Pulmonary Hypertension Program

Pulmonary hypertension (PH) is a chronic disease which if not treated appropriately leads to right sided heart failure and other complications leading to poor quality of life and shortened survival. It is relatively rare and may be familial or idiopathic (without a known cause) or associated with other medical conditions. In the last decade there has been considerable progress in the treatment of this disease and new medications are available for therapy which have improved symptoms, quality of life as well as survival. (Please see "patient education")

At Wayne State University Pulmonary Hypertension program, we are committed to providing excellent care to patients with Pulmonary Hypertension based on the current State of the Art. The program is run by board certified physicians trained in pulmonary and critical care medicine, with special interest in pulmonary hypertension, assisted by a team of other health care providers. In addition to clinical evaluation, diagnostic work up (including on site echocardiography, right heart catheterization, pulmonary function test etc) treatment and follow up, the program provides help with approval of drug therapy, management of drug therapy through patient assistance programs and opportunities to participate in clinical research trials. The physicians work closely with other specialists in cardiology, rheumatology, infectious disease, hematology, sleep medicine and others to co-ordinate comprehensive care.

Dr. Ghulam Saydain, M.D., F.C.C.P.

Professor and Associate Chair, Department of Internal Medicine
Pulmonary Critical Care & Sleep Division
Wayne State University School of Medicine

Chief of Medicine, Harper-Hutzel University Hospital

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Appointments

Pulmonary Hypertension Clinic

400 Mack Avenue, 2nd Floor

Detroit, Michigan, 48201

Main appointment number 877-929-6342 (877-WAYNE-HC)

For your appointment, please be sure to bring any old medical records, list of medications you are taking, any x-ray films, and appropriate insurance information including referral.

When you arrive in the clinic, you may first be seen by a Pulmonary Fellow before being seen by a staff physician.

If you are on oxygen and have only a limited supply, please ask the receptionist to place you on oxygen available in the clinic so your supply does not run out while you are waiting to be seen.
Research
We have the following ongoing clinical trials:

(If you're interested in participation or have any questions, please contact our Research Office at 313-745-9537.)
- ATHENA-1 : A Randomized, Multicenter Study of Ambrisentan and Sildenafil Combination Therapy in Subjects With Pulmonary Arterial Hypertension Who Have Demonstrated a Sub-Optimal Response to Sildenafil
  Principal Investigator: Ghulam Saydain, M.D.
- COMPASS-2: Effects of Combination of Bosentan and Sildenafil Versus Sildenafil Monotherapy on Morbidity and Mortality in Symptomatic Patients With Pulmonary Arterial Hypertension - A Multicenter, Double-Blind, Randomized, Placebo-Controlled, Parallel Group, Prospective, Event Driven Phase IV Study.
  Principal Investigator: Ghulam Saydain, M.D.
- REVEAL Registry:Registry to Evaluate Early And Long-Term PAH Disease Management.
  Principal Investigator: Ghulam Saydain, M.D.
- PAH QuERI: Pulmonary Arterial Hypertension Quality Enhancement Research Initiative.
  Principal Investigator: Ghulam Saydain, M.D.
- SERAPHIN: A Multicenter, Double-Blind, Randomized, Placebo-Controlled, Parallel Group, Event-Driven, Phase III Study to Assess the Effects of ACT-064992 on Morbidity and Mortality in Patients With Symptomatic Pulmonary Arterial Hypertension.
  Principal Investigator: Ghulam Saydain, M.D.
We have also successfully completed the following Clinical Trials in the past:
- PHIRST-2: Open-label, Extension Study to Evaluate the Long-term Safety and Efficacy of the Phosphodiesterase Type 5 (PDE5) Inhibitor Tadalafil in the Treatment of Patients with Pulmonary Arterial Hypertension.
  Principal Investigator: Ghulam Saydain, M.D./ Kamal Mubarak, M.D.
- ARIES-3: Phase 3, Long-Term, Open-Label, Multicenter Safety and Efficacy Study of Ambrisentan in Subjects With Pulmonary Hypertension.
  Principal Investigator: Ghulam Saydain, M.D./ Kamal Mubarak, M.D.
- STRIDE-III: Long-Term, Open-Label Study to Evaluate the Safety of Sitaxsentan Sodium Treatment in Patients with Pulmonary Arterial Hypertension.
  Principal Investigator: Kamal Mubarak, M.D.
- ASSET-1 & ASSET-2: Randomized, Placebo-controlled, Double-blind, Multi-center, Parallel Group Study To Assess the Efficacy, Safety and Tolerability of Bosentan in Patients with Symptomatic Pulmonary Arterial Hypertension Associated with Sickle Cell Disease.
  Principal Investigator: Kamal Mubarak, M.D.
- ASSET-3: Long-Term, Open-Label, Multi-center, Extension Study of Bosentan in Patients with Pulmonary Hypertension Associated with Sickle Cell Disease Completing a Double-blind ASSET study.
  Principal Investigator: Kamal Mubarak, M.D.
- PHIRST-1: Randomized, Double-Blind, Placebo-Controlled Phase 3 Study of the Phosphodiesterase Type 5 (PDE5) Inhibitor Tadalafil in the Treatment of Patients With Pulmonary Arterial Hypertension.
  Principal Investigator: Kamal Mubarak, M.D.
Patient Education

