Roundtable: Pulmonary Hypertension Due to Left Heart Disease

2015 ◽  
Vol 14 (2) ◽  
pp. 105-110
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Guest Editor ◽  
Mayo Clinic ◽  
Diagnosis And Treatment ◽  
Left Heart ◽  
Health Network ◽  
University Of Utah ◽  
School Of Medicine ◽  
Left Heart Disease

Guest editor Teresa De Marco, MD, along with Brian Shapiro, MD, Mayo Clinic, Jacksonville, FL, convened a panel of experts to discuss the challenges in diagnosis and treatment and the emerging science regarding pulmonary hypertension due to left heart disease. Contributing to the engaging discussion were James Fang, MD, University of Utah School of Medicine; Barry Borlaug, MD, Mayo Clinic, Rochester, MN; and Srinivas Murali, MD, Allegheny Health Network, Pittsburgh, PA.

scholarly journals Pulmonary Hypertension Due to Left Heart Disease

2017 ◽  
Vol 38 (05) ◽  
pp. 662-676
Author(s):  
Mario Gerges ◽  
Christian Gerges ◽  
Robert Naeije ◽  
Irene Lang
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Ejection Fraction ◽  
Unmet Need ◽  
Diagnosis And Treatment ◽  
Pulmonary Vascular Disease ◽  
Left Heart ◽  
Left Heart Disease ◽  
Number Of Patients ◽  
Hemodynamic Assessment

Pulmonary hypertension (PH) due to left heart disease (PH-LHD) is a significant predictor of outcome for patients with any type of heart failure (HF), and represents a subset of PH affecting a large number of patients. Because the condition is no standalone inherent pulmonary vascular disorder but the consequence of heart disease, its understanding is dependent on a thorough insight in current HF epidemiology, pathophysiology, diagnosis, and treatments. Although the age-specific incidence of HF is decreasing, this trend is less dramatic for HF with preserved ejection fraction than for HF with reduced ejection fraction. Both the current 2015 ESC/ERS guidelines for the diagnosis and treatment of PH, and the 2016 ESC guidelines for the diagnosis and treatment of acute and chronic HF have adopted new insights in the current understanding of PH-LHD (PH group 2), but no consensus has been reached. Due to multimorbidity, advanced age, referral biases, and a large proportion of noncardiovascular deaths in this population, proper hemodynamic and clinical characterization of patients with and without significant pulmonary vascular disease is important. Definitions largely depend on fluid status which should be assessed prior to any hemodynamic assessment. Benefit from pulmonary arterial hypertension–targeted treatments appears unlikely from today's perspective, but there is an immense unmet need for any treatments of this condition, and proper trials still have to be done.

Characterization of a Pulmonary Hypertension Model Caused by Left Heart Disease in Mouse

2020 ◽  
Author(s):  
L. K. Pallos ◽  
J. M. Dietrich ◽  
A. Simon ◽  
E. Carls ◽  
M. Matthey ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Left Heart ◽  
Left Heart Disease

Pulmonary Hypertension secondary to Left Heart Disease

2018 ◽  
Vol 16 (6) ◽  
pp. 555-560 ◽  
Author(s):  
Ghazal Kabbach ◽  
Debabrata Mukherjee
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Left Heart ◽  
Left Heart Disease

scholarly journals Under pressure: pulmonary hypertension associated with left heart disease

2015 ◽  
Vol 24 (138) ◽  
pp. 665-673 ◽  
Author(s):  
Harrison W. Farber ◽  
Simon Gibbs
Keyword(s):  
Pulmonary Hypertension ◽  
Heart Disease ◽  
Survival Rates ◽  
Left Ventricular ◽  
Left Heart ◽  
Mean Pulmonary Arterial Pressure ◽  
Left Heart Disease ◽  
Right Heart Catheterisation ◽  
Pulmonary Capillary ◽  
Pulmonary Arterial

Pulmonary hypertension (PH) associated with left heart disease (PH-LHD) is the most common type of PH, but its natural history is not well understood. PH-LHD is diagnosed by right heart catheterisation with a mean pulmonary arterial pressure ≥25 mmHg and a pulmonary capillary wedge pressure >15 mmHg. The primary causes of PH-LHD are left ventricular dysfunction of systolic and diastolic origin, and valvular disease. Prognosis is poor and survival rates are low. Limited progress has been made towards specific therapies for PH-LHD, and management focuses on addressing the underlying cause of the disease with supportive therapies, surgery and pharmacological treatments. Clinical trials of therapies for pulmonary arterial hypertension in patients with PH-LHD have thus far been limited and have provided disappointing or conflicting results. Robust, long-term clinical studies in appropriate target populations have the potential to improve the outlook for patients with PH-LHD. Herein, we discuss the knowledge gaps in our understanding of PH-LHD, and describe the current unmet needs and challenges that are faced by clinicians when identifying and managing patients with this disease.

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