Pulmonary Hypertension in Heart Failure: Pathophysiology, Pathobiology, and Emerging Clinical Perspectives

Marco Guazzi, Robert Naeije

Research output: Contribution to journalReview articlepeer-review

Abstract

Pulmonary hypertension is a common hemodynamic complication of heart failure. Interest in left-sided pulmonary hypertension has increased remarkably in recent years because its development and consequences for the right heart are now seen as mainstay abnormalities that begin in the early stages of the disease and bear unfavorable prognostic insights. However, some knowledge gaps limit our ability to influence this complex condition. Accordingly, attention is now focused on: 1) establishing a definitive consensus for a hemodynamic definition, perhaps incorporating exercise and fluid challenge; 2) implementing the limited data available on the pathobiology of lung capillaries and small arteries; 3) developing standard methods for assessing right ventricular function and, hopefully, its coupling to pulmonary circulation; and 4) searching for effective therapies that may benefit lung vessels and the remodeled right ventricle. The authors review the pathophysiology, pathobiology, and emerging clinical perspectives on pulmonary hypertension across the broad spectrum of heart failure stages.

Original languageEnglish
Pages (from-to)1718-1734
Number of pages17
JournalJournal of the American College of Cardiology
Volume69
Issue number13
DOIs
Publication statusPublished - Apr 4 2017

Keywords

  • cardiac output
  • pulmonary circulation
  • pulmonary wedge pressure
  • right ventricle

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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