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Left heart disease-associated pulmonary hypertension: advances in its diagnosis and treatment |
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DOI:10.3724/SP.J.1264.2012.00017 |
Key words:pulmonary hypertension heart failure diagnosis treatment |
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Abstract: |
Left heart disease (LHD) is one of the most common causes of heart failure. Pulmonary hypertension (PH) is a common hemodynamic finding in patients with LHD and is usually associated with increased morbidity and mortality. LHD-assoicated PH is one of the most common types. Doppler echocardiography remains the most useful noninvasive tool for assessing the presence of PH in patients with LHD, and for diagnosis and assessment of LHD. Typical hemodynamic finding in LHD-associated PH is pre-capillary PH. Hemodynamic parameters, including pulmonary capillary wedge pressure, pulmonary artery pressure, pulmonary vascular resistance and transpulmonary pressure gradient (for example mPAP–mPCWP), are all valuable in diagnosis, differential diagnosis, assessment, and effective treatment of LHD-associated PH. Most importantly, the underlying cause of LHD should be treated firstly. Drugs with proven efficacy in pulmonary arterial hypertension are being increasingly used in LHD-associated PH, despite the virtual absence of supporting evidence from clinical trials. LHD-associated PH may be the hot and difficult point in the future researches on PH, as well as heart failure. |
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