title: Pulmonary hypertension in patients with heart failure and preserved ejection fraction: differential diagnosis and management.
abstract: The most common cause of pulmonary hypertension (PH) due to left heart disease (LHD) was previously rheumatic mitral valve disease. However, with the disappearance of rheumatic fever and an aging population, nonvalvular LHD is now the most common cause of group 2 PH in the developed world. In this review, we examine the challenge of investigating patients who have PH and heart failure with preserved ejection fraction (HF-pEF), where differentiating between pulmonary arterial hypertension (PAH) and PH-LHD can be difficult, and also discuss the entity of combined precapillary and postcapillary PH. Given the proven efficacy of targeted therapy for the treatment of PAH, there is increasing interest in whether these treatments may benefit selected patients with PH associated with HF-pEF, and we review current trial data.
authors.affiliation: Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield National Health Service (NHS) Teaching Hospitals Foundation Trust, Sheffield, United Kingdom.
authors.forename: Nehal
authors.initials: N
authors.lastname: Hussain
authors.affiliation: Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield National Health Service (NHS) Teaching Hospitals Foundation Trust, Sheffield, United Kingdom.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Charalampopoulos
authors.affiliation: Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield National Health Service (NHS) Teaching Hospitals Foundation Trust, Sheffield, United Kingdom.
authors.forename: Sheila
authors.initials: S
authors.lastname: Ramjug
authors.affiliation: Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield National Health Service (NHS) Teaching Hospitals Foundation Trust, Sheffield, United Kingdom.
authors.forename: Robin
authors.initials: R
authors.lastname: Condliffe
authors.affiliation: Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield National Health Service (NHS) Teaching Hospitals Foundation Trust, Sheffield, United Kingdom.
authors.forename: Charlie A
authors.initials: CA
authors.lastname: Elliot
authors.affiliation: Department of Cardiology, Northern General Hospital, Sheffield NHS Teaching Hospitals Foundation Trust, Sheffield, United Kingdom.
authors.forename: Laurence
authors.initials: L
authors.lastname: O'Toole
authors.affiliation: Academic Unit of Radiology, University of Sheffield, Royal Hallamshire Hospital, Sheffield NHS Teaching Hospitals Foundation Trust, Sheffield, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Swift
authors.affiliation: Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield National Health Service (NHS) Teaching Hospitals Foundation Trust, Sheffield, United Kingdom.
authors.forename: David G
authors.initials: DG
authors.lastname: Kiely
keywords: combined pre- and postcapillary pulmonary hypertension; diastolic dysfunction; heart failure with preserved ejection fraction; pulmonary arterial hypertension