This year the SAPH2014 Conference, also known as the Saudi Association for Pulmonary Hypertension and the PVRI Eastern Mediterranean Region 7th Annual Joint Pulmonary Hypertension Assembly, took place in Muscat, Oman.
Spanning three days from May 1st to May 3rd, the program promised sessions on classifications and updates, new developments in PAH therapy, insights in pulmonary hypertension due to left heart disease, a detailed look at CTEPH, management challenges in PAH patients and pregnancy challenges in PH patients, as well as practical clinical scenarios and more specific PAH management particularities, such as pericardial effusion and CTD associated PAH- and it certainly delivered.
As usual with SAPH, the high quality scientific program was accompanied by a flawless and aesthetic organisation, this year in the Ritz Carlton Al Bustan Palace in Muscat, Oman. A jewel on the coast of Oman, the hotel is situated right on the beach, whilst some of the rooms are located right at the edge of the pool a near necessity in a country where May temperatures reach well into + 45C.
The meeting kicked off on such an evening, when the temperatures rose high outside and attendees retreated into the cool blast of the hotel air conditioning. After registration, which included name tags, PVRI/SAPH pins and mocktails, attendees took a seat in the impressive ballroom. The Opening Ceremony included a welcome from Conference Chairman Dr. Saleh Al Dammas, followed by an introduction to PVRI* by PVRI President Sheila G. Haworth, an introduction to SAPH by Head of SAPH Majdy Idrees, and a more detailed look at the program from Head of SAPH Scientific Committee Abdullah Al Dalaan.
Then followed the talks, focusing on ‘Classification & Updates,’ chaired by Drs. Mohamed Al Hajjaj and Saleh Al Dammas. These presentations covered the basic physiobiological and genetic aspects of pulmonary arterial hypertension, and were spearheaded by Prof. Ardeschir Ghofrani, FPVRI, with ‘PH phenotypes: Distinct Inflammatory Pathways’.
Originally due to give two talks, Prof. Stephan Rosenkranz, FPVRI had a change in schedule which meant he would leave earlier than expected. As such, he combined both talks ‘Pulmonary Vascular Changes in PH Due to Left Heart Disease: Closer Look at the Histopathological Level’ and ‘Insight into RV assessment: Size and Function as Predictors of Clinical Worsening (Echo & MRI)’ into one, entitled ‘Pulmonary Vascular Changes Due to Left Heart Disease’, a two-part talk which can be found at the link. His presentation was followed by Prof. Ghazwan Butrous, who provided an update on the genetics of PH, which will become available on the PVRI website at a later date. Each lecture was followed by discussion amongst presenters and attendees, which continued during dinner and made for an excellent, involved and interesting start to the Conference.
The Friday Morning Sessions focused on topics ‘PAH Therapy: New Developments’, chaired by Drs. Abdullah Al Dalaan and Hussam Sakkijha, and ‘Definitions: New Changes’, chaired by Drs. Nasser Al Busaidi and Bader Al Ghamdi. The former looked at new publications concerning the indications of macitentan (the potent dual endothelin receptors antagonist), riociguat (sGC stimulator), and the role of anti-neoplastic TKI. It included talks by Prof. Ardeschir Ghofrani, FPVRI, Dr. Nazzareno Galie, Dr. Marius Hoeper, FPVRI, with ‘Inoperable CTEPH: Medical Treatment ‘CHEST 1’ and ‘CHEST 2’ Studies’, and Dr. Majdy Idrees, who presented ‘Targeting Tyrosine Kinase Pathways: Where do we stand?’. After coffee, Dr. AbdelGhafour Gari opened ‘Definitions: New Changes’ with ‘Borderline PH: Does it exist?. His presentation was followed by Dr. Marius Hoeper, FPVRI, who presented ‘Out of Proportion PH- Why was it omitted?’, and the topic ended, after much discussion, with Prof. Ghazwan Butrous’ ‘Clinical Relevance of Exercise-Induced PH?’
Following a gorgeous lunch with a view of the palmtrees, birds and sea, delegates returned for the Afternoon Sessions, which focused on ‘PH Due to Left Heart Disease’, chaired by Drs. Khalid Al Najashi and Mohamed Zeitouni. Detailing the management of PH, the sessions intended (and delivered) to highlight the important points about the contribution of the left heart on pulmonary circulation, and the invasive measurements that help to disinguish the dysfunction from both sides of the heart. Dr. Waleed Al Habeeb woke everyone up from their post-lunch reverie with ‘Dilemma of Wedge Pressure Measurement: Challenges and Pitfalls’, which inspired much discussion. It was followed by Dr. Nazzareno Galie’s ‘Definition and assessment of severity of PH due to left heart disease’, and then by Dr. Nedim Selimovic whopresented on ‘The Role of Specific Pulmonary Vasodilator Therapy in PH Due to Left Heart Disease’. Originally scheduled for Dr. Stephan Rosenkranz, Dr. Hoeper instead filled the next slot with ‘PH Guidelines: What is New after the 5th World Congress?’
