Abstract
Background: Heart Failure (HF) is the most frequent cause of pulmonary hypertension (PH). The nature of the response of the pulmonary circulation to the increased left atrial pressure in patients with HF with reduced ejection fraction and pulmonary hypertension (HFrEF-PH) as opposed to patients with HF with preserved ejection fraction and pulmonary hypertension (HFpEF-PH) is unknown.
Methods: We investigate pulmonary hemodynamics profiles focusing mainly on pulmonary vascular compliance (PVC), by comparing the hemodynamic data from patients with HFrEF-PH to patients with HFpEF-PH.
Results: We retrospectively reviewed the clinical and hemodynamic data of 47 patients with HFrEF-PH and 37 with HFpEF-PH. Compare to patients with HFrEF-PH, patients with HFpEF-PH had significantly higher transpulmonary gradient (TPG) and the diastolic pulmonary gradient (DPG), with significantly higher PVR, while no significant difference was found in the PVC. PVR and PCWP had a significant impact on the PVC. However, in HFpEF-PH, PVR has the most impact on the PVC while the PCWP has a much minor effect whereas in HFrEF-PH the PCWP contribute more than the PVR.
Conclusion: Our results suggest that the association between PVR and PVC in patients with HF and associated PH has different characteristics when comparing reduced to preserved ejection fraction HF. Specifically, the contribution and the effect of PVR on the PVC is more prominent in the HFpEF-PH group while the impact of the wedge pressure was more significant in determining the PVC of the HFrEF-PH group.
- © 2014 ERS