Pulmonary hypertension (PH) represents a group of conditions in which the pressure within the blood vessels of the lungs is increased. This leads to stress and strain of the right side of the heart, which may ultimately cause right-sided heart failure.

PH is sometimes confused with "systemic hypertension" which means high blood pressure in the systemic blood vessels, which affects "left" side of the heart mainly.

In the last decade or so there have been advances in the management of PH resulting in improved symptoms, better quality of life as well as increased survival. At present there are six FDA approved medications to treat this disease.

Unfortunately the symptoms of PH are non-specific and the diagnosis may be delayed in the absence of an appropriate work up. One of the reasons for difficulty in managing this disease is late referral to a specialist.

PH may be Idiopathic (without a known cause) or familial (which runs in families). This used to be previously called "Primary Pulmonary Hypertension". Pulmonary hypertension may be associated with other conditions like systemic sclerosis (scleroderma), Lupus and other connective tissue disorders, liver disease, HIV/AIDS, use of weight reducing medications, sickle cell disease and various other conditions.

Other conditions that may cause PH include lung problems like emphysema and chronic bronchitis, pulmonary fibrosis, blood clots in the lungs, Sarcoidosis as well as left sided heart disease. Previously all these conditions were called as "secondary pulmonary hypertension".

Symptoms of pulmonary hypertension include easy fatigability, shortness of breath, chest pain, swelling of the feet and belly. In advanced cases patients may pass out.

Patients with pulmonary hypertension need comprehensive work up to confirm the diagnoses as well as to find out the underlying cause. Initially echocardiogram is the best tool for screening but to confirm the diagnosis the patients needs to have a right heart catheterization, which actually measures the pressure in the heart and blood vessels by introducing a catheter into the body. Physicians follow specific procedures and protocols to ascertain essential information, which may include possible response to medications, which helps to determine the best possible therapy.

In addition to a chest x-ray, electrocardiograph (EKG), and breathing test (Pulmonary Function Test), patients may need a CT scan of the chest or a VQ scan to look for other lung diseases or clots in the lungs.

Another important test is a six-minute walk test. This gives the physician an idea about the patient's capacity to tolerate day-to-day activities, degree of disability and need for oxygen therapy. In addition this test is done periodically to monitor for improvement or worsening and assess the response to medication. Physicians may add or change therapy based on these results.

At present mediations approved for treatment of Pulmonary Arterial Hypertension (PAH) include calcium channel blockers, Flolan (epoprostenol), Remodulin (treprostenol), Ventavis ( iloprost), Tracleer (bosentan), Letairis (ambrisentan) and Revatio (sildenafil). The choice of medication is based on the patient's condition at the time of diagnosis. Advanced cases may be referred for lung transplant.

View Patient Resources and Links for more information.
>Patient Resources/Links
General Pulmonary Hypertension resources:
Patient Support groups:

Available FDA-approved therapies: