Evaluation of pulmonary hypertension in heart failure with preserved ejection fraction

Borlaug BA, Sharma K, Shah SJ, Ho JE (2023) Heart failure with preserved ejection fraction: JACC Scientific Statement. J Am Coll Cardiol 81:1810–1834

PubMed  Google Scholar 

Reddy YNV et al (2020) Characterization of the progression from ambulatory to hospitalized heart failure with preserved ejection fraction. J Card Fail 26:919–928

PubMed  PubMed Central  Google Scholar 

Omote K et al (2023) Central haemodynamic abnormalities and outcome in patients with unexplained dyspnoea. Eur J Heart Fail 25:185–196

PubMed  CAS  Google Scholar 

Reddy YNV et al (2019) The β-adrenergic agonist albuterol improves pulmonary vascular reserve in heart failure with preserved ejection fraction. Circ Res 124:306–314

PubMed  PubMed Central  CAS  Google Scholar 

Andersen MJ et al (2015) Enhanced pulmonary vasodilator reserve and abnormal right ventricular: pulmonary artery coupling in heart failure with preserved ejection fraction. Circ Heart Fail 8:542–550

PubMed  Google Scholar 

Reddy YNV et al (2024) Clinical implications of pretest probability of HFpEF on outcomes in precapillary pulmonary hypertension. J Am Coll Cardiol 84:2196–2210

PubMed  Google Scholar 

Reddy YNV, Carter RE, Obokata M, Redfield MM, Borlaug BA (2018) A Simple, evidence-based approach to help guide diagnosis of heart failure with preserved ejection fraction. Circulation 138:861–870

PubMed  PubMed Central  Google Scholar 

Obokata M et al (2017) Role of diastolic stress testing in the evaluation for heart failure with preserved ejection fraction: a simultaneous invasive-echocardiographic study. Circulation 135:825–838

PubMed  Google Scholar 

Reddy YNV et al (2022) Diagnosis of heart failure with preserved ejection fraction among patients with unexplained dyspnea. JAMA Cardiol 7:891–899

PubMed  PubMed Central  Google Scholar 

Santos M et al (2015) E/e’ ratio in patients with unexplained dyspnea: lack of accuracy in estimating left ventricular filling pressure. Circ Heart Fail 8:749–756

PubMed  PubMed Central  Google Scholar 

Verbrugge FH et al (2022) Heart failure with preserved ejection fraction in patients with normal natriuretic peptide levels is associated with increased morbidity and mortality. Eur Heart J ehab911 https://doi.org/10.1093/eurheartj/ehab911

Reddy YNV, Tada A, Obokata M, Carter RE, Kaye DM, Handoko ML, Andersen MJ, Sharma K, Tedford RJ, Redfield MM, Borlaug BA (2025) Evidence-based application of natriuretic peptides in the evaluation of chronic heart failure with preserved ejection fraction in the ambulatory outpatient setting. Circulation 151(14):976–989

Obokata M, Reddy YNV, Pislaru SV, Melenovsky V, Borlaug BA (2017) Evidence supporting the existence of a distinct obese phenotype of heart failure with preserved ejection fraction. Circulation 136:6–19

PubMed  PubMed Central  CAS  Google Scholar 

van Riel ACMJ et al (2017) Accuracy of echocardiography to estimate pulmonary artery pressures with exercise: a simultaneous invasive-noninvasive comparison. Circ Cardiovasc Imaging 10:e005711

PubMed  PubMed Central  Google Scholar 

Obokata M et al (2020) Noninvasive evaluation of pulmonary artery pressure during exercise: the importance of right atrial hypertension. Eur Respir J 55:1901617

PubMed  Google Scholar 

Reddy YNV et al (2019) Left atrial strain and compliance in the diagnostic evaluation of heart failure with preserved ejection fraction. Eur J Heart Fail 21:891–900

PubMed  Google Scholar 

Galie N et al (2016) 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: the Joint Task Force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J 37:67–119

PubMed  Google Scholar 

Kovacs G et al (2024) Definition, classification and diagnosis of pulmonary hypertension. Eur Respir J 64:2401324

PubMed  PubMed Central  CAS  Google Scholar 

Grinstein J et al (2023) Variation in hemodynamic assessment and interpretation: a call to standardize the right heart catheterization. J Card Fail 29:1507–1518

PubMed  Google Scholar 

Reddy YNV, El-Sabbagh A, Nishimura RA (2018) Comparing pulmonary arterial wedge pressure and left ventricular end diastolic pressure for assessment of left-sided filling pressures. JAMA Cardiol 3:453–454

PubMed  Google Scholar 

Reddy YNV (2023) Heart failure with preserved ejection fraction and the diagnosis of pulmonary hypertension. Adv Pulm Hypertens 22:130–133

Google Scholar 

Smiseth OA, Thompson CR, Ling H, Robinson M, Miyagishima RT (1994) Juxtacardiac pleural pressure during positive end-expiratory pressure ventilation: an intraoperative study in patients with open pericardium. J Am Coll Cardiol 23:753–758

PubMed  CAS  Google Scholar 

Vanderpool RR, Saul M, Nouraie M, Gladwin MT, Simon MA (2018) Association between hemodynamic markers of pulmonary hypertension and outcomes in heart failure with preserved ejection fraction. JAMA Cardiol 3:298–306

