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Pulmonary Hypertension Due to Left Heart Disease-A Practical Approach to Diagnosis and Management.
- Source :
-
The Canadian journal of cardiology [Can J Cardiol] 2021 Apr; Vol. 37 (4), pp. 572-584. Date of Electronic Publication: 2020 Nov 17. - Publication Year :
- 2021
-
Abstract
- Pulmonary hypertension (PH) due to left heart disease (LHD) is a frequent complication of heart failure (HF) and is associated with exercise intolerance, poor quality of life, increased risk of hospitalisations, and reduced overall survival. Since the recent Sixth World Symposium on Pulmonary Hypertension in 2018, there have been significant changes in the hemodynamic definitions and clinical classification of PH-LHD. PH-LHD can be subdivided into (1) isolated postcapillary PH (IpcPH) and (2) combined precapillary and postcapillary PH (CpcPH). This categorisation of PH-LHD is important because CpcPH shares certain pathophysiologic, clinical, and hemodynamic characteristics with pulmonary arterial hypertension and is associated with worse outcomes compared with IpcPH. A systematic approach using clinical history and noninvasive investigations is required in the diagnosis of PH-LHD. Right heart catheterisation with and without provocative testing is performed in expert centres and is indicated in selected individuals. Although the definition of IpcPH and CpcPH is based on measurements made with right heart catheterisation, distinguishing between these two entities is not always necessary. Despite strong evidence for medical therapy in patients with pulmonary arterial hypertension, those options have limited benefit in PH-LHD. Expert PH centres in Canada have been established to provide ongoing care for the more complex patient subgroups.<br /> (Copyright © 2020 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Antihypertensive Agents therapeutic use
Cardiac Catheterization
Diagnostic Techniques, Cardiovascular
Exercise Test
Humans
Phenotype
Pulmonary Wedge Pressure
Ventricular Dysfunction, Left complications
Ventricular Dysfunction, Left etiology
Heart Failure complications
Hypertension, Pulmonary diagnosis
Hypertension, Pulmonary therapy
Ventricular Dysfunction, Left diagnosis
Ventricular Dysfunction, Left therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1916-7075
- Volume :
- 37
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The Canadian journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 33217522
- Full Text :
- https://doi.org/10.1016/j.cjca.2020.11.003