Pulmonary Hypertension in Left Heart Disease

  • Wolfgang Krüger
Chapter
First Online:

Abstract

Elevated left ventricular filling pressures are a general feature and hallmark of heart failure resulting from cardiac dysfunctions, essentially arising from and affecting the left ventricle [1, 2]. These disorders include heart failure due to diastolic and/or systolic malfunctions, as such heart failure with preserved (HFpEF) and without preserved; reduced (HFrEF) ejection fraction; valvular diseases; congenital cardiomyopathies; and congenital and acquired afflictions of left heart inflow and/or outflow tract [2, 3]. Thereby, the pressure of the left atrium will be elevated, either subsequently due to the increased LV-filling pressure [1, 4] or even initially, primarily in case of mitral stenosis [5]. In any case, left heart disease (LHD) is generally characterized by elevated left-sided filling pressures [4, 6]. The left-sided filling pressures are transmitted backwards, downstream, thereby causing an increase in pulmonary venous pressures [1, 5–7], a condition “of passive or congestive nature” as associated with pulmonary venous congestion [6]. In the literature this issue has in the past been called pulmonary venous hypertension (PvH) [8], or post-capillary pulmonary hypertension [9] or passive pulmonary hypertension [10]. Consequently, with the rise in pulmonary venous pressure, pulmonary artery pressure (PAP) also increases [11].

Keywords

Left heart disease (LHD) Pulmonary venous hypertension (PvH) Postcapillary pulmonary hypertension Precapillary pulmonary hypertension Pulmonary capillary wedge pressure (PCWP) Pulmonary hypertension Pulmonary vascular resistance Alveolar-capillary stress failure Pulmonary edema Pulmonary congestion Venous congestion Endothelial dysfunction Systemic inflammation RV-PA-coupling Rv afterload RV systolic function Combined pre- and postcapillary pulmonary hypertension (Backward) transmitted elevated filling pressures Pulmonary vasculopathy Transpulmonary pressure gradient (TPG) Diastolic pressure difference/gradient (DPG) Pulmonary artery stiffening Clinical hemodynamic characteristics 
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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Wolfgang Krüger
    • 1
  1. 1.Kantonsspital AarauMedizinische UniversitätsklinikAarauSwitzerland

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