Pulmonary hypertension with left-sided heart disease

Marco Guazzi, Ross Arena

Research output: Contribution to journalArticle

Abstract

Pulmonary hypertension (PH) with left-sided heart disease is defined, according to the latest Venice classification, as a Group 2 PH, which includes left-sided ventricular or atrial disease, and left-sided valvular diseases. These conditions are all associated with increased left ventricular filling pressure. Although PH with left-sided heart disease is a common entity, and long-term follow-up trials have provided firm recognition that development of left-sided PH carries a poor outcome, available data on incidence, pathophysiology, and therapy are sparse. Mitral stenosis was reported as the most frequent cause of PH several decades ago, but PH with left-sided heart disease is now usually caused by systemic hypertension and ischemic heart disease. In patients with these conditions, PH develops as a consequence of impaired left ventricular relaxation and distensibility. Chronic sustained elevation of cardiogenic blood pressure in pulmonary capillaries leads to a cascade of untoward retrograde anatomical and functional effects that represent specific targets for therapeutic intervention. The pathophysiological and clinical importance of the hemodynamic consequences of left-sided heart disease, starting with lung capillary injury and leading to right ventricular overload and failure, are discussed in this Review, focusing on PH as an evolving contributor to heart failure that may be amenable to novel interventions.

Original languageEnglish
Pages (from-to)648-659
Number of pages12
JournalNature Reviews Cardiology
Volume7
Issue number11
DOIs
Publication statusPublished - Nov 2010

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Pulmonary Hypertension
Heart Diseases
Mitral Valve Stenosis
Lung Injury
Ventricular Pressure
Myocardial Ischemia
Heart Failure
Hemodynamics
Blood Pressure
Hypertension
Lung
Incidence
Therapeutics

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Pulmonary hypertension with left-sided heart disease. / Guazzi, Marco; Arena, Ross.

In: Nature Reviews Cardiology, Vol. 7, No. 11, 11.2010, p. 648-659.

Research output: Contribution to journalArticle

Guazzi, Marco ; Arena, Ross. / Pulmonary hypertension with left-sided heart disease. In: Nature Reviews Cardiology. 2010 ; Vol. 7, No. 11. pp. 648-659.
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