This protocol covers the management of pulmonary hypertension secondary to left heart disease specifically in patients with heart failure with reduced ejection fraction (HFrEF, LVEF ≤40%) or heart failure with mildly reduced ejection fraction (HFmrEF, LVEF 41–49%).
Patients present with pulmonary hypertension in the context of significantly or mildly impaired left ventricular systolic function. Guideline-directed treatment—encompassing established medical and interventional therapies—is required in this population.
In patients with advanced heart failure in this setting, a mechanical circulatory support approach may be indicated. The complete structured regimen, including precise patient selection criteria and clinical pathway, is available in the full protocol.
The primary target is a significant reduction or normalization of mean pulmonary arterial pressure. The full protocol details the monitoring parameters and relevant prognostic considerations.
DOI: 10.1093/eurheartj/ehac237
Patients with HFrEF or HFmrEF require guideline-directed treatment including established medical and interventional therapies.
In patients with advanced HFrEF, implanting an LVAD may significantly reduce or even normalize mPAP, although this is not achieved in all patients, and an increased DPG emerged as a negative prognostic factor after LVAD implantation.
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