Group D PAH-CHD is a problematic increasingly recognized group of patients, in which pulmonary hypertension continues to progress despite the correction of a significant cardiac lesion with pulmonary overflow. Early and non-invasive testing that can predict this subset of patients, prior to correction of their underlying cardiac lesion, is still non-established in practice and under-investigated in literature. Serum markers and angiogenic molecules denoting apoptosis resistance, can be game changer to the standard practice in this context. We hope that this letter can encourage researchers concerned with PAH-CHD to start investigating the diagnostic accuracy and cut-off values of these biomarkers.
