MEET THE
SPEAKERS
RIMANTAS BENETIS
Kaunas, Lithuania
Rimantas Benetis – the professor, PhD, cardiac surgeon, the Rector of the Lithuanian University of Health Sciences, head of Department of Cardiothoracic and Vascular Surgery. The professor was a leader of the cardiac surgery team which completed the first heart transplantation in Kaunas and the first lung and heart-lung transplantation in the Baltic States. Has published about 500 research papers, delivered papers at international conferences and congresses, as well as expert specialist training sessions in the USA, India, Germany, Belgium, France, England, Sweden, Denmark, Latvia, Lithuania, Netherlands, Iceland, Portugal, Spain, Italy, Brazil, Russia, Kazakhstan, and Poland. Professor consults and treats patients, that suffer from cardiac and cardiovascular diseases, delivers lectures for students and residents, conducts tutorials, seminars and practical exercises. From 1996 to present Rimantas has been a supervisor of 25 doctoral students. From 2010 to 2024 Rimantas has taken part in 11 biomedical clinical research studies as the main researcher. He received following awards: the Cross of the Officer of the Order for Merits to Lithuania, the Cross of the Officer of the Order of the Lithuanian Grand Duke Gediminas. Professor is a member of the Lithuanian Society of Thoracic and Cardiac Surgery, the European Association of Cardio-Thoracic Surgery (EACTS), and the European Valve Repair Group (EVRG).
MARC HUMBERT
Paris, France
Marc Humbert is Dean of the Medical School and Professor of Respiratory Medicine at the University Paris-Saclay and Inserm, France. He is the Director of the Respiratory and Intensive Care Medicine Department, French Pulmonary Hypertension Reference Centre, Assistance Publique Hôpitaux de Paris. Marc Humbert was President of the European Respiratory Society (2022) and Chief Editor of the European Respiratory Journal (2013-2017). He is vice-coordinator of the European Reference Network for rare and low prevalence respiratory diseases (ERN-LUNG). Since 2018, Clarivate Analytics has listed Marc Humbert as one of the world's highly cited researchers in the field of Clinical Medicine.
LECTURE: PULMONARY HYPERTENSION: INSIGHTS TO THE CURRENT SITUATION AND THE FUTURE
Pre-capillary pulmonary hypertension and pulmonary arterial hypertension are severe conditions caused by pulmonary vascular remodelling. Thanks to basic science discoveries, randomized controlled trials, real-world data, and clinical practice guidelines, considerable progress has been made in the treatment options and outcomes for patients with different forms of pulmonary hypertension, underscoring the importance of seamless translation of information from bench to bedside and, ultimately, to the patients. However, pulmonary hypertension still carries a high mortality rate, highlighting the urgent need for transformative innovations in the field. We will summarize the current knowledge on the cellular and molecular mechanisms of pulmonary hypertension with an emphasis on current and emerging treatable pathways and optimisation of available management. When looking to the future, the ambition is to identify therapies that stall or reverse pulmonary vascular remodelling.
ANTON VONK NOORDEGRAAF
Amsterdam UMC, The Netherlands
Anton Vonk Noordegraaf, MD, PhD, is Full professor and Chair of the division of Pulmonary Sciences at the Amsterdam University Medical Center, a tertiary referral centre for pulmonary arterial hypertension (PAH) in The Netherlands. Professor Vonk Noordegraaf obtained his medical degree with honours from the Vrije Universiteit Medical Centre, Amsterdam, in 1995. Between 1995 and 1997 he studied for his PhD, exploring the function of the right ventricle in chronic obstructive pulmonary disease-related PAH. He then spent a year as a postdoctoral fellow at The University of Pennsylvania, PA, USA, where he was dedicated to the research of the pulmonary circulation in acute respiratory distress syndrome (ARDS). After completing a 6-year fellowship in pulmonary medicine at Vrije Universiteit, he joined the division of Pulmonary Sciences at the University in 2003, where he remains to the present day. Professor Vonk Noordegraaf has published over 500 articles in peer-reviewed journals. His research is focused on the mechanisms and treatment of pulmonary arterial hypertension, right ventricular failure, pulmonary haemodynamics, and clinical studies in the field of pulmonary hypertension. In 2008 he received the Dutch Research Council (NWO) VIDI award and in 2016 the NWO VICI award. Additionally, in 2009 he received the ‘Pulmonary Hypertension Research Award’ from the European Respiratory Society. In 2016 he received the ERS Award for Lifetime Achievement in PAH. He is nucleus member of the working group ‘ Pulmonary Circulation’ of the European Society of Cardiology and past chair of Assembly 13: Pulmonary Vascular Diseases of the ‘European Society of Respiratory Medicine’.
