Phenotyping Sarcoidosis-Associated Pulmonary Hypertension: A Review of Pathophysiology and Management

Sarcoidosis-associated pulmonary hypertension (SAPH) is a significant yet often overlooked complication of sarcoidosis that profoundly affects both morbidity and mortality rates. The development of SAPH illustrates the intricate relationship among lung tissue damage, granulomatous inflammation of blood vessels, and remodeling of cardiac or vascular structures. This complexity highlights the multifaceted nature of sarcoidosis pathophysiology. In this review, we delve into key topics, including epidemiology, underlying mechanisms, and current treatment options, while also discussing the path forward for precision medicine applications. SAPH serves as a clear example of the systemic and vascular intricacies of sarcoidosis, connecting immune-mediated granulomatous inflammation with pulmonary vascular involvement. By gaining a deeper understanding of its unique molecular, hemodynamic, and imaging characteristics, we can enhance risk stratification and therapeutic decision-making, ultimately paving the way for more tailored management of sarcoidosis.