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Pulmonary hypertension due to left heart disease

Arch Cardiovasc Dis. 2017 Jun-Jul;110(6-7):420-431. doi: 10.1016/j.acvd.2017.01.010. Epub 2017 Apr 12.

Abstract

Pulmonary hypertension due to left heart disease, also known as group 2 pulmonary hypertension according to the European Society of Cardiology/European Respiratory Society classification, is the most common cause of pulmonary hypertension. In patients with left heart disease, the development of pulmonary hypertension favours right heart dysfunction, which has a major impact on disease severity and outcome. Over the past few years, this condition has been considered more frequently. However, epidemiological studies of group 2 pulmonary hypertension are less exhaustive than studies of other causes of pulmonary hypertension. In group 2 patients, pulmonary hypertension may be caused by an isolated increase in left-sided filling pressures or by a combination of this condition with increased pulmonary vascular resistance, with an abnormally high pressure gradient between arteries and pulmonary veins. A better understanding of the conditions underlying pulmonary hypertension is of key importance to establish a comprehensive diagnosis, leading to an adapted treatment to reduce heart failure morbidity and mortality. In this review, epidemiology, mechanisms and diagnostic approaches are reviewed; then, treatment options and future approaches are considered.

Keywords: Cardiopathie gauche; Hypertension pulmonaire; Left heart disease; Management; Pathophysiology; Physiopathologie; Prise en charge; Pulmonary hypertension.

Publication types

  • Review

MeSH terms

  • Heart Failure / epidemiology
  • Heart Failure / physiopathology
  • Humans
  • Hypertension, Pulmonary / diagnosis
  • Hypertension, Pulmonary / epidemiology*
  • Hypertension, Pulmonary / physiopathology
  • Hypertension, Pulmonary / therapy
  • Predictive Value of Tests
  • Prognosis
  • Risk Factors
  • Stroke Volume
  • Ventricular Dysfunction, Left / diagnosis
  • Ventricular Dysfunction, Left / epidemiology*
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Dysfunction, Left / therapy
  • Ventricular Dysfunction, Right / epidemiology
  • Ventricular Dysfunction, Right / physiopathology
  • Ventricular Function, Left*
  • Ventricular Function, Right
  • Ventricular Pressure