Pulmonary Hypertension Due to Left Ventricular Cardiomyopathy: Is it the Result or Cause of Disease Progression?

Curr Heart Fail Rep. 2017 Dec;14(6):507-513. doi: 10.1007/s11897-017-0368-2.

Abstract

Purpose of review: The purpose of this review is to define pulmonary hypertension in the setting of left heart disease (PH-LHD), discuss its epidemiology and pathophysiology, and highlight the cause and effect relationship it has with disease progression in the setting of cardiomyopathy.

Recent findings: Both pulmonary hypertension (PH) and heart failure are becoming increasingly common. As such, PH-LHD is now the most common form of PH. The pathophysiology of the condition relates to backward transmission of elevated left ventricular filling pressures into the pulmonary circulation and, ultimately, right ventricular (RV) strain/dysfunction. It is evident that these pathophysiologic processes are both the effect and cause of left heart disease progression. In this review, we describe the complex relationship between disease progression in left ventricular cardiomyopathy and PH-LHD. Clinicians and researchers should take note of the importance of PH-LHD and RV dysfunction to appropriately risk stratify patients and develop therapies for the condition.

Keywords: Cardiomyopathy; Heart failure; Left heart disease; Pulmonary hypertension; Valvular heart disease; WHO group 2.

Publication types

  • Review

MeSH terms

  • Cardiomyopathies / complications*
  • Cardiomyopathies / physiopathology
  • Disease Progression
  • Global Health
  • Heart Ventricles / physiopathology*
  • Humans
  • Hypertension, Pulmonary* / epidemiology
  • Hypertension, Pulmonary* / etiology
  • Hypertension, Pulmonary* / physiopathology
  • Incidence
  • Ventricular Dysfunction, Left / complications*
  • Ventricular Dysfunction, Left / physiopathology