TY - JOUR T1 - Treat-to-target approach in pulmonary arterial hypertension: a consensus-based proposal JF - European Respiratory Review JO - EUROPEAN RESPIRATORY REVIEW SP - 259 LP - 262 DO - 10.1183/09059180.00003612 VL - 21 IS - 125 AU - Olivier Sitbon AU - Adolfo Baloira Villar AU - Fabrice Bauer AU - Björn Ekmehag AU - Wendy Gin-Sing AU - Kjell Jansson AU - David G. Kiely AU - Hanno Leuchte AU - Alessandra Manes AU - Stephan Rosenkranz AU - Pilar Escribano Y1 - 2012/09/01 UR - http://err.ersjournals.com/content/21/125/259.abstract N2 - To the Editor:Goal-oriented therapy, also known as treat-to-target therapy, is recommended in the European Society of Cardiology (ESC)/European Respiratory Society (ERS) guidelines for the diagnosis and treatment of pulmonary hypertension [1, 2]. This approach, first described by Hoeper et al. [3], has emerged, alongside early detection, as a central aspect of managing pulmonary arterial hypertension (PAH). Goal-oriented therapy is proactive as it defines treatment goals ahead of time and proposes to alter the treatment strategy if those goals are not met.In a review article on goal-oriented therapy in PAH by Sitbon and Galiè [4], the authors noted that existing treatment goals are mainly based on parameters with prognostic value at baseline and highlighted the need for additional data to identify goals that have prognostic relevance during treatment. Subsequently, a single-centre study in 109 patients with idiopathic PAH has provided evidence to support the prognostic importance of achieving certain goals during therapy [5]. In this study, the following parameters were individually associated with improved prognosis when assessed at the first follow-up visit (3–12 months after initiation of PAH-specific therapy), supporting their use as treatment goals: 1) improvement to, or maintenance of, New York Heart Association/World Health Organization functional class (FC) I or II; 2) cardiac index ≥2.5 L·min−1·m−2; 3) mixed venous oxygen saturation ≥65%; or 4) N-terminal pro-brain natriuretic peptide (BNP) levels … ER -