Partitioning of pulmonary vascular resistances in group 2 pulmonary hypertension: insightful suggestions for bridging haemodynamics to underlying mechanisms

Haemodynamic profiling of group 2 pulmonary hypertension (PH) is constantly evolving, and poses a number of challenges in terms of diagnosis and staging [1]. Given that the haemodynamic signature of left-sided PH is the increased pulmonary arterial wedge pressure (PAWP) at rest (>15 mmHg) with a mean pulmonary arterial pressure (mPAP) ≥25 mmHg, some diagnostic uncertainty may occur when mPAP is elevated in the presence of a non-dilated left ventricular (LV) chamber with preserved LV ejection fraction and a PAWP at rest within the upper normal limit (range 12–15 mmHg) [2]. Mounting evidence suggests that a haemodynamic assessment under physical stress [3] or fluid load [4, 5] may be of help to distinguish the primary from secondary origin of PH.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Editorials Source Type: research