Sharing Diagnostic and Therapeutic Pathways in Pulmonary Arterial Hypertension: A Roadmap for the Triveneto Region

Background: Pulmonary arterial hypertension (PAH) is a rare and progressive disease characterized by high mortality and a significant impact on quality of life. Despite therapeutic advances, considerable heterogeneity persists in Italy’s diagnostic and therapeutic pathways, leading to delays in diagnosis and disparities in access to care.Objective: With this work we aim to define a roadmap for a shared diagnostic, therapeutic, and care pathway for PAH in the Triveneto region, aiming to reduce management variability, improve continuity of care, and optimize the use of available resources.Methods: A multidisciplinary group of cardiologists, pulmonologists, and rheumatologists from Triveneto, along with a representative from the Pulmonary Hypertension Patients’ Association, convened in a series of meetings to discuss diagnostic and therapeutic pathways.Results: Early identification of PAH should be based on the classification of symptomatic patients into three main phenotypes (cardiac, pulmonary, and not better specified), followed by a specific diagnostic process based on updated hemodynamic criteria. Therapeutic strategies should be defined according to risk stratification, with clear guidelines for comorbidity management and monitoring through quality indicators (Key Performance Indicators) to assess the effectiveness of care pathways.Conclusions: The proposed roadmap represents a shared model for PAH management in the Triveneto region, promoting a multidisciplinary and integrated approach. Its adoption could enhance care quality, reduce regional disparities, and align with European guidelines, ultimately improving patient prognosis and quality of life.