LECTURE: RIGHT VENTRICLE: ALL THAT MATTERS IN PULMONARY HYPERTENSION
This lecture will show how the right ventricle adapts and the principles of failure. Based on these findings it will become clear that right heart failure not only involved the right ventricle but all chambers of the heart. In addition, it will show the consequences of decreased systolic and diastolic function. From this knowledge it will be explained how the right ventricle can be used as treatment target.
EGLE EREMINIENE
Kaunas, Lithuania
Egle Ereminiene is a cardiologist, a Lithuanian University of Health Sciences (LSMU) professor, and a Fellow of the European Society of Cardiology (FESC).
Since 2014, she has been the head of the Center for Rare Cardiovascular Diseases of the LSMU Hospital Kaunas Clinics. Since 2019, she has represented the Hospital at ERN Guard Heart.
The professor also leads the working group on rare cardiovascular diseases in the Lithuanian Society of Cardiology and heads the Laboratory of Clinical Cardiology at the LSMU Institute of Cardiology.
Her main areas of research interest are pulmonary hypertension, heart valvular diseases, and rare cardiovascular diseases. The findings and results of these studies are presented in over 60 scientific articles published in peer-reviewed journals.
The professor features personal skills and expertise in 2D and 3D echocardiography, transesophageal echocardiography, intraoperative transesophageal echocardiography, extracranial vascular ultrasonography, and stress echocardiography.
LECTURE: ECHOCARDIOGRAPHY IN PULMONARY HYPERTENSION: OLD AND NEW TECHNOLOGIES
AINARS RUDZITIS
Riga, Latvia
Ainars Rudzitis is an Associate Professor at Riga Stradins University and a cardiologist at Pauls Stradins Clinical University Hospital, Latvian Centre of Cardiology. He holds a PhD in Medicine and has extensive training in cardiology, including echocardiography and cardiac catheterization, with experience from institutions in Latvia and Switzerland.
Dr. Rudzitis is the Chairman of the Board of the Rare Diseases Research Fund and a member of the Latvian Society of Cardiology. He serves as a proctor in the Baltic States for Abbott Structural and CARDIA devices. He has authored numerous peer-reviewed publications and is recognized for his contributions to research on pulmonary hypertension and structural heart disease.
LECTURE: RIGHT HEART CATHETERIZATION - PITFALLS AND CHALLENGES
ALAN ALTRAJA
Tartu, Estonia
1) Professor of Pulmonary Medicine, Head of the Department of Pulmonology, University of Tartu, Estonia.
2) Senior Consultant at the Lung Clinic of the Tartu University Hospital, Tartu, Estonia.
Alan Altraja is professor of pulmonary medicine at the University of Tartu and senior respiratory consultant at the Tartu University Hospital, Estonia. He graduated the Faculty of Medicine, University of Tartu in 1990 and received the degree of specialist in pulmonary medicine from the University of Tartu in 1999. He received the scientific degree of Doctor of Medicine and Surgery form the University of Helsinki, Finland, in 1999. Professor Altraja’s research interests include respiratory omics, mechanisms and phenotypes/endotypes of obstructive pulmonary diseases, various issues associated with severe asthma, therapeutic use of biologics, diagnosis and management of interstitial and pulmonary vascular diseases (incl. pulmonary hypertension), respiratory infections, and precision bronchoscopy. Professor Altraja is member of the Board of the Estonian Respiratory Society and member of the European Respiratory Society and many of its Assemblies. Since 2007, Professor Altraja is associate editor of the Clinical Respiratory Journal and has contributed as a peer reviewer for numerous international journals.
LECTURE: PULMONARY ARTERIAL HYPERTENSION IN CONNECTIVE TISSUE DISEASES
MARCIN KURZYNA
Warsaw, Poland
Marcin Kurzyna graduated from the Medical University of Warsaw, Poland. He has been a physician in Intensive Care Unit and, since 2003, Head of Hemodynamic Lab at the National Institute for Lung Diseases. Currently is a Head of the Department of Pulmonary Circulation, Thromboembolic Diseases and Cardiology of the Centre of Postgraduate Medical Education in Warsaw. He was the President of the Working Group on Pulmonary Circulation of the Polish Cardiac Society. Since 2019, a Fellow of the European Society of Cardiology and a member of the Nucleus of the WG on Pulmonary Circulation and Right Ventricular Function of ESC and Pulmonary Vascular Research Institute. Since 2023 is Board Member of Polish Cardiac Society. He is a specialist in internal medicine and cardiology and has a Ph.D. in respiratory medicine. His research interests are related to the role of invasive procedures in diagnosing and treating pulmonary vascular diseases.
