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Vol. 61. Issue 10.
Pages 617-625 (October 2025)
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Vol. 61. Issue 10.
Pages 617-625 (October 2025)
SEPAR's Voice
A Systematic Review and Expert Recommendation on the Diagnosis of Pulmonary Hypertension Associated With Lung Disease: A Position Paper of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR)
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Diego A. Rodríguez-Chiaradíaa,
, Rodrigo Torres-Castrob, Lucilla Piccaria, Alberto García-Ortegac, Gregorio Miguel Perez-Peñated, Javier de Miguel-Díeze, Raquel Perez-Rojof, Irene Cano-Pumaregag,h, Víctor Mora-Cuestai,j, Isabel Blancok,l, Juan Marco Figueira-Gonçalvesm, Roberto del Pozon, Manuel López-Meseguero,j, Amaya Martínez-Meñacai,j, Andrés Tenesg,h, María Molina-Molinap, Joan Albert Barberàk,l
a Pulmonology Department, Hospital del Mar, Hospital del Mar Research Institute, Universitat Pompeu Fabra, CIBERES, (ISCIII), Barcelona, Spain
b Pulmonology Department, Hospital Clínic de Barcelona-FCRB-IDIBAPS, Universitat de Barcelona, Departamento de Kinesiología, Universidad de Chile, Santiago, Chile
c Pulmonology Department, Hospital Doctor Peset, Fundación para el Fomento de la Investigación Sanitaria de la Comunidad Valenciana (FISABIO), Valencia, Spain
d Pulmonary Vascular Unit, Pulmonology Department, Hospital Universitario de Gran Canaria “Dr Negrin”, Spain
e Pulmonology Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, CIBER de Enfermedades Respiratorias (CIBERES), Madrid, Spain
f Pulmonology Department, Hospital Universitario 12 de Octubre, Fundación Investigación Biomédica Hospital Universitario 12 de Octubre, Madrid, Spain
g Pulmonology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
h IRYCIS, Instituto Ramón y Cajal de investigación sanitaria, CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain
i Pulmonology Department, Hospital Universitario Marqués de Valdecilla – IDIVAL, Santander, Cantabria, Spain
j ERN-LUNG (European Reference Network on Rare Respiratory Diseases), Spain
k Pulmonology Department, Hospital Clínic de Barcelona-FCRB-IDIBAPS, Universitat de Barcelona, Spain
l CIBERES, ERN-LUNG (European Reference Network on Rare Respiratory Diseases), Spain
m Pulmonology Department, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
n Pulmonology Department, Hospital Juan Ramón Jiménez, Huelva, Spain
o Pulmonology Department, Hospital Vall d’Hebron, Barcelona, CIBERES, Spain
p Interstitial Lung Diseases Unit (UFIP), Pulmonology Department, Hospital Universitario de Bellvitge, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
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Tables (4)
Table 1. Recommendation regarding which clinical data should raise suspicions of PH in COPD, ILD and OHS.
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Table 2. Recommendations regarding which complementary tests could contribute to the detection of PH in COPD, ILD and OHS.
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Table 3. Echocardiographic signs suggestive of pulmonary hypertension.
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Table 4. Recommendation regarding when to perform RHC for diagnosis of PH in COPD, ILD or OHS.
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Abstract

Pulmonary hypertension (PH) is a common complication of chronic respiratory diseases (CRD) associated with increased morbidity and mortality. Early and individualized identification of PH in these patients is crucial to better understand the evolution of the disease and to assess the application of therapeutic measures aimed at its control. However, there is no consensus on how to approach the diagnostic process. The scarce scientific evidence in this field justifies the creation of this SEPAR position paper, which aims to become a tool to aid in the diagnosis of PH associated with CRD that facilitates decision making for the benefit of patients and the optimization of resources. A panel of 16 SEPAR experts has identified three critical questions. The answers to these questions were developed by the panel members, who were divided into three groups according to their expertise in the underlying disease in question: chronic obstructive pulmonary disease, interstitial lung disease and obesity hypoventilation syndrome. Prior to the discussion and drafting of the document by each group, a systematic review of the literature was performed according to the guidelines recommended by the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). We generated a schematic proposal adjusted to the characteristics of each disease for the diagnostic approach to PH associated with respiratory disease.

Keywords:
Screening
Early diagnosis
Pulmonary vascular disease
Chronic lung disease

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