LETTERS

Echocardiography of pulmonary vascular function in asymptomatic carriers of BMPR2 mutations To the Editors: Pulmonary arterial hypertension (PAH) is a rare, life-threatening dyspnoea–fatigue syndrome, caused by progressive increase in pulmonary vascular resistance (PVR) and eventual right ven-tricular failure [1]. The heritable form of PAH has been shown to be associated with mutations of the gene encoding the bone morphogenetic protein receptor-2 (BMPR2). Asymptomatic carriers of BMPR2 mutations are at high risk of developing PAH [2]. Careful follow-up of these subjects might help to detect early-stage disease with a more favourable response to targeted therapies. However, there is uncertainty about the optimal screening method. A recent European multicentre study showed that relatives of patients with idiopathic PAH (IPAH) presen