NYMC Faculty Publications

DOI

10.21037/jtd.2017.07.24

Journal Title

Journal of Thoracic Disease

First Page

2640

Last Page

2649

Document Type

Article

Publication Date

8-1-2017

Department

Medicine

Abstract

Pulmonary hypertension in left heart disease (PH-LHD) commonly complicates prolonged heart failure (HF). When advanced, the PH becomes fixed or out of proportion and is associated with increased morbidity and mortality in patients undergoing orthotopic heart transplant (OHT). To date, the only recommended treatment of out of proportion PH is the treatment of the underlying HF by reducing the pulmonary capillary wedge pressure (PCWP) with medications and often along with use of mechanical circulatory support. Medical therapies typically used in the treatment of World Health Organization (WHO) group 1 pulmonary arterial hypertension (PAH) have been employed off-label in the setting of PH-LHD with varying efficacy and often negative outcomes. We will discuss the current standard of care including treating HF and use of mechanical circulatory support. In addition, we will review the studies published to date assessing the efficacy and safety of PAH medications in patients with PH-LHD being considered for OHT.

Publisher's Statement

Originally published in Journal of Thoracic Disease; 9(8):2640-2649. The original material can be found here.

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