LECTURE: CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION: STATE OF THE ART
CTEPH, or thromboembolic pulmonary hypertension, is a rare but very serious consequence of acute pulmonary embolism. At the same time, it is one of the rarest forms of pulmonary hypertension. The last decade has seen a real breakthrough in the treatment options for CTEPH. The introduction of balloon pulmonary angioplasty and PAH-like targeted therapy into clinical practice has changed the faces of this disease. At the same time, still surgical pulmonary endarterectomy has retained its important place in the therapeutic algorithm. This provides opportunities to select a specific therapeutic strategy according to the anatomical location of the vascular lesions and the overall condition of the patient. Currently, the multi-modal treatment of CTEPH makes it a curable disease in most cases.
SKAIDRIUS MILIAUSKAS
Kaunas, Lithuania
Skaidrius Miliauskas is a pulmonologist, the professor, and the Head of the Department of Pulmonology at Kaunas Clinics, the Hospital of Lithuanian University of Health Sciences (LSMU), Kaunas, Lithuania. Professor Skaidrius Miliauskas graduated from the same university in 1994. In 1999, he completed a residency in respiratory medicine and, after his PhD studies in 2001, defended the dissertation “Peculiarities of Formation and Course of Thromboembolic Pulmonary Hypertension.” Since 2012, he has been the Head of the Pulmonary Hypertension Center of Kaunas Clinics, the Hospital of LSMU, Kaunas, Lithuania. He is the representative of the Hospital at the ERN Lung.
Professor Skaidrius Miliauskas has published over 70 articles in scientific journals. His main areas of interest are disorders of pulmonary circulation (pulmonary hypertension and pulmonary embolism) and lung cancer. He is a member of the European Respiratory Society, ERN Lung, and deputy head of the Lithuanian Society of Pulmonology and Allergy.
LECTURE: PULMONARY HYPERTENSION IN PULMONARY DISEASES: CAN WE HELP OUR PATIENTS?
Pulmonary hypertension (PH) associated with lung diseases and/or hypoxia (CLD-PH) is common. The existence of PH in this group of diseases significantly worsens the prognosis and all outcomes. This group is very heterogeneous. Apparent pathogenic differences contribute to various chronic lung diseases and PH, so the response to the treatment should also be different. The symptoms of CLD and PH significantly overlap, which often leads to delays in diagnosing the pulmonary vascular component. We need a multimodal approach, primarily relying on high-quality radiographic and pulmonary function assessments. We also have to define the clinical and hemodynamic phenotypes. Right heart catheterization RHC should be done in cases where the findings provide prognostic information or change the disease management. Currently, we have no approved drugs for CLD-PH. The treatment is primarily based on a holistic approach with optimal management of the underlying disease, additional general measures, and maybe drugs approved for pulmonary arterial hypertension. Comorbidities such as sleep-disordered breathing, concomitant cardiac disease, nutritional status, and other factors that may contribute to the pathogenesis and severity of PH, such as hypoxemia, smoking, and acute/chronic thromboembolism, must also be appropriately managed.
Andris Skride
Riga, Latvia
Andris Skride is a cardiologist and the Head of the Pulmonology Circulation and Right Ventricular Function Working Group at Pauls Stradins Clinical University Hospital, Latvian Cardiology Center, in Riga, Latvia. He graduated from Riga Stradins University in 2006 with a Medical Doctor degree and later completed a fellowship and board certification in Internal Medicine and Cardiology at the University of Latvia in 2009 and 2011, respectively. In 2018, he earned his PhD in Medicine from Riga Stradins University.
Since 2007, Dr. Skride has led the Pulmonary Arterial Hypertension and CTEPH Registry of Latvia, and since 2018, he has been the Head of the Rare Disease Unit at Pauls Stradins Clinical University Hospital. He specializes in pulmonary hypertension, invasive cardiology, and right ventricular function.
Dr. Skride has served as a principal investigator in multiple interventional trials focusing on pulmonary arterial hypertension, contributing to both Phase II and Phase III studies. He has also worked as a sub-investigator in clinical trials related to type 2 diabetes and heart failure.
He has authored 94 scientific publications, with 1,178 citations and a Hirsch index of 19. His research interests include pulmonary circulation disorders, pulmonary hypertension, and interventional cardiology. Dr. Skride is an active member of the Latvian medical community and an advocate for advancements in cardiovascular and pulmonary research.
LECTURE: COMBINED PRE- AND POSTCAPILLARY PULMONARY HYPERTENSION
Introduction. Combined pre- and postcapillary pulmonary hypertension (cpcPH) belongs to the most common - Group 2 of pulmonary hypertension (PH-LHD) and its pathophysiology involves both pulmonary venous and arterial component. The first that is involved is the left side of the heart. The causes are different – valvular diseases, cardiomyopathies, other myocardial diseases, but they all lead to congestion in pulmonary veins. Thus usually the patients first experience symptoms of left heart failure – orthopnea and nocturnal dyspnea and cough.
