Right Heart Failure in Chronic Lung Disease. Where Are We Now?

Author(s):  
V. Ježek ◽  
M. Morpurgo
2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Amirmasoud Zangiabadi ◽  
Carmine G. De Pasquale ◽  
Dimitar Sajkov

Group 3 pulmonary hypertension (PH) is a common complication of chronic lung disease (CLD), including chronic obstructive pulmonary disease (COPD), interstitial lung disease, and sleep-disordered breathing. Development of PH is associated with poor prognosis and may progress to right heart failure, however, in the majority of the patients with CLD, PH is mild to moderate and only a small number of patients develop severe PH. The pathophysiology of PH in CLD is multifactorial and includes hypoxic pulmonary vasoconstriction, pulmonary vascular remodeling, small vessel destruction, and fibrosis. The effects of PH on the right ventricle (RV) range between early RV remodeling, hypertrophy, dilatation, and eventual failure with associated increased mortality. The golden standard for diagnosis of PH is right heart catheterization, however, evidence of PH can be appreciated on clinical examination, serology, radiological imaging, and Doppler echocardiography. Treatment of PH in CLD focuses on management of the underlying lung disorder and hypoxia. There is, however, limited evidence to suggest that PH-specific vasodilators such as phosphodiesterase-type 5 inhibitors, endothelin receptor antagonists, and prostanoids may have a role in the treatment of patients with CLD and moderate-to-severe PH.


2017 ◽  
Vol 26 (143) ◽  
pp. 160053 ◽  
Author(s):  
Marios Panagiotou ◽  
Alistair C. Church ◽  
Martin K. Johnson ◽  
Andrew J. Peacock

Pulmonary vascular and cardiac impairment is increasingly appreciated as a major adverse factor in the natural history of interstitial lung disease. This clinically orientated review focuses on the current concepts in the pathogenesis, pathophysiology and implications of the detrimental sequence of increased pulmonary vascular resistance, pre-capillary pulmonary hypertension and right heart failure in interstitial lung disease, and provides guidance on its management.


2011 ◽  
Vol 49 (01) ◽  
Author(s):  
K Herzer ◽  
G Kneiseler ◽  
F Post ◽  
M Schlattjan ◽  
T Neumann ◽  
...  

2016 ◽  
Vol 94 (supplement5) ◽  
pp. 82
Author(s):  
A. K. Gulick ◽  
K. M. Freeman ◽  
B. C. Bernhard ◽  
J. O. Sarturi ◽  
J. M. Neary

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