Pulmonary hypertension in heart failure.
BACKGROUND
Pulmonary hypertension occurs in 60% to 80% of patients with heart failure and is associated with high morbidity and mortality.


RESULTS
Pulmonary artery pressure correlates with increased left ventricular end-diastolic pressure. Therefore, pulmonary hypertension is a common feature of heart failure with preserved as well as reduced systolic function. Pulmonary hypertension is partially reversible with normalization of cardiac filling pressures. Pulmonary vasculature remodeling and vasoconstriction create a second component, which does not reverse immediately, but has been shown to improve with vasoactive drugs and especially with left ventricular assist devices.


CONCLUSIONS
Many drugs used for idiopathic pulmonary arterial hypertension are being considered as treatment options for heart failure-related pulmonary hypertension. This is of particular significance in the heart transplant population. Randomized clinical trials with interventions targeting heart failure patients with elevated pulmonary artery pressure would be justified.
Guglin
Maya
M
Department of Cardiology, University of South Florida, Tampa, Florida 33618, USA. mguglin@health.usf.edu
Khan
Hammad
H
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002316:Cardiotonic Agents / Q000627:therapeutic use; D065128:Endothelin Receptor Antagonists; D006333:Heart Failure / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D009569:Nitric Oxide / Q000008:administration & dosage / Q000627:therapeutic use; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D011453:Prostaglandins / Q000627:therapeutic use; D012307:Risk Factors; D013318:Stroke Volume; D014655:Vascular Resistance; D014665:Vasodilator Agents / Q000627:therapeutic use; D016277:Ventricular Function, Left
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D002316:Cardiotonic Agents; D065128:Endothelin Receptor Antagonists; D010726:Phosphodiesterase Inhibitors; D011453:Prostaglandins; D014665:Vasodilator Agents; D009569:Nitric Oxide