Pathophisiology. The pulmonary veins are overloaded and distended. The initial raise in PVR happens due to pulmonary arteriole vasoconstriction as a protective mechanism – to avoid pulmonary oedema. If the volume in pulmonary veins persist and pulmonary arterial vasoconstrictors are still predominant over vasodilators, both precapillary and postcapillary remodelation starts. Over time the changes in vessels – hypertrophy, hyperplasia and fibrosis of tunica media and loss of compliance – become irreversible.
Therapy. As there are few pharmacological therapy options for Groups 3, 4 and 5, sometimes an off-label use of Group 1 drugs can be helpful; however, that is not the case for cpcPH. Randomized clinical trials herald that off-label medications can do more harm than good for these patients. The best treatment plan for a cpcPH patient involves
surgical or pharmacological treatment of the preexisting left heart disease, which is the cause of pulmonary hypertension in these patients. A promising Phase II trial has just started that targets relaxin RXFP1 receptor that gives hope for conventional treatment for Group 2 patients in future.
Conclusion. As prevalence of left heart disease rises due to longer living, so does the number of patients with cpcPH. That is why it is very important to monitor left heart disease patients with regular examinations like echocardiography; and in our minds don’t reduce heart failure to only left heart disease!
LY ANTON
Tallinn, Estonia
Professional Titles: MD, Cardiologist
Additional Titles:
- Member of the Heart Failure Association of the ESC
- Member of the European Association of Cardiovascular Imaging
- Member of the European Association of Heart Failure
Workplace: North Estonia Medical Centre Foundation, Centre of Cardiology; Tallinn. Senior Cardiologist and Leader of the Pulmonary Hypertension Unit.
Principal Investigator of the Estonian Pulmonary Hypertension Epidemiologic Study.
Member of the Organizing and Scientific Committee of the Baltic Pulmonary Hypertension Conferences in 2016, 2018, 2021, and 2023.
LECTURE: INTENSIVE TREATMENT OF RIGHT VENTRICULE FAILURE
The right ventricle and its stress response is the most important factor of survival in patients with pulmonary hypertension. There is a substatial progress in treatment options to avoid right heart failure but still patients diagnosed with acute or decompensated right heart failure need intensive care treatment. Treatment strategies for these patients remain a challange. The current principles of acute or decompensated right ventricular failure management are discussed.
EGLE GRIGONIENE
Vilnius, Lithuania
Egle Grigoniene (formerly Paleviciute), MD, PhD, is a cardiologist and researcher, with expertise in pulmonary hypertension and heart failure. She leads the Pulmonary Hypertension Referral Center at Vilnius University Hospital Santaros Klinikos, Lithuania, and is a teaching assistant at Vilnius University.
Dr. E. Grigonienė completed her cardiology residency in 2015, and in 2023, she obtained her PhD from Vilnius University, focusing her doctoral research on the feasibility and effectiveness of exercise training programs for pulmonary hypertension and heart failure patients. Dr. E. Grigonienė has over a decade of experience in clinical cardiology, research, and teaching. She has extensive experience in clinical trials and is a published author of articles in indexed journals; she actively collaborates with professional societies, including the European Society of Cardiology. In addition to her clinical and academic roles, Dr. E. Grigonienė is engaged in public health advocacy, supporting patient education and developing resources for those living with pulmonary hypertension and advanced heart failure.
LECTURE: CONTROVERSIES OF PULMONARY HYPERTENSION IN LEFT HEART DISEASES
Pulmonary hypertension (PH) associated with left heart disease (PH-LHD) remains a significant clinical challenge due to its complex pathophysiology, diagnostic controversies, and a relatively high prevalence. In PH-LHD, elevated pulmonary pressures are secondary to left ventricular systolic dysfunction, diastolic dysfunction, and/or valvular heart disease, leading to increased pulmonary vascular resistance. The differential diagnosis between pulmonary arterial hypertension (PAH) with comorbidities and PH-LHD, especially PH associated with heart failure with preserved ejection fraction, is always challenging. Moreover, the management of PH-LHD is controversial, as treatment strategies remain unclear, especially regarding the use of targeted PAH medication therapy. While these therapies are well established for PAH, their role in PH-LHD remains uncertain. Recent studies show that while selective pulmonary vasodilators may provide symptomatic relief in some PH-LHD patients, they may also increase the risk of adverse outcomes due to the complex interaction with left heart dysfunction. Conversely, optimizing heart failure therapy through guideline-directed medical treatment remains a cornerstone of care, and evidence supporting the concurrent use of pulmonary-targeted therapies is limited.