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To the Editor In clinical practice, pulmonary arterial hypertension (PAH) associated with congenital cardiac shunts may possibly progress to end-stage pulmonary arterial vasculopathy even after successful shunt closure potentially leading to substantially worse prognosis in certain settings.1 In their recently published article, van der Feen et al have discussed a variety of modalities in assessing the reversibility of PAH in the setting of congenital heart disease (CHD).1 We agree on the potential utility of most of these modalities along with the limited, value of well-known biomarkers including natriuretic peptides in this setting.1 On the other hand, we hold the opinion …
Contributors All the authors have significantly contributed to this work.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.