May 01, 2011
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Study findings elucidate common form of pulmonary hypertension

Thenappan T. Circ Heart Fail. 2011;doi:10.1161/CIRCHEARTFAILURE.110.958801.

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Researchers of a new study in Circulation: Heart Failure have reported differences in characteristics between pulmonary hypertension associated with left-sided HF and preserved ejection fraction and pulmonary arterial hypertension, including less severe pulmonary hypertension and a higher prevalence of CV comorbidities.

In the study, investigators enrolled three groups of patients — those with pulmonary hypertension associated with left-sided HF and preserved ejection fraction (PH-HFpEF; n=100), those with pulmonary arterial hypertension (n=522) and those with HFpEF but without pulmonary vascular disease (n=45). They then compared clinical, echocardiographic and hemodynamic characteristics of the three groups to distinguish clinically relevant differences in patients with PH-HFpEF.

Compared with patients with PAH, those with PH-HFpEF were found to have less severe pulmonary hypertension (P<.001). Specifically, those with PH-HFpEF vs. PAH were older and had an increased likelihood of CV comorbidities, worse exercise capacity and renal function, and left atrial enlargement, and they also had a lesser likelihood of right atrial enlargement.

When compared with patients with HFpEF but without pulmonary vascular disease, however, individuals with PH-HFpEF were more often female and symptomatic, had higher right atrial pressure, and had a higher likelihood of right atrial enlargement and right ventricular hypertrophy.

For future research, the researchers wrote: “Studies to determine why some patients with HFpEF develop pulmonary vascular disease while others do not are needed to better understand the pathophysiology of PH-HFpEF. Because of the increasing frequency in which these patients are becoming diagnosed, a better understanding of their outcome and response to treatments is urgently needed.”

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