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- Title
Treatment of pulmonary hypertension with left heart disease: a concise review.
- Authors
Desai, Anish; Desouza, Shilpa A.
- Abstract
Pulmonary hypertension (PH) is defined by a mean pulmonary artery pressure ≥ 25 mmHg, as determined by right heart catheterization. Pulmonary arterial hypertension (PAH) can no longer be considered an orphan disease given the increase in awareness and availability of new drugs. PH carries with it a dismal prognosis and leads to significant morbidity and mortality. Symptoms can range from dyspnea, fatigue and chest pain to right ventricular failure and death. PH is divided into five groups by the World Health Organization (WHO), based on etiology. The most common cause of PH in developed countries is left heart disease (group 2), owing to the epidemic of heart failure (HF). The data regarding prevalence, diagnosis and treatment of patients with group 2 PH is unclear as large, prospective, randomized controlled trials and standardized protocols do not exist. Current guidelines do not support the use of PAH-specific therapy in patients with group 2 PH. Prostacyclins, endothelin receptor antagonists, phosphodiesterase-5 inhibitors and guanylate cyclase stimulators have been tried in treatment of patients with HF and/or group 2 PH with mixed results. This review summarizes and critically appraises the evidence for diagnosis and treatment of patients with group 2 PH/HF and suggests directions for future research.
- Subjects
PULMONARY hypertension treatment; HEART diseases; CARDIAC catheterization; CHEST pain; DYSPNEA; PULMONARY hypertension diagnosis; ARTERIES; BLOOD pressure; HEART physiology; LEFT heart ventricle; HEART failure; ANTIHYPERTENSIVE agents; PULMONARY artery; PULMONARY hypertension; VASODILATORS; VENTRICULAR remodeling; TREATMENT effectiveness; DISEASE prevalence; DIAGNOSIS; THERAPEUTICS
- Publication
Vascular Health & Risk Management, 2017, Vol 13, p415
- ISSN
1176-6344
- Publication type
journal article
- DOI
10.2147/VHRM.S111597