Klassifikasjon (WHO)

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Condensed clinical classification (2008) of pulmonary hypertension (updated from Simonneau et al.)

1. Pulmonary arterial hypertension (PAH)

1.1 Idiopathic
1.2 Heritable
1.2.1 BMPR2 mutation
1.2.2 Other mutations
1.3 Drugs and toxins induced
1.4 Associated with:
1.4.1 Connective tissue disease
1.4.2 HIV infection
1.4.3 Portal hypertension
1.4.4 Congenital heart disease (Table 6)
1.4.5 Schistosomiasis

1’. Pulmonary veno-occlusive disease and/or pulmonarycapillary haemangiomatosis

1”. Persistent pulmonary hypertension of the newborn

2. Pulmonary hypertension due to left heart disease

2.1 Left ventricular systolic dysfunction
2.2 Left ventricular diastolic dysfunction
2.3 Valvular disease
2.4 Congenital / aquired left heart inflow/outflow tract obstruction and congenital cardiomyopathies
2.5 Other

3. Pulmonary hypertension due to lung diseases and/or hypoxia

3.1 Chronic obstructive pulmonary disease
3.2 Interstitial lung disease
3.3 Other pulmonary diseases with mixed restrictive and obstructive pattern
3.4 Sleep-disordered breathing
3.5 Alveolar hypoventilation disorders
3.6 Chronic exposure to high altitude
3.7 Developmental lung diseases (Web Table III)

4. Chronic thromboembolic pulmonary hypertension and other pulmonary artery obstructions

4.1 Chronic thromboembolic pulmonary hypertension
4.2 Other pulmonary artery obstructions

5. Pulmonary hypertension with unclear and/or multifactorial mechanisms

5.1 Haematological disorders
5.2 Systemic disorders
5.3 Metabolic disorders
5.4 Others

Referanser: 2015 ESC/ERS clinical guidelines on the diagnosis and treatment of pulmonary hypertension: https://www.escardio.org/static_file/Escardio/Guidelines/Publications/PAH/2015%20ESC-ERS%20Gles%20PH-Web%20addenda-ehv317.pdf

 

The Venice 2003 Revised Classification system

  • WHO Group I – Pulmonary arterial hypertension (PAH)
  • Idiopathic (IPAH)
  • Familial (FPAH)
  • Associated with other diseases (APAH): collagen vascular disease (e.g. scleroderma), congenital shunts between the systemic and pulmonary circulation, portal hypertension, HIV infection, drugs, toxins, or other diseases or disorders

Associated with venous or capillary disease
WHO Group II – Pulmonary hypertension associated with left heart disease

  • Atrial or ventricular disease
  • Valvular disease (e.g. mitral stenosis)

WHO Group III – Pulmonary hypertension associated with lung diseases and/or hypoxemia

  •  Chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD)
  • Sleep-disordered breathing, alveolar hypoventilation
  • Chronic exposure to high altitude
  • Developmental lung abnormalities

WHO Group IV – Pulmonary hypertension due to chronic thrombotic and/or embolic disease

  •  Pulmonary embolism in the proximal or distal pulmonary arteries
  • Embolization of other matter, such as tumor cells or parasites

WHO Group V – Miscellaneous