PubMed  PubMed Central  Google Scholar 

Borlaug BA et al (2022) Latent pulmonary vascular disease may alter the response to therapeutic atrial shunt device in heart failure. Circulation 145:1592–1604

PubMed  PubMed Central  CAS  Google Scholar 

Gorter TM, Obokata M, Reddy YNV, Melenovsky V, Borlaug BA (2018) Exercise unmasks distinct pathophysiologic features in heart failure with preserved ejection fraction and pulmonary vascular disease. Eur Heart J 39:2825–2835

PubMed  PubMed Central  Google Scholar 

Maron BA et al (2024) Pulmonary hypertension associated with left heart disease. Eur Respir J 64:2401344

PubMed  PubMed Central  CAS  Google Scholar 

Rayner SG, Tedford RJ, Leary PJ, Mak S, Houston BA (2024) ‘This patient needs a doctor, not a guideline!’ The zone of uncertainty in pulmonary arterial wedge pressure measurement. Am J Respir Crit Care Med 210:712–714

PubMed  PubMed Central  Google Scholar 

Reddy YNV, Asokan AK, Frantz RP, Hemnes A, Hassoun PM, Barnard J, Horn E, Leopold JA, Rischard F, Rosenzweig EB, Hill NS, Erzurum SC, Beck GJ, Finet JE, Grunig G, Jellis CL, Mathai SC, Simpson CE, Tang WHW, Nair KS, Borlaug BA (2025) PVDOMICS study group. Metabolomic evidence of biological overlap with HFpEF in a subset of pulmonary arterial hypertension. Am J Respir Crit Care Med

Reddy YNV et al (2025) Left heart abnormalities in patients with lung disease, OSA, and chronic thromboemboli at risk for or with known pulmonary hypertension. Circ Heart Fail e012912. https://doi.org/10.1161/CIRCHEARTFAILURE.125.012912

Huang W, Oliveira RKF, Lei H, Systrom DM, Waxman AB (2018) Pulmonary vascular resistance during exercise predicts long-term outcomes in heart failure with preserved ejection fraction. J Card Fail 24:169–176

PubMed  CAS  Google Scholar 

Reddy YNV et al (2024) An evidence-based screening tool for heart failure with preserved ejection fraction: the HFpEF-ABA score. Nat Med 30:2258–2264

PubMed  PubMed Central  CAS  Google Scholar 

Assad TR et al (2016) Clinical and biological insights into combined post- and pre-capillary pulmonary hypertension. J Am Coll Cardiol 68:2525–2536

PubMed  PubMed Central  Google Scholar 

Opitz CF et al (2016) Pre-capillary, combined, and post-capillary pulmonary hypertension: a pathophysiological continuum. J Am Coll Cardiol 68:368–378

PubMed  Google Scholar 

McLaughlin VV et al (2019) Patients with pulmonary arterial hypertension with and without cardiovascular risk factors: results from the AMBITION trial. J Heart Lung Transplant Off Publ Int Soc Heart Transplant 38:1286–1295

Kearney K et al (2024) Impact of left heart disease risk factors on outcomes in pulmonary arterial hypertension therapy. Chest 165:967–977

PubMed  Google Scholar 

Rosenkranz S et al (2024) Safety and efficacy of riociguat in patients with pulmonary arterial hypertension and cardiometabolic comorbidities: data from interventional clinical trials. J Heart Lung Transplant Off Publ Int Soc Heart Transplant S1053–2498(24)01807–2. https://doi.org/10.1016/j.healun.2024.08.018

McLaughlin VV et al (2024) Initial combination therapy with macitentan and tadalafil in patients with pulmonary arterial hypertension, with and without cardiac comorbidities. Eur J Heart Fail. https://doi.org/10.1002/ejhf.3319

Article  PubMed  Google Scholar 

Fayyaz AU et al (2018) Global pulmonary vascular remodeling in pulmonary hypertension associated with heart failure and preserved or reduced ejection fraction. Circulation 137:1796–1810

PubMed  Google Scholar 

Obokata M et al (2019) The neurohormonal basis of pulmonary hypertension in heart failure with preserved ejection fraction. Eur Heart J 40:3707–3717

PubMed  PubMed Central  CAS  Google Scholar 

Sera F et al (2022) Pulmonary hypertension with a precapillary component in heart failure with preserved ejection fraction. Heart Br Card Soc heartjnl-2022–321565. https://doi.org/10.1136/heartjnl-2022-321565

Reddy YNV, Borlaug BA (2021) Pulmonary hypertension in left heart disease. Clin Chest Med 42:39–58

PubMed  Google Scholar 

Yamamoto K, Ikeda U, Shimada K (1993) Endothelin production in mitral stenosis. N Engl J Med 329:1740–1741

PubMed  CAS  Google Scholar 

Chowdhury MA et al (2019) Endothelin 1 is associated with heart failure hospitalization and long-term mortality in patients with heart failure with preserved ejection fraction and pulmonary hypertension. Cardiology 143:124–133

PubMed  CAS  Google Scholar 

Kiowski W et al (1995) Evidence for endothelin-1-mediated vasoconstriction in severe chronic heart failure. Lancet 346:732–736

PubMed  CAS  Google Scholar 

Aronson D, Eitan A, Dragu R, Burger AJ (2011) Relationship

Comments (0)

No login
gif