Advances in Pulmonary Hypertension

Advances in Pulmonary Hypertension CME Section

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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 6 articles that review the outcomes of the 4th World Symposium on Pulmonary Hypertension.

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, 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:

  1. Review modifications from the 4th World Symposium on Pulmonary Hypertension in Dana Point, California
  2. Identify changes to the PH classification system and current understanding in genetics in PAH
  3. Understand the rationale behind current treatment guideline recommendations
  4. Assess latest recommendations in diagnosing PAH
  5. Know current understanding in secondary forms of PH

Self-Assessment Examination

See pages 87and 88 for self-assessment questions, answer key, and evaluation form.

Faculty

Chair
Myung H. Park, MD

Assistant Professor of Medicine
Director, Pulmonary Vascular Diseases Program
Division of Cardiology
University of Maryland School of Medicine
Baltimore, Maryland

Contributing Authors

Ivan M. Robbins, MD
Associate Professor of Medicine
Vanderbilt University School of Medicine

C. Gregory Elliott, MD
University of Utah School of Medicine
Murray, Utah

Adam Torbicki, MD, PhD
Department of Chest Medicine
Institute of Tuberculosis and Lung Diseases
Warsaw, Poland

Robyn J. Barst, MD
Professor Emerita
Columbia University
New York, NY

Marius M. Hoeper, MD
Department of Respiratory Medicine
University of Hannover Medical School
Hannover, Germany

Karen A. Fagan, MD
Chief, Division of Pulmonary and Critical Care
Medicine
University of South Alabama
Mobile, Alabama

Agenda

Epidemiology and Classification of Pulmonary Hypertension
Ivan M. Robbins, MD

Summary of Pulmonary Hypertension Genetics and Genomics
Greg Elliott, MD

Diagnosis and Assessment of Pulmonary Arterial Hypertension: A Glance at the Output From the Dana Point Conference
Adam Torbicki, MD, PhD

Updated Evidence-Based Treatment Algorithm in Pulmonary Arterial Hypertension
Robyn J. Barst, MD

Diagnosis, Assessment, and Treatment of Nonpulmonary Arterial Hypertension Pulmonary Hypertension
Marius M. Hoeper, MD

Future Perspectives for the Treatment of Pulmonary Arterial Hypertension
Karen A. Fagan, MD

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 87 to help physicians review important points. A form is also included on page 88 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 September 25, 2009 through September 25, 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., 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 participating 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.

Ivan Robbins, MD, has no declarable relationships.

C. Gregory Elliott, MD, has received grants from Pfizer, Encysive, Actelion, Eli Lilly/ICOS, and United Therapeutics for contracts on which he is the site principal investigator. He serves as a consultant to Actelion as a member of the steering committee for the REVEAL registry.

Adam Torbicki, MD, has served as a consultant for Eli Lilly, GSK, and mondoBiotech. He has received speakers' honoraria from Bayer Schering, Eli Lilly, and Sanofi- Aventis. He has conducted research supported by Actelion, Bayer Schering, Bristol-Meyers Squibb, Eli Lilly, GSK, mondoBiotech, and Pfizer.

Robyn J. Barst, MD, has received grants or outside funding from Actelion, GSK, Gilead, United Therapeutics, Pfizer, and Novartis. She is an advisory board member for Actelion, Pfizer, GSK, Gilead, and Eli Lilly. She has a paid consulting relationship with Actelion, Pfizer, Eli Lilly, GSK, and Gilead.

Marius M. Hoeper, MD, has received payments for speaking at conferences and consultancies from Actelion, Bayer, Gilead, GSK, Pfizer, LungRx, and Novartis.

Karen A. Fagan, MD, has received payments from Gilead for serving on a speaker panel, advisory board, and research committee.

Myung H. Park, MD, has received payment for serving as a consultant and advisory board member for Actelion, Gilead, and United Therapeutics. 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.