Outcomes in World Health Organization Group II Pulmonary Hypertension: Mortality and Readmission Trends With Systolic and Preserved Ejection Fraction–Induced Pulmonary Hypertension

Salamon, Jason N.; Kelesidis, Iosif; Msaouel, Pavlos; Mazurek, Jeremy A.; Mannem, Santhosh; Adzic, Aleksandar; Zolty, Ronald

doi:10.1016/j.cardfail.2014.05.003

Cited by 35 publications

(21 citation statements)

References 47 publications

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“…), it is not surprising that the presence of atrial fibrillation was reported in 28–48% of patients with PH‐HFpEF (Salamon et al . ; Berthelot et al . ).…”

Section: Definitions Classification Of Subtypes and Diagnostic Factomentioning

confidence: 99%

Insights into the pulmonary vascular complications of heart failure with preserved ejection fraction

Lai

Wang

Gladwin

2018

The Journal of Physiology

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Pulmonary hypertension in the setting of heart failure with preserved ejection fraction (PH-HFpEF) is a growing public health problem that is increasing in prevalence. While PH-HFpEF is defined by a high mean pulmonary artery pressure, high left ventricular end-diastolic pressure and a normal ejection fraction, some HFpEF patients develop PH in the presence of pulmonary Yen-Chun (Charly) Lai is an Assistant Professor at Indiana University. Her lab focuses primarily on investigating pathogenesis and development of alternative therapies for effective treatment of cardiopulmonary diseases, with the particular emphasis of metabolic syndrome, pulmonary hypertension and heart failure with preserved ejection fraction. Mark Gladwin is a Jack D. Myers Professor and Chair at University of Pittsburgh. He is recognized internationally as an expert in pulmonary hypertension, having described the pathobiology and clinical characteristics of pulmonary hypertension in patients with sickle cell disease and other chronic hereditary and acquired haemolytic diseases. He served on the Dana Point Pulmonary Hypertension Classification Committee and co-authored the report. He served on the NHLBI advisory committee to develop the 'Strategic Plan for Lung Vascular Research' . He has authored more than 10 textbook chapters on pulmonary vascular disease and has published over 100 papers on the topic of pulmonary hypertension alone. vascular remodelling with a high transpulmonary pressure gradient or pulmonary vascular resistance. Ageing, increased left atrial pressure and stiffness, mitral regurgitation, as well as features of metabolic syndrome, which include obesity, diabetes and hypertension, are recognized as risk factors for PH-HFpEF. Qualitative studies have documented that patients with PH-HFpEF develop more severe symptoms than those with HFpEF and are associated with more significant exercise intolerance, frequent hospitalizations, right heart failure and reduced survival. Currently, there are no effective therapies for PH-HFpEF, although a number of candidate drugs are being evaluated, including soluble guanylate cyclase stimulators, phosphodiesterase type 5 inhibitors, sodium nitrite and endothelin receptor antagonists. In this review we attempt to provide an updated overview of recent findings pertaining to the pulmonary vascular complications in HFpEF in terms of clinical definitions, epidemiology and pathophysiology. Mechanisms leading to pulmonary vascular remodelling in HFpEF, a summary of pre-clinical models of HFpEF and PH-HFpEF, and new candidate therapeutic strategies for the treatment of PH-HFpEF are summarized. Abstract figure legendPrevalence and pathophysiology of pulmonary hypertension (PH) in patients with heart failure with preserved ejection fraction (HFpEF). LA, left atrium; LV, left ventricle; LVEDP, left ventricular end-diastolic pressure; PA, pulmonary artery/arterial; PV, pulmonary vein; PVR, pulmonary vascular resistance; RV, right ventricle. Definitions, classification of subtypes and diagnostic factors of...

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“…), it is not surprising that the presence of atrial fibrillation was reported in 28–48% of patients with PH‐HFpEF (Salamon et al . ; Berthelot et al . ).…”

Section: Definitions Classification Of Subtypes and Diagnostic Factomentioning

confidence: 99%

Insights into the pulmonary vascular complications of heart failure with preserved ejection fraction

Lai

Wang

Gladwin

2018

The Journal of Physiology

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“…In CKD, a proposed for HF staging, which includes the characterization "H" for heart, "L" for lung, and "M" for malfunction of other organs including the kidney (39). Most distant organ malfunctions (e.g., liver, kidney, or bowel) are the result of right-sided HF and acute on chronic venous congestion (40). Additionally, AKI occurs in 25% to 33% of acute decompensated HF, which is an independent risk factor for prolonged hospitalization, need for renal replacement therapies, readmission, increased stroke risk, and mortality (41).…”

mentioning

confidence: 99%

Cardio-Pulmonary-Renal Interactions

Husain‐Syed

McCullough

Birk

et al. 2015

Journal of the American College of Cardiology

167

110

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Over the past decade, science has greatly advanced our understanding of interdependent feedback mechanisms involving the heart, lung, and kidney. Organ injury is the consequence of maladaptive neurohormonal activation, oxidative stress, abnormal immune cell signaling, and a host of other mechanisms that precipitate adverse functional and structural changes. The presentation of interorgan crosstalk may include an acute, chronic, or acute on chronic timeframe. We review the current, state-of-the-art understanding of cardio-pulmonary-renal interactions and their related pathophysiology, perpetuating nature, and cycles of increased susceptibility and reciprocal progression. To this end, we present a multidisciplinary approach to frame the diverse spectrum of published observations on the topic. Assessment of organ functional reserve and use of biomarkers are valuable clinical strategies to screen and detect disease, assist in diagnosis, assess prognosis, and predict recovery or progression to chronic disease.

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“…According to Leung and colleagues 21 , PHͲHFpEF is more frequently associated with higher LV endͲdiastolic pressure, more advanced age, atrial arrhythmias, obesity, and chronic obstructive pulmonary disease, compared to HFpEF with normal PAP. In two reports comparing PHͲHFpEF and PHͲHFrEF 27 and HFpEF without PH 13 the incidence of atrial fibrillation was the comorbid condition that differenced best the HFpEF entity. An echoͲ derived PASP ш 39 mmHg identifies a worse prognosis in HFpEF vs. HFrEF 28 and, interestingly, for a similar degree of PH, prognosis is worse compared to HFrEF 27 .…”

Section: Definition and Prevalencementioning

confidence: 96%