourth session focused on chronic thromboembolic Pulmonary Hypertension (CTEPH), a field in which we have recently experienced considerable progress, including  balloon pulmonary angioplasty, BPA, endarterectomy, and pharmacologic therapy, and studies have been initiated on how to best implement them alone or in combination. Experts in this field have proposed that a specific CTEPH team should be developed at centers with expertise in all three treatment strategies in order to optimize the management of this complex condition.

And finally, clinical cases were presented and discussed, including patients with PAH  at low, intermediate, or high-risk, and patients with congenital heart disease, chronic thromboembolic pulmonary hypertension, and connective tissue disease. The presentation and discussion of clinical cases was the perfect conclusion for this symposium because it reminds us that our focus is on patients and not just on lectures or algorithms.