Pulmonary hypertension in chronic heart failure.
The presence of PH in patients who suffer from CHF is common and predicts a poor outcome. However, precise definitions for PH associated with left heart disease, or 'out-of-proportion' PH as well as standardised vasodilator testing protocols are lacking. Moreover, apart from single-centre observations no large-scale trial to date has demonstrated a long-term benefit from pulmonary vasoactive drugs. As a result, there are currently no consensus recommendations for the treatment of PH in the presence of CHF. Off-label use of specific vasodilators in this patient population is discouraged. In a majority of cases, treatment of the underlying left heart disease leads to a decrease in pulmonary pressures. In light of novel agents to treat PH, trials that specifically address 'out-of-proportion' PH in CHF patients are warranted.
Bonderman
D
D
Department of Cardiology, Medical University of Vienna, Waehringer Guertel 18-20, Vienna, Austria. diana.bonderman@meduniwien.ac.at
Martischnig
A M
AM
Moertl
D
D
Lang
I M
IM
D000959:Antihypertensive Agents / Q000627:therapeutic use; D006328:Cardiac Catheterization / Q000379:methods; D004730:Endothelium, Vascular / Q000503:physiopathology; D006333:Heart Failure / Q000150:complications*; D016027:Heart Transplantation; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D014661:Vasoconstriction / Q000502:physiology
D000959:Antihypertensive Agents