title: Pulmonary Hypertension in Heart Failure: Pathophysiology, Pathobiology, and Emerging Clinical Perspectives.
abstract: Pulmonary hypertension is a common hemodynamic complication of heart failure. Interest in left-sided pulmonary hypertension has increased remarkably in recent years because its development and consequences for the right heart are now seen as mainstay abnormalities that begin in the early stages of the disease and bear unfavorable prognostic insights. However, some knowledge gaps limit our ability to influence this complex condition. Accordingly, attention is now focused on: 1) establishing a definitive consensus for a hemodynamic definition, perhaps incorporating exercise and fluid challenge; 2) implementing the limited data available on the pathobiology of lung capillaries and small arteries; 3) developing standard methods for assessing right ventricular function and, hopefully, its coupling to pulmonary circulation; and 4) searching for effective therapies that may benefit lung vessels and the remodeled right ventricle. The authors review the pathophysiology, pathobiology, and emerging clinical perspectives on pulmonary hypertension across the broad spectrum of heart failure stages.
authors.affiliation: IRCCS Policlinico San Donato Hospital, University of Milan, Milan, Italy. Electronic address: marco.guazzi@unimi.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Guazzi
authors.affiliation: Erasme Hospital, Free University of Brussels, Brussels, Belgium.
authors.forename: Robert
authors.initials: R
authors.lastname: Naeije
mesh_terms: D001808:Blood Vessels / Q000473:pathology; D015444:Exercise / Q000502:physiology; D006333:Heart Failure / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology*; D008168:Lung / Q000098:blood supply / Q000473:pathology; D011652:Pulmonary Circulation; D018497:Ventricular Dysfunction, Right / Q000209:etiology
keywords: cardiac output; pulmonary circulation; pulmonary wedge pressure; right ventricle