Abstract:Purpose of review
Pulmonary hypertension associated with left heart disease (PHLHD) is common and associated with adverse prognosis. Proper diagnosis is critical to avoid inappropriate treatment. Practical approaches to noninvasive diagnosis are available, though invasive hemodynamics including volume loading or exercise are often necessary for definitive diagnosis. Treatment strategies and research in the field is rapidly evolving.
Recent findings
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Pulmonary hypertension (PH) is defined as elevated pressures in the pulmonary artery and is associated with significant morbidity and mortality. The World Health Organization classifies PH into 5 distinct groups based on underlying etiology, pathology, and modality of treatment. Therapeutic approach may be challenging due to the extensive spectrum of causes and underlying mechanisms mediating PH. The 5 groups include pulmonary arterial hypertension (group 1), PH secondary to left heart disease (group 2), PH secondary to chronic lung disease (group 3), chronic thromboembolic pulmonary hypertension (group 4), and PH due to miscellaneous causes (group 5). Although significant progress has been made in the treatment of group 1 PH, there is a continued need to develop new therapies for all types of PH. Additionally, most treatments currently available improve functional capacity and symptoms but without a significant benefit in mortality. In this review, we aim to describe the various etiologies of PH and their established pharmacotherapies, as well as expand on emerging therapeutic options for each group.
Pulmonary hypertension (PH) is defined as elevated pressures in the pulmonary artery and is associated with significant morbidity and mortality. The World Health Organization classifies PH into 5 distinct groups based on underlying etiology, pathology, and modality of treatment. Therapeutic approach may be challenging due to the extensive spectrum of causes and underlying mechanisms mediating PH. The 5 groups include pulmonary arterial hypertension (group 1), PH secondary to left heart disease (group 2), PH secondary to chronic lung disease (group 3), chronic thromboembolic pulmonary hypertension (group 4), and PH due to miscellaneous causes (group 5). Although significant progress has been made in the treatment of group 1 PH, there is a continued need to develop new therapies for all types of PH. Additionally, most treatments currently available improve functional capacity and symptoms but without a significant benefit in mortality. In this review, we aim to describe the various etiologies of PH and their established pharmacotherapies, as well as expand on emerging therapeutic options for each group.
Introduction. Heart failure, with its economic and social burden and increasing incidence in the general population, is a global problem. Since 2015, a new class of drugs with angiotensin and neprilysin re-ceptor inhibitory action, namely the combination of sacubitril and valsartan (S/V), has been introduced in the treatment of HF. The study aimed to perform a bibliometric analysis of the available knowledge and assess research trends through quantitative analysis of the literature related to the use of S/V and physical training in HF. Methods. In the study, we used the Web of Science database, period 2015-January 2024. The data obtained was processed with Vos viewer and Microsoft Excel. The results obtained and their interpretation provided an overview of the most relevant and prolific journals, countries, authors, and organizations. Conclusion. After marketing approval, the publication trend was upward until 2023, when the number of publica-tions decreased significantly. Our study shows that although the number of publications de-creased, updates of treatment guidelines were published, and a significant number of articles supporting the benefits of S/V treatment in chronic HF (with reduced or preserved ejection frac-tion) but also in acute forms were published. Although the number of articles on cardiac rehabilitation is low, this is highlighted in treatment guidelines and studies have emerged assessing the reasons why patients do not follow a cardiac rehabilitation programme. Cardiac rehabilitation is important for its physiological benefits: improving VO2max, myocardial blood flow and endothelial function. Health policies should be put in place to raise awareness of the importance of cardiac rehabilitation, including distances to a rehabilitation centre.
Keywords: sacubitril/valsartan; heart failure; cardiac rehabilitation; bibliometric analysis
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