Pulmonary hypertension due to left heart diseases

Jean Luc Vachiéry, Yochai Adir, Joan Albert Barberà, Hunter Champion, John Gerard Coghlan, Vincent Cottin, Teresa De Marco, Nazzareno Galiè, Stefano Ghio, J. Simon R Gibbs, Fernando Martinez, Marc Semigran, Gerald Simonneau, Athol Wells, Werner Seeger

Research output: Contribution to journalArticle

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.

Original languageEnglish
JournalJournal of the American College of Cardiology
Volume62
Issue number25 SUPPL.
DOIs
Publication statusPublished - Dec 24 2013

Keywords

  • clinical trials
  • heart failure
  • pulmonary hypertension
  • pulmonary vascular disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Vachiéry, J. L., Adir, Y., Barberà, J. A., Champion, H., Coghlan, J. G., Cottin, V., De Marco, T., Galiè, N., Ghio, S., Gibbs, J. S. R., Martinez, F., Semigran, M., Simonneau, G., Wells, A., & Seeger, W. (2013). Pulmonary hypertension due to left heart diseases. Journal of the American College of Cardiology, 62(25 SUPPL.). https://doi.org/10.1016/j.jacc.2013.10.033