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Precision medicine – the future of diagnostic approach to pulmonary hypertension? [Anatol J Cardiol]
Anatol J Cardiol. Ahead of Print: AJC-97820 | DOI: 10.14744/AnatolJCardiol.2019.97820  

Precision medicine – the future of diagnostic approach to pulmonary hypertension?

Piotr Kedzierski, Adam Torbicki
Department Of Pulmonary Circulation, Thromboembolic Diseases And Cardiology, Centre Of Postgraduate Medical Education, European Health Centre Otwock, Poland

Pulmonary hypertension (PH) is a common finding and it can result from many different pathological conditions. Depending on the aetiology, treatment should be quite different but early diagnosis and correct classification of PH is difficult. With ageing population and recently suggested decreased pulmonary arterial pressure threshold defining PH we are facing even more diagnostic uncertainties. New approach to patients’ phenotyping is needed. Here we present available data and future perspectives of employing in-depths analysis of omics cascade to allow earlier and more reliable diagnosis and classification of PH. Indeed, with the help of super-fast computing it became possible to simultaneously consider levels of thousands of potential biomarkers in order to find patterns specific for clinically suspected disease. Omics cascade is an invaluable source of information. However, while genome can be perceived as providing possibilities, transcryptome - as carving them this is metabolome which may tell us “what is really going on” in an individual living organism. Metabolomics research requires blinded search for characteristic patterns of discreet changes in the levels of detectable metabolites. Since as many as 40 000 various substances are produced as a “side effect of staying alive”, metabolite profiling can be compared to fishing up for organized signals in a universe of chaos. Though difficult, such search for metabolic patterns which might lead to replacing the term “biomarker” by metabolic “fingerprinting” in the area of pulmonary circulation has already begun.

Keywords: Pulmonary hypertension, systems biology, metabolome, genome, transcriptome, proteome, epigenetics

Corresponding Author: Adam Torbicki, Poland

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