Table 31—

Recommendations for pulmonary hypertension(PH) due to left heart disease

Statement	Class^#	Level^¶
The optimal treatment of the underlying left heart disease is recommended in patients with PH due to left heart disease	I	C
Patients with “out of proportion” PH due to left heart disease (table 3) should be enrolled in RCTs targeting PH specific drugs	IIa	C
Increased left-sided filling pressures may be estimated by Doppler echocardiography	IIb	C
Invasive measurements of P_pcw or LV end-diastolic pressure may be required to confirm the diagnosis of PH due to left heart disease	IIb	C
RHC may be considered in patients with echocardiographic signs suggesting severe PH in patients with left heart disease	IIb	C
The use of PAH specific drug therapy is not recommended in patients with PH due to left heart disease	III	C

RCT: randomised controlled trial; P_pcw: pulmonary capillary wedge pressure; LV: left ventricular; RHC: right heart catheterisation; PAH: pulmonary arterial hypertension. ^#: class of recommendation; ^¶: level of evidence.