Preface Ten years ago, the prognosis of patients with pulmonary hypertension (PH) was poor. At that time, no pharmaceutical treatment was effective in all patients. This has changed dramatically with the introduction of inhaled prostacyclin as maintenance therapy. Endothelial antagonists and phosphodiesterase inhibitors, both based on pathophysiological considera- tions and used as monotherapy or in combination, have extended the spectrum of treatment possibilities. All of the drugs used have been shown to be efficient with regard to the different outcome measures, including haemodynamic parameters, exercise tolerance and life quality. As a result, observational studies have demonstrated an incredible increase in the life expectancy of patients with PH. When the development of new therapies began, idiopathic pulmonary arterial hypertension (IPAH) was the focus of research. The therapeutic success in this field initiated studies in patients with different forms of secondary PH, starting with PH associated with connective tissue disease, followed by patients with interstitial lung fibrosis or chronic thromboembolism, and then moving on to those with chronic obstructive pulmonary disease (COPD) or congestive heart failure. Huge randomised controlled trials have been performed for most of these indications, meaning it has been possible to establish very specific algorithms for diagnosis and treatment with regard to the baseline disease causing PH. Due to the intensive collaboration of PH researchers all over the world and a special effort within the PH community, guidelines have been developed and quickly corrected in the light of new experiences and findings, making PH an example of standardised management of disease on a worldwide scale. However, the story of PH continues. Basic research in PH has raised interesting new concepts for further treatment options. The pharmaceutical industry and public research institutes are also working together to consider different methods of diagnosis and treatment. And personalised medicine based on pathophysiological concepts and risk stratification is no longer just a vision, as work is underway to improve outcome of patients with PH. This issue of the European Respiratory Monograph summarises the current pathophysiology, diagnosis, and pharmacological and non-pharmacological treatment of PH. The best experts in the field have contributed to this book, which should be of interest not only to basic scientists and clinicians, but also to those in the pharmaceutical industry, as it provides in-depth consideration of the future of PH. The issue is also the first to include continuing medical education (CME) questions (accredited by the European Board for Accreditation in Pneumology (EBAP)), meaning it will be particularly attractive to those in training. To earn 5 CME credits, simply read the issue and answer the questions at the back of the book and provided online. I want to personally congratulate the Guest Editors of this excellent Monograph, which provides an excellent overview of PH. Marius and Marc, thank you very much for a fantastic collaboration. I am convinced that this Monograph will be a major success. Editor in Chief Tobias Welte Eur Respir Monogr 2012 57: vi. Copyright ERS 2012. DOI: 10.1183/1025448x.10024312. Print ISBN: 978-1-84984-025-5. Online ISBN: 978-1-84984-026-2. Print ISSN: 1025-448x. Online ISSN: 2075-6674. vi
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