Universität zu Köln

Rosenkranz, S., Kramer, T., Gerhardt, F., Opitz, C., Olsson, K. M. and Hoeper, M. M. (2019). Pulmonary hypertension in HFpEF and HFrEF: Pathophysiology, diagnosis, treatment approaches. Herz, 44 (6). S. 483 - 491. MUNICH: URBAN & VOGEL. ISSN 1615-6692

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Abstract

Pulmonary hypertension (PH) is a frequent hemodynamic condition that is highly prevalent in patients with heart failure and reduced (HFrEF) or preserved ejection fraction (HFpEF). Irrespective of left ventricular EF, the presence of PH and right ventricular (RV) dysfunction are highly relevant for morbidity and mortality in patients with heart failure. While elevated left-sided filling pressures and functional mitral regurgitation primarily lead to post-capillary PH, current guidelines and recommendations distinguish between isolated post-capillary PH (IpcPH) and combined post- and pre-capillary PH (CpcPH), the latter being defined by a pulmonary vascular resistance (PVR) of >= 3 Wood units. Here, we describe the pathophysiology and clinical relevance of these distinct entities, and report on the diagnostic work-up including remote pulmonary artery pressure (PAP) monitoring. Furthermore, we highlight strategies to manage PH and improve RV function in heart failure, which may include optimized management of HFrEF and HFpEF (medical and interventional), sufficient volume control, catheter-based mitral valve repair, and-in selected cases-targeted PH therapy. In this context, we also highlight gaps in evidence and the need for further research.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Rosenkranz, S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kramer, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gerhardt, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Opitz, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Olsson, K. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoeper, M. M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-142930
DOI:	10.1007/s00059-019-4831-6
Journal or Publication Title:	Herz
Volume:	44
Number:	6
Page Range:	S. 483 - 491
Date:	2019
Publisher:	URBAN & VOGEL
Place of Publication:	MUNICH
ISSN:	1615-6692
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PRESERVED EJECTION FRACTION; CHRONIC HEART-FAILURE; VENTRICULAR ASSIST DEVICES; ARTERY PRESSURE; PHOSPHODIESTERASE-5 INHIBITION; EXERCISE CAPACITY; PRE-CAPILLARY; DYSFUNCTION; SILDENAFIL; HEMODYNAMICS Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14293