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Pulmonary hypertension in left heart disease

Marco Guazzi, Nazzareno Galiè
European Respiratory Review 2012 21: 338-346; DOI: 10.1183/09059180.00004612
Marco Guazzi
*Heart Failure Unit, University of Milan, IRCCS Policlinico San Donato, Milan, and #Institute of Cardiology, University of Bologna, Bologna, Italy.
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  • For correspondence: marco.guazzi@unimi.it
Nazzareno Galiè
*Heart Failure Unit, University of Milan, IRCCS Policlinico San Donato, Milan, and #Institute of Cardiology, University of Bologna, Bologna, Italy.
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Abstract

Pulmonary hypertension (PH) is a frequent complication of left heart disease arising from a wide range of cardiac disorders. In the clinical classification, PH associated with left heart disease is classified as Group 2, which includes left heart systolic dysfunction, left heart diastolic dysfunction and left heart valvular disease. In the past, rheumatic mitral valve disease was the most common cause of PH in left heart disease; however, today it is more likely to be associated with hypertensive and/or ischaemic heart disease.

As the incidence of these conditions is increasing, the number of patients presenting with PH is also increasing and, today, left heart disease represents the most frequent cause of PH. The development of PH in patients with left heart disease is associated with poor prognosis. However, despite the increasingly large number of patients affected and the impact of PH on outcome, there are currently no specific treatment options for these patients.

This review gives an overview of the pathophysiology and epidemiology of PH associated with left heart disease, and discusses the challenges associated with its management and treatment.

  • Left heart disease
  • preserved ejection fraction
  • pulmonary hypertension

Footnotes

  • Provenance

    Publication of this peer-reviewed article was supported by Actelion Pharmaceuticals Ltd, Switzerland (principal sponsor, European Respiratory Review issue 126).

  • Statement of Interest

    M. Guazzi has served as a consultant for medical meetings from Merck and received payment for lecture fees from Actelion Pharmaceuticals Ltd. N. Galiè has served as a consultant and received payment for lecture fees from Actelion Pharmaceuticals Ltd, Pfizer, GSK, Eli Lilly and Bayer Schering Pharma.

  • Received August 23, 2012.
  • Accepted September 13, 2012.
  • ©ERS 2012
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Pulmonary hypertension in left heart disease
Marco Guazzi, Nazzareno Galiè
European Respiratory Review Dec 2012, 21 (126) 338-346; DOI: 10.1183/09059180.00004612

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Pulmonary hypertension in left heart disease
Marco Guazzi, Nazzareno Galiè
European Respiratory Review Dec 2012, 21 (126) 338-346; DOI: 10.1183/09059180.00004612
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    • Abstract
    • PATHOPHYSIOLOGY OF PH-LHD
    • EPIDEMIOLOGY AND NATURAL HISTORY OF PH-LHD
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