Heart failure with preserved ejection fraction (HFpEF) is a common medical condition associated with increased morbidity and mortality. Through different mechanisms, including passive left-sided congestion and/or vasculopathy, patients with HFpEF can develop pulmonary hypertension (PH). This association -PH-HFpEF- is linked with worsening symptomatology and long-term outcomes. Although pulmonary vasodilators have been effective in treating patients with a pulmonary vasculopathy, such as pulmonary arterial hypertension (PAH), these results have not been replicated in those with PH-HFpEF. There is an unmet need to develop effective medical therapy for this challenging population. In this article, we focus on understanding the definition, epidemiology, diagnosis, clinical implications, and treatment for PH in the setting of HFpEF.
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http://dx.doi.org/10.1016/j.ccl.2022.06.007 | DOI Listing |
Lipids Health Dis
January 2025
Department of Cardiology, West China Hospital, Sichuan University West China School of Medicine, 37 Guoxue Road, Chengdu, Sichuan, 610041, China.
Background: Atrial fibrillation (AF) is the most prevalent arrhythmia encountered in clinical practice. Triglyceride glucose index (Tyg), a convenient evaluation variable for insulin resistance, has shown associations with adverse cardiovascular outcomes. However, studies on the Tyg index's predictive value for adverse prognosis in patients with AF without diabetes are lacking.
View Article and Find Full Text PDFHeart Fail Rev
January 2025
Department of Cardiology, San Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy.
Left atrial (LA) hypertension is central in the pathophysiology of heart failure (HF) in general and of HF with preserved ejection fraction (HFpEF) in particular. Despite approved treatments, a number of HF patients continue experiencing disabling symptoms due to LA hypertension, causing pulmonary congestion, pulmonary hypertension, and right heart dysfunction, at rest and/or during exercise. LA decompression therapies, i.
View Article and Find Full Text PDFRadiol Clin North Am
March 2025
Department of Medicine, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8558, USA; Department of Pediatrics, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390-8558, USA. Electronic address:
Pulmonary vascular diseases, particularly when accompanied by pulmonary hypertension, are complex disorders often requiring multimodal imaging for diagnosis and monitoring. Echocardiography is the primary screening tool for pulmonary hypertension, while cardiac MR imaging (CMR) is used for more detailed characterization and risk stratification in right ventricular failure. Chest computed tomography (CT) is used to detect vascular anomalies and parenchymal lung diseases.
View Article and Find Full Text PDFRadiol Clin North Am
March 2025
Radiology Department, Northwestern University Feinberg School of Medicine, Arkes Pavilion, 676 North St Clair Street, Suite 800, Chicago, IL 60611, USA. Electronic address:
Cardiac MR imaging and pulmonary MR angiography (MRA) are important clinical tools for the assessment of pulmonary vascular diseases. There are evolving noncontrast and contrast-enhanced techniques to evaluate pulmonary vasculature. Pulmonary MRA is a feasible imaging alternative to CTA in pulmonary embolism detection.
View Article and Find Full Text PDFRadiol Clin North Am
March 2025
Department of Radiology, University of California San Diego, La Jolla, CA, USA. Electronic address:
Chronic thromboembolic pulmonary hypertension (CTEPH) is pulmonary hypertension secondary to chronic obstruction of pulmonary arteries by organized thromboemboli. Echocardiography and Echocardiography and ventilation/perfusion (V/Q) scan are the initial screening examinations for CTEPH; the diagnosis is often missed on computed tomography (CT). Imaging findings of chronic thromboembolic pulmonary disease overlap with those of acute pulmonary embolism, and radiologists should evaluate for the presence of concurrent chronic disease in all cases of acute pulmonary embolism detected on CT pulmonary angiography.
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