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Pulmonary hypertension in potential heart transplant recipients: current treatment strategies
Journal article   Open access

Pulmonary hypertension in potential heart transplant recipients: current treatment strategies

Manreet Kanwar, Amresh Raina, Maria Patarroyo Aponte and Raymond Benza
Current opinion in organ transplantation, v 20(5), pp 570-576
01 Oct 2015
PMID: 26262457
url
https://doi.org/10.1097/MOT.0000000000000228View
Published, Version of Record (VoR) Restricted

Abstract

Life Sciences & Biomedicine Science & Technology Transplantation
Purpose of review Pulmonary hypertension associated with left heart disease is the most commonly encountered form of pulmonary hypertension and is associated with a poor prognosis. As the global burden of heart failure grows, this associated disease can be a major impediment to those patients undergoing cardiac transplantation, given its association with post-transplant right ventricular failure. Unfortunately, the pathophysiology of pulmonary hypertension secondary to left heart failure remains poorly understood, thereby rendering targeted treatment strategies largely undefined. In this review, we provide a review of the currently available literature in this unique patient population. Recent findings The current focus on better defining the underlying pathophysiology and standardizing diagnostic and therapeutic approaches to pulmonary hypertension associated with left heart disease need to be interpreted and made applicable in the context of clinical practice. Given the relative paucity of successful, targeted pharmacological options, there is an increasing evidence that device-based therapies, used in conjuncture with medical therapy, may help in lowering the pulmonary pressures by causing sustained left ventricular unloading. Summary Pulmonary hypertension in the context of left heart disease is the most common form of pulmonary hypertension encountered in clinical practice and is associated with worse prognosis in patients being considered for cardiac transplantation. Therapies targeting left ventricular unloading, as well as pulmonary vascular remodeling, are being increasingly studied and used in daily practice.

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Web of Science research areas
Transplantation
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