After a quick coffee break, the sessions resumed with ‘CTEPH’, which was overseen by Drs. Mohamed Bader Al Salad and Hadeel Al Otair and focused on the selection criteria of operable patients, and the best peri-operative, operative and post-operative management. Dr. Eckhard Mayer, FPVRI, set the tone with ‘Evaluating Operability of CTEPH: Important Decision!’ and ‘Advancements in Surgical Treatment of CTEPH, PEA and Beyond: The Role of Pulmonary Angioplasty’. Dr. Talant Sooronbaev ended the day’s scientific programme with ‘PH Due to High Altitude, a Special Condition’, an informative talk which featured details on the upcoming Bishkek meeting in Kyrgyzstan.
The sessions overran by about an hour, which is always a good indicator of an involved audience and many discussions. Nonetheless, delegates were given about an hour to relax at the pool and get ready for the Gala Dinner, which took place outside on hotel grounds. Big fans sprayed cool droplets onto the dressed up delegates, who found their places at the round tables in the picturesque and exciting setting. A small stage was formed at the front, whilst attendees enjoyed ice water and fruit juices, and chatted amongst themselves. Before long, Conference Chairman Saleh Al Dammas and Head of SAPH Majdy Idrees took to the stage to thank the speakers, attendees and organisers for their presence and contributions. They presented an award to each speaker and honourable guest, and announced a new tradition of recognising one particular SAPH member at each meeting, based on their hard work for SAPH throughout the year. However, this year they chose to honour two, namely Head of SAPH Scientific Committee Abdullah Al Dalaam, and Head of the SAPH Pediatric Taskforce, the unofficial Queen of SAPH, Maha Al Dabbagh, FPVRI. Shortly after the ceremony, dinner was served, much to the delight and enjoyment of all attendees.
Saturday’s scientific programme started at 9am, with a focus on ‘Challenges in PAH Management’. It was chaired by Drs. Abdulmajeed Al Otay and Amjad Kouatli, and looked at PH management challenges and new strategies that might be adopted by PH-treating physicians. Dr. Robert Levy, FPVRI, started the day off right with ‘Upfront Combination Therapy for Severe PAH: Should it be the Standard of Care?’ He was followed by Prof. Ardi Ghofrani FPVRI, who presented ‘Treatment Goals: Review of Evidence’. Next was Nazzareno Galie with ‘PH in hemolytic anemia, why was it removed from Group I?’, and the session ended as it started, with Robert Levy presenting ‘Timing of Lung Transplant in advanced PAH: A Critical Decision!’
After coffee, ‘Practical Clinical Scenarios in PH’ was chaired by Drs. Nazzareno Galie and Maha al Dabbagh, and focused on different challenging clinical scenarios of interest to PH physicians in the EMR region (and beyond). This included a talk on Pregnancy Challenges in PH patients by Dr. Manal Al Hazmi, and a presentation by Dr. Abdullah Al Dalaan on ‘Pericardial Effusion and CTD Associated PAH.’
Then it was time for the best abstract winner, Dr. Stephen Chan FPVRI, to make his presentation, entitled ‘Acquired and Genetic Alterations of the MiR-210-ISCU Axis Promote Iron-Sulfur Cluster Deficiency and Pulmonary Hypertension.’ He was honoured in the abstract ceremony afterwards, and presented with a Certificate by Drs Saleh Al Dammas, Abdullah Al Dalaam and Ghazwan Butrous. Another Certificate was presented to Ellsa Booysen, a PH-patient of Maha Al Dabbagh who attended the SAPH 2014 Conference with her husband Ronnie Booysen to share her story.
With nearly a hundred attendees and a wide variety of topics, high quality presentations and discussion, the Joint SAPH/PVRI Conference 2014 was a real success. Thanks are due to the organising committee of Drs. Majdy Idrees, Saleh Al Dammas, Abdullah Al Dalaan, Nasser Al Busaidi and Hassan Alorainy, as well as to each speaker and attendee who made the SAPH2014 conference a reality. Special thanks also go to the Global Access team, who once again worked tirelessly to ensure excellent organisation and a faultless experience for all. All links in this story are recordings of the conference talks, and can be viewed by PVRI members only. The images featured in this blog can be seen here, along with many others from the SAPH 2014.