Advances in Pulmonary Hypertension CME Section

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 role of lung disease and hypoxia in 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. Appreciate the diversity of diseases in which PH is a determinant of functional limitation and prognosis.
  2. Understand which populations should be screened and the best diagnostic approaches for them.
  3. Realize the implications of PH in OSA related to functional capacity and prognosis.
  4. Appreciate diagnostic and management options for patients with pulmonary hypertension associated with pulmonary fibrosis, sarcoidosis, and COPD

Self-Assessment Examination

See pages 161 -162 for self-assessment questions, answer key, and evaluation form.

Faculty

Chair
Omar A. Minai, MD

Department of Pulmonary, Allergy and Critical Care Medicine
Cleveland Clinic
Cleveland, Ohio

Contributing Authors
Omar A. Minai, MD

Department of Pulmonary, Allergy and Critical Care Medicine
Cleveland Clinic
Cleveland, Ohio

AP Chua, MD
Department of Pulmonary, Allergy and Critical Care Medicine
Cleveland Clinic
Cleveland, Ohio

James R. Klinger, MD
Division of Pulmonary, Sleep and Critical Care Medicine
Rhode Island Hospital
Alpert Medical School of Brown University
Providence, Rhode Island

Reda E. Girgis, MB, BCh
Associate Professor
Division of Pulmonary and Critical Care Medicine
Johns Hopkins University
Baltimore, Maryland

Ioana R. Preston, MD
Tufts University Medical Center
Co-director, Pulmonary Hypertension Center
Tufts Medical Center
Boston, Massachusetts

Agenda

Pulmonary Hypertension in Obstructive Sleep Apnea Syndrome
AP Chua, MD, and Omar A. Minai, MD

Diagnosis and Management of Pulmonary Hypertension Associated with Pulmonary Fibrosis
James R. Klinger, MD

Pulmonary Hypertension Associated with Sarcoidosis
Reda B. Girgis, MB, BCh

Pulmonary Hypertension in Chronic Obstructive Pulmonary Disease: Diagnosis and Management
Ioana R. Preston, 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 ac-credited 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 161 to help physicians review important points. A form is also included on page 162 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 December 15, 2009 through December 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 edu-cational 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 participa- ting 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.

Omar A. Minai, MD, in the past 3 years has been a member of the scientific advisory boards for Actelion, United Therapeutics, Gilead, and Bayer. He has been a member of the speakers bureau for Actelion, United Therapeutics, and Gilead.

James R. Klinger, MD, in the past 3 years has received consulting fees and speaker honoraria from Actelion.

Reda B. Girgis, MB, BCh, in the past 3 years has received consulting fees from Actelion, Gilead, and United Therapeutics.

Ioana R. Preston, MD, has indicated no relevant financial or personal relationships to disclose.

AP Chua, MD, has indicated no relevant financial or personal relationships to disclose.

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.