Advances in Pulmonary Hypertension CME Section
Faculty
Francisco J. Soto, MD, MS
Pulmonary and Critical Care Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
Contributing Authors
Stephen C. Mathai, MD, MHS
Paul M. Hassoun, MD
Johns Hopkins University School of Medicine, Department of Medicine, Division of Pulmonary and Critical Care Medicine, Baltimore, MD
James F. Kleczka, MD
Cardiovascular Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
Ravi Desai, MD
Himanshu Gupta, MD
Department of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, Alabama
Fernando Torres, MD
UT Southwestern Dallas
Agenda
The Role of Echocardiography in the Diagnosis and Assessment of Pulmonary Hypertension
Stephen C. Mathai, MD, MHS
Paul M. Hassoun, MD
Cardiopulmonary Hemodynamics in Pulmonary Hypertension: Pressure Tracings, Waveforms, and More
Francisco J. Soto, MD, MS
James F. Kleczka, MD
Role of Cardiac MRI in Pulmonary Hypertension
Ravi Desai, MD
Fernando Torres, MD
Himanshu Gupta, MD
Program Overview
Pulmonary arterial hypertension (PAH), an incurable disease, is characterized by medial hypertrophy, intimal fibrosis, and in situ thrombi in small muscular pulmonary arteries. PAH was considered a rapidly fatal illness with a median survival of 2.8 years in the 1980s when no evidence-based therapies were available. Since then the treatment of this disease has made tremendous advances, and the last 10 years have seen the discovery of new medications that have positively influenced the prognosis and survival of patients with PAH.
This self-study activity is based on 4 articles that review the latest information on new information on diagnostic modalities from clinical trials.
This activity is jointly sponsored by the University of Michigan Medical School and the Pulmonary Hypertension Association and supported by an unrestricted education grant from Actelion Pharmaceuticals US, Inc, Encysive Pharmaceuticals, Inc, Gilead Sciences, Inc, Pfizer, Inc, and United Therapeutics Corporation.
Target Audience
This self-study activity is appropriate for cardiologists, pulmonologists, rheumatologists, and other physicians who treat patients with pulmonary hypertension.
Learning Objectives
Upon completion of this activity participants will be able to:
- Describe the common echocardiographic measurements and techniques to evaluate cardiac performance and severity of disease in pulmonary arterial hypertension (PAH)
- Learn the recommended methodology to identify the A and V waveforms of a pulmonary capillary wedge pressure (PCWP) tracing and measure a mean PCWP and pulmonary artery pressure following the guidelines of pulmonary artery catheter education project (www.pacep.org)
- Describe therapeutic challenges and trials that can be performed during a right heart catheterization to unmask impaired left ventricular compliance and its role in the patient's pulmonary hypertension
- Summarize the role of cardiac magnetic resonance imaging for the assessment of pulmonary vascular disease and the evaluation of right ventricular performance in PAH
- Discuss the current status of continuous intravascular pulmonary hemodynamic monitoring through an implantable device in patients with PAH.
Self-Assessment Examination
See pages 409 and 410 for self-assessment questions, answer key, and evaluation form.
Accreditation Statement
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the University of Michigan Medical School and the Pulmonary Hypertension Association. The University of Michigan is accredited by the ACCME to provide continuing medical education to physicians.
Credit Designation
The University of Michigan Medical School designates this activity for a maximum of 2.0 AMA PRA Category 1 CreditsTM. Physicians should claim credit commensurate with the extent of their participation in the activity.
Instructions for Earning Credit
This activity is a self-study program; a self-assessment examination is included on page 409 to help physicians review important points. A form is also included on page 410 for physicians to evaluate the CME activity. Completion of this activity involves reading the journal and completing the self-assessment examination and evaluation form, which may take up to 2 hours. Credits for this self-study program are available from April 15, 2009 through April 15, 2010. There is no fee for this program.
Please note that this self-study program may also be viewed online at: http://www.cme.med.umich.edu
University of Michigan Privacy Statement
http://www.cme.med.umich.edu/privacy.asp
Sponsorship
This CME self-study program is jointly sponsored by the University of Michigan Medical School and the Pulmonary Hypertension Association.
Support
This CME self-study program is supported by an educational grant from Actelion Pharmaceuticals US, Inc., Encysive Pharmaceuticals, Inc., Gilead Sciences, Inc., Pfizer, Inc., and United Therapeutics Corporation.
Oversight and Accreditation
Arlene Bradford, BA
Assistant Director
Office of CME
University of Michigan Medical School
Disclosures
The Accreditation Council for Continuing Medical Education and the Association of American Colleges have standards and guidelines to ensure that individuals partici- pating in CME activities are aware of relationships between authors and commercial companies that could potentially affect the information presented. To be disclosed to participants are all personal financial relationships with a commercial interest whose products are relevant to the content of this CME activity. The University of Michigan Medical School follows these national policies to ensure balance, independence, objectivity, and scientific rigor in all its CME activities. Each author was asked to complete a disclosure information form for this activity. Disclosures are reported below.
Francisco J. Soto, MD, in the past 12 months has had no relevant personal financial relationship with regard to the content of this CME activity.
Stephen C. Mathai, MD, MHS, in the past 12 months has had no relevant personal financial relationship with regard to the content of this CME activity.
Paul M. Hassoun, MD, in the past 12 months has had no relevant personal financial relationship with regard to the content of this CME activity.
James F. Kleczka, MD, in the past 12 months has had no relevant personal financial relationship with regard to the content of this CME activity.
Ravi Desai, MD, in the past 12 months has had no relevant personal financial relationship with regard to the content of this CME activity.
Fernando Torres, MD, in the past 12 months has had no relevant personal financial relationship with regard to the content of this CME activity.
Himanshu Gupta, MD, in the past 12 months has had no relevant personal financial relationship with regard to the content of this CME activity.
Arlene Bradford, BA, has no relevant personal financial relationships to disclose.
CME Reviewer
Kevin M. Chan, MD
Assistant Professor of Medicine
Division of Pulmonary and Critical Care Medicine
University of Michigan Health Systems
Ann Arbor, Michigan
Dr Chan has no relevant personal financial relationships to disclose.