Hemodynamic Definitions, Phenotypes, Pathophysiology, and Evaluation of Pulmonary Hypertension Related to Left Heart Disease

Pulmonary hypertension (PH) can develop from multiple etiologic mechanisms and disease states. Of all such conditions, left-sided heart disease (LHD) is commonly understood to be the most common etiology or mechanism. Given the widespread prevalence of left heart disease and the prognostic implicati...

Full description

Saved in:
Bibliographic Details
Main Authors: Elizabeth C. Ghandakly, Akshat Banga, Roop Kaw
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Journal of Cardiovascular Development and Disease
Subjects:
Online Access:https://www.mdpi.com/2308-3425/12/7/238
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849303493946376192
author Elizabeth C. Ghandakly
Akshat Banga
Roop Kaw
author_facet Elizabeth C. Ghandakly
Akshat Banga
Roop Kaw
author_sort Elizabeth C. Ghandakly
collection DOAJ
description Pulmonary hypertension (PH) can develop from multiple etiologic mechanisms and disease states. Of all such conditions, left-sided heart disease (LHD) is commonly understood to be the most common etiology or mechanism. Given the widespread prevalence of left heart disease and the prognostic implications of PH, early diagnosis is imperative. More recently, the diagnostic cut-offs for mean pulmonary arterial pressure as well as peripheral vascular resistance have been lowered to achieve this objective. Despite these revised standards, the current indications for right heart catheterization are mostly aimed at identifying advanced disease. Proven vasodilator therapies for pulmonary arterial hypertension have so far not shown a meaningful role in the management of PH in LHD. This is largely related to the fact that multiple mechanisms and co-morbidities can independently lead to the development of PH in an individual patient. Understanding and identifying those phenotypes remain important in devising future treatment strategies. Molecular pathways that eventually lead to irreversibility of PH can provide another frontier in the pharmacologic management of PH in LHD.
format Article
id doaj-art-69cef289e5af4490b97396bea390fc1c
institution Kabale University
issn 2308-3425
language English
publishDate 2025-06-01
publisher MDPI AG
record_format Article
series Journal of Cardiovascular Development and Disease
spelling doaj-art-69cef289e5af4490b97396bea390fc1c2025-08-20T03:58:26ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252025-06-0112723810.3390/jcdd12070238Hemodynamic Definitions, Phenotypes, Pathophysiology, and Evaluation of Pulmonary Hypertension Related to Left Heart DiseaseElizabeth C. Ghandakly0Akshat Banga1Roop Kaw2Department of Internal Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USADepartment of Internal Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, MA 02138, USADepartments of Hospital Medicine and Outcomes Research Anesthesiology, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USAPulmonary hypertension (PH) can develop from multiple etiologic mechanisms and disease states. Of all such conditions, left-sided heart disease (LHD) is commonly understood to be the most common etiology or mechanism. Given the widespread prevalence of left heart disease and the prognostic implications of PH, early diagnosis is imperative. More recently, the diagnostic cut-offs for mean pulmonary arterial pressure as well as peripheral vascular resistance have been lowered to achieve this objective. Despite these revised standards, the current indications for right heart catheterization are mostly aimed at identifying advanced disease. Proven vasodilator therapies for pulmonary arterial hypertension have so far not shown a meaningful role in the management of PH in LHD. This is largely related to the fact that multiple mechanisms and co-morbidities can independently lead to the development of PH in an individual patient. Understanding and identifying those phenotypes remain important in devising future treatment strategies. Molecular pathways that eventually lead to irreversibility of PH can provide another frontier in the pharmacologic management of PH in LHD.https://www.mdpi.com/2308-3425/12/7/238pulmonary hypertensionleft heart disease
spellingShingle Elizabeth C. Ghandakly
Akshat Banga
Roop Kaw
Hemodynamic Definitions, Phenotypes, Pathophysiology, and Evaluation of Pulmonary Hypertension Related to Left Heart Disease
Journal of Cardiovascular Development and Disease
pulmonary hypertension
left heart disease
title Hemodynamic Definitions, Phenotypes, Pathophysiology, and Evaluation of Pulmonary Hypertension Related to Left Heart Disease
title_full Hemodynamic Definitions, Phenotypes, Pathophysiology, and Evaluation of Pulmonary Hypertension Related to Left Heart Disease
title_fullStr Hemodynamic Definitions, Phenotypes, Pathophysiology, and Evaluation of Pulmonary Hypertension Related to Left Heart Disease
title_full_unstemmed Hemodynamic Definitions, Phenotypes, Pathophysiology, and Evaluation of Pulmonary Hypertension Related to Left Heart Disease
title_short Hemodynamic Definitions, Phenotypes, Pathophysiology, and Evaluation of Pulmonary Hypertension Related to Left Heart Disease
title_sort hemodynamic definitions phenotypes pathophysiology and evaluation of pulmonary hypertension related to left heart disease
topic pulmonary hypertension
left heart disease
url https://www.mdpi.com/2308-3425/12/7/238
work_keys_str_mv AT elizabethcghandakly hemodynamicdefinitionsphenotypespathophysiologyandevaluationofpulmonaryhypertensionrelatedtoleftheartdisease
AT akshatbanga hemodynamicdefinitionsphenotypespathophysiologyandevaluationofpulmonaryhypertensionrelatedtoleftheartdisease
AT roopkaw hemodynamicdefinitionsphenotypespathophysiologyandevaluationofpulmonaryhypertensionrelatedtoleftheartdisease