Breathwork: Pulmonary Hypertension with Professor Sean Gaine (Part 2)

07/07/2025 39 min
Breathwork: Pulmonary Hypertension with Professor Sean Gaine (Part 2)

Listen "Breathwork: Pulmonary Hypertension with Professor Sean Gaine (Part 2)"

Episode Synopsis

This week, we’re joined by Professor Seán Gaine, Ireland’s foremost expert in pulmonary hypertension. In this insightful episode, he shares his expert perspective on the diagnosis, classification, and clinical presentation of the condition, as well as the latest advances in treatment.

A must-listen for all healthcare professionals, Professor Gaine also discusses when to suspect pulmonary hypertension and highlights the nuances in the management of patients with pulmonary hypertension. Don’t miss this opportunity to learn from a global leader in the field.



Chapters

0:52 Rapid fire round on pulmonary hypertension

01:42 Definition of pulmonary hypertension

02:08 Signs and symptoms of pulmonary hypertension

02:56 Five groups of pulmonary hypertension

03:33 Group 1 pulmonary hypertension: Pulmonary arterial hypertension

04:34 Group 2 pulmonary hypertension: Left heart disease

05:23 Group 3 pulmonary hypertension: Chronic lung disease/hypoxia

05:58 Group 4 pulmonary hypertension: Pulmonary vascular obstruction

06:30 Group 5 pulmonary hypertension: Miscellaneous

07:25 Referral to the national pulmonary hypertension centre: right heart catheterisation

09:37 Work up in the pulmonary hypertension clinic

11:06 Risk stratification in pulmonary hypertension

12:06 Diagnostic criteria pulmonary hypertension

Dynamic testing right heart catheterisation: Cardiopulmonary exercise testing Reliability of right heart catheterisation



Treatment algorithm in pulmonary arterial hypertension Tripple therapy for high risk patients



Double combination therapy for non-high risk patients



Fourth treatment pathway, Quadruple therapy?: Sotatercept - an activin

scavenger Treatment options for groups 4 pulmonary hypertension: Balloon pulmonary angioplasty



Treatment options for groups 2, 3 and 5



Side effects of triple therapy



Lung transplant in pulmonary hypertension: Double or single lung transplant



Pitfalls in the acute management of patients with pulmonary hypertension



Interpretation of the B Natriuretic Peptide level



Medications contraindicated pulmonary hypertensions



Outcomes in pulmonary hypertension



Take home message on pulmonary hypertension



Show Notes

- https://lumen5.com/user/edofficer/sotatercept-emergin-d5jg6/

- Irish Thoracic Society Flashcard Pulmonary Hypertension

https://irishthoracicsociety.com/wp-content/uploads/2021/06/5.-Pulmonary-Hypertension.pdf

- Benza RL, Kanwar MK, Raina A, et al. Development and validation of an abridged version of the REVEAL 2.0 risk score calculator, REVEAL Lite 2, for use in patients with pulmonary arterial hypertension. Chest 2021; 159: 337–346.



- Humbert M, Kovacs G, Hoeper MM, Badagliacca R, Berger RMF, Brida M, et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. European Respiratory Journal. 2022:2200879.

DOI: https://doi.org/10.1183/13993003.00879-2022



- Chin KM, Gaine SP, Gerges C, Jing Z-C, Mathai SC, Tamura Y, et al. Treatment algorithm for pulmonary arterial hypertension. European Respiratory Journal. 2024;64(4):2401325. DOI: https://doi.org/10.1183/13993003.01325-2024



- Hoeper, M.M., Badesch, D.B., Ghofrani, H.A., Gibbs, J.S.R., GombergMaitland, M., McLaughlin, V.V. et al. (2023) ‘Phase 3 trial of sotatercept for treatment of pulmonary arterial hypertension’, New England Journal of Medicine, 388(17), pp. 1478–1490. Available at:

https://doi.org/10.1056/NEJMoa2213558



- Humbert M, McLaughlin VV, Badesch DB, Ghofrani HA, Gibbs JSR, Gomberg-Maitland M, et al. Sotatercept in Patients with Pulmonary Arterial Hypertension at High Risk for Death. N Engl J Med. 2025;392(20):1987-2000. DOI: 10.1056/NEJMoa2415160

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