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

Pulmonary hypertension due to left heart disease.

Author information

1
AP-HP, Service de Cardiologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France. Electronic address: Emmanuelle.berthelot@aphp.fr.
2
AP-HP, Service de Cardiologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; Univ. Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France.
3
AP-HP, Service de Cardiologie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.
4
Univ. Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France; AP-HP, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, Hôpital Bicêtre, Le Kremlin Bicêtre, France; INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France.
5
Univ. Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France; AP-HP, Service de Physiologie, Unité INSERM U_999, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.

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

PMID:
28411107
DOI:
10.1016/j.acvd.2017.01.010
[Indexed for MEDLINE]
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