title: Pulmonary hypertension in valvular disease: a comprehensive review on pathophysiology to therapy from the HAVEC Group.
abstract: Pulmonary hypertension (PH) is a classic pathophysiological consequence of left-sided valvular heart disease (VHD). However, as opposed to other forms of PH, there are relatively few published data on the prevalence, impact on outcome, and management of PH with VHD. The objective of this paper is to present a systematic review of PH in patients with VHD. PH is found in 15% to 60% of patients with VHD and is more frequent among symptomatic patients. PH is associated with higher risk of cardiac events under conservative management, during valve replacement or repair procedures, and even following successful corrective procedures. In addition to its usefulness in assessing the presence and severity of VHD, Doppler echocardiography is a key tool in diagnosis of PH and assessment of its repercussion on right ventricular function. Assessment of pulmonary arterial pressure during exercise stress echocardiography may provide additional prognostic information beyond resting evaluation. Cardiac magnetic resonance is also useful for assessing right ventricular geometry and function, which provide additional prognostic information in patients with VHD and PH.
authors.affiliation: Cardiology Department, CHU Dupuytren and INSERM 1094, Faculté de Médecine de Limoges, Limoges, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Magne
authors.affiliation: Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec City, Québec, Canada. Electronic address: philippe.pibarot@med.ulaval.ca.
authors.forename: Philippe
authors.initials: P
authors.lastname: Pibarot
authors.affiliation: Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Partho P
authors.initials: PP
authors.lastname: Sengupta
authors.affiliation: Cardiologie-CHU Rennes and LTSI-INSERM U 1099, Université Rennes-1, Rennes, France.
authors.forename: Erwan
authors.initials: E
authors.lastname: Donal
authors.affiliation: Department of Cardiology, Medical University of Vienna, Vienna, Austria.
authors.forename: Raphael
authors.initials: R
authors.lastname: Rosenhek
authors.affiliation: University of Liège Hospital, GIGA Cardiovascular Sciences, Department of Cardiology, Heart Valve Clinic, CHU Sart Tilman, Liège, Belgium; GVM Care and Research, Bologna, Italy. Electronic address: plancellotti@chu.ulg.ac.be.
authors.forename: Patrizio
authors.initials: P
authors.lastname: Lancellotti
mesh_terms: D015415:Biomarkers / Q000032:analysis; D004452:Echocardiography; D006349:Heart Valve Diseases / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D008944:Mitral Valve Insufficiency / Q000503:physiopathology; D008946:Mitral Valve Stenosis / Q000503:physiopathology; D005082:Physical Exertion
chemical_list: D015415:Biomarkers
keywords: cardiovascular imaging; exercise echocardiography; pulmonary hypertension; therapy; valve