Pulmonary hypertension due to left heart diseases. Review uri icon

Overview

abstract

  • Pulmonary hypertension (PH), a common complication of left heart diseases (LHD), negatively impacts symptoms, exercise capacity, and outcome. Although the true prevalence of PH-LHD is unknown, a subset of patients might present significant PH that cannot be explained by a passive increase in left-sided filling pressures. The term "out-of-proportion" PH has been used to identify that population without a clear definition, which has been found less than ideal and created confusion. We propose a change in terminology and a new definition of PH due to LHD. We suggest to abandon "out-of-proportion" PH and to distinguish "isolated post-capillary PH" from "post-capillary PH with a pre-capillary component" on the basis of the pressure difference between diastolic pulmonary artery pressure and pulmonary artery wedge pressure. Although there is no validated treatment for PH-LHD, we provide insights into management and discuss completed and randomized trials in this condition. Finally, we provide recommendations for future clinical trials to establish safety and efficacy of novel compounds to target this area of unmet medical need.

publication date

  • December 24, 2013

Research

keywords

  • Hypertension, Pulmonary
  • Ventricular Dysfunction, Left

Identity

Scopus Document Identifier

  • 84890771619

Digital Object Identifier (DOI)

  • 10.1016/j.jacc.2013.10.033

PubMed ID

  • 24355634

Additional Document Info

volume

  • 62

issue

  • 25 Suppl