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Pulmonary Hypertension Due to Left Heart Disease: an Update

  • Heart Failure (HJ Eisen, Section Editor)
  • Published:
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Abstract

Purpose of Review

Pulmonary hypertension (PH) frequently complicates heart failure and portends a worse prognosis. This review will summarize and discuss recent updates in the classification and management of patients with PH due to left heart disease.

Recent Findings

Careful hemodynamic assessment is critical to the classification of patients with PH and heart failure. Two hemodynamic subgroups of PH in heart failure patients have been described: isolated post-capillary pulmonary hypertension and combined post- and precapillary pulmonary hypertension. The cornerstone in management of PH due to left heart disease is the treatment of the underlying left heart pathology; however, ongoing trials have been designed to test pulmonary vasodilators in this cohort.

Summary

PH-specific therapies have not demonstrated a benefit in patients with pulmonary hypertension due to left heart disease. Understanding the distinct pathobiology of each hemodynamic subgroup may lead to the development of useful biomarkers and effective targeted therapies.

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Authors and Affiliations

  1. Division of Cardiology, University of California San Francisco, 505 Parnassus Avenue, Box 0124, San Francisco, CA, 94143, USA

    Mandar A. Aras & Teresa De Marco

  2. Inova Heart and Vascular Institute, Falls Church, VA, USA

    Mitchell A. Psotka

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  1. Mandar A. Aras
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Correspondence to Teresa De Marco.

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Mandar A. Aras reports no conflict of interest.

Mitchell A. Psotka reports being a consultant for Roivant, Amgen, and Cytokinetics.

Teresa De Marco reports grants from Pfizer and personal fees from Actelion Pharm, Arena Pharm, United Therapeutics, Novartis, Boston Scientific, Bellerophon, Respirix, and Gilead.

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Aras, M.A., Psotka, M.A. & De Marco, T. Pulmonary Hypertension Due to Left Heart Disease: an Update. Curr Cardiol Rep 21, 62 (2019). https://doi.org/10.1007/s11886-019-1149-1

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