Pulmonary Hypertension

Clinical Centers


Mission Statement:

Pulmonary hypertension (PH) is a complex disorder with significant effects on morbidity and mortality. It is of paramount importance to gain greater understanding of the mechanisms responsible for disease pathogenesis in these patients to provide more comprehensive treatment options. The mission of the Pulmonary Hypertension Center at Boston Medical Center (Boston University School of Medicine) is to improve the lives of persons living with pulmonary hypertension by providing state-of-the-art patient care coupled with innovative research aimed at understanding the pathogenesis and natural history of pulmonary hypertension.

Background:

The staff of the Pulmonary Hypertension Center at Boston Medical Center is comprised of four physicians and one nurse practitioner with expertise in pulmonary hypertension and a dedicated clinic staff. The center is directed by Dr. Elizabeth Klings, an Associate Professor of Medicine at Boston University School of Medicine, who is an international expert in the care of patients with pulmonary hypertension related to sickle cell disease, and has been caring for patients with PH for nearly 20 years. Dr. Klings is a member of the American Thoracic Society, the American Society of Hematology and the Pulmonary Hypertension Association and lectures locally, nationally and internationally on topics related to PH.

Patients with PH are referred to the Pulmonary Hypertension Clinic from both within Boston Medical Center and areas throughout New England and beyond. Some patients come only for an initial evaluation or second opinion, while others may be followed for years. Approximately 100-150 new referrals per year are seen at the Pulmonary Hypertension Clinic, staffed by Dr. Klings and Denise Curran, RNP. Right heart catheterizations are performed routinely in the Cardiac Catheterization Laboratory of Boston Medical Center by Drs. Klings, Hector Marquez and Ehab Billatos of Pulmonary/Critical Care and Dr. Nir Ayalon of Cardiology with our clinical fellows. We perform approximately 200 right heart catheterizations annually.  A PH consultation service led by Drs. Klings and Marquez evaluates and follows all inpatients with PH related issues at Boston Medical Center along with our clinical fellows.  All first year clinical fellows spend 10 weeks on the inpatient PH consult service.  Senior fellows with interest in PH have the opportunity for additional inpatient or outpatient clinical experience.

Clinical Activities:

    • Initial assessment of patients with pulmonary hypertension
    • Diagnostic right heart catheterizations with vasodilator trials
    • Use of oral, inhaled and systemic pulmonary vasodilator therapy when indicated
    • Ongoing treatment for pulmonary hypertension including clinical follow-up with 6 minute walk tests, echocardiography and right heart catheterizations, and referral for lung transplant as needed
    • Participation in clinical trials and on-going Investigator-initiated research with the goal of advancing knowledge about the pathogenesis and treatment of pulmonary hypertension

Research Activities:

  • See Pulmonary Hypertension – Clinical and Translational Research and Vascular Biology websites.

Investigators/Personnel:

        • Elizabeth S. Klings, MD, Associate Professor of Medicine, Director, Pulmonary Hypertension Center
        •  Hector Marquez, MD, Assistant Professor of Medicine
        •  Ehab Billatos, MD, Assistant Professor of Medicine, Assistant Director of Bronchoscopy
        •  Nir Ayalon, MD, Assistant Professor of Medicine, Interventional Cardiology, Heart Failure, Pulmonary Hypertension, and Advanced Hemodynamics (Section of Cardiology)
        • Denise Brett-Curran, RNP

    Selected Publications:

    1. Gopal DM, Santhanakrishnan R, Wang YC, Ayalon N, Donohue C, Rahban Y, Perez AJ, Downing J, Liang CS, Gokce N, Colucci WS, Ho, JE. Impaired Right Ventricular Hemodynamics Indicate Preclinical Pulmonary Hypertension In Patients With Metabolic Syndrome. J Am Heart Assoc. 2015 Mar 10;4(3):e001597. PubMed PMID: 25758604; PubMed Central PMCID: PMC4392440.
    2. Gopal DM, Ayalon N, Wang YC, Siwik D, Sverdlov A, Donohue C, Perez A, Downing J, Apovian C, Silva V, Panagia M, Kolachalama V, Ho JE, Liang CS, Gokce N, Colucci WS. Utility of Galectin-3 In Identifying Stage B Metabolic Heart Disease and Pulmonary Hypertension in Obese Patients. Circulation: Heart Failure. Submitted for review.
    3. Morris CR, Kim HY, Wood J, Trachtenberg F, Klings ES, Porter JB, et al. Sildenafil Therapy in Thalassemia Patients with Doppler-defined Risk for Pulmonary Hypertension. Haematologica 2013 Sep;98(9):1359-67.
    4. Weir NA, Saiyed R, Alam S, Conrey A, Desai HD, George MP, Keeley JH, Klings ES, Mehari A, Taylor JG 6th, Minniti CP, Kato GJ. Prostacyclin-Analog Therapy In Sickle Cell Pulmonary Hypertension. Haematologica 2017;102:E163-E165.
    5. Kim D, Lee KM, Freiman MR, Powell WR, Klings ES, Rinne S, Miller D, Rose AJ, Wiener RS. Phosphodiesterase-5-inhibitor Therapy for Pulmonary Hypertension in the US: Actual vs Recommended Use. Ann Am Thorac Soc. 2018; 15(6):693-701.
    6. Klings ES, Machado RF, Barst RJ, Morris CR, Mubarek K, Gordeuk VR, Kato GJ, Ataga KI, et al. An Official ATS Clinical Practice Guideline: Diagnosis and Treatment of Pulmonary Hypertension of Sickle Cell Disease. Am J Resp Crit Care Med 2014; 189: 727-740.

    For Patients

    To schedule a clinic visit, refer a patient, or speak with one of our physicians, please contact us at:

    Boston Medical Center
    Pulmonary, Allergy & Sleep
    Shapiro Center
    9th Floor, Suite 9B
    725 Albany Street
    Boston, MA 02118
    (617)638-7480
    Fax: (617) 638-7486