title: Characterization of pulmonary venous hypertension patients with reactive pulmonary hypertension as compared to proportional pulmonary hypertension.
abstract: BACKGROUND
  Patients with pulmonary venous hypertension (PVH) secondary to left heart disease can be further classified according to their hemodynamic profile: pulmonary hypertension (PH) in proportion to the pulmonary capillary wedge pressure (PCWP) and PH out of proportion to the PCWP or reactive PH. Currently, there are no measures that enable prediction of the development of reactive PH in patients with left heart disease.
  
  
  OBJECTIVE
  In this study, we aim to characterize PVH patients with reactive PH as compared to proportional PH in an attempt to create a distinct profile for patients with left heart disease carrying a high risk for the development of reactive PH.
  
  
  METHODS
  Thirty-three PVH patients with reactive PH and 29 PVH patients with proportional PH were analyzed retrospectively over a 6-year period. Clinical, laboratory, echocardiographic and hemodynamic parameters were noted and compared between subgroups.
  
  
  RESULTS
  There was no significant difference between PVH patients with reactive and proportional PH with regard to gender, age (65.91 ± 11.9 vs. 66.69 ± 10.5 years) and body surface area (1.89 ± 0.24 vs. 1.9 ± 0.23 m(2)). Prevalence of the metabolic syndrome components was similar in both groups. Interestingly, PCWP was similar in both groups, as were the structural and functional parameters of the left heart.
  
  
  CONCLUSIONS
  PVH patients with reactive PH have a similar profile as patients with proportional PH; consequently, the evolution of reactive PH is unpredictable. Therefore, it is imperative that physicians maintain a high index of suspicion for the development of reactive PH even in the early stage of heart disease.
authors.affiliation: Division of Pulmonary Medicine, Rambam Health Care Campus, Haifa, Israel.
authors.forename: Gidon
authors.initials: G
authors.lastname: Berger
authors.forename: Emilia
authors.initials: E
authors.lastname: Hardak
authors.forename: Waleed
authors.initials: W
authors.lastname: Obaid
authors.forename: Beatrice
authors.initials: B
authors.lastname: Shaham
authors.forename: Shemi
authors.initials: S
authors.lastname: Carasso
authors.forename: Arthur
authors.initials: A
authors.lastname: Kerner
authors.forename: Mordechai
authors.initials: M
authors.lastname: Yigla
authors.forename: Zaher S
authors.initials: ZS
authors.lastname: Azzam
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006328:Cardiac Catheterization; D005260:Female; D006331:Heart Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000145:classification / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011660:Pulmonary Heart Disease / Q000503:physiopathology; D011669:Pulmonary Wedge Pressure; D012189:Retrospective Studies; D016277:Ventricular Function, Left