Haemodynamics to predict outcome in pulmonary hypertension due to left heart disease: a meta-analysis

Pulmonary hypertension (PH) is a common complication of left heart disease (LHD), as the result of a “passive” increase of left atrial pressure (LAP), leading to isolated post-capillary PH [1–3]. Several haemodynamic parameters have been proposed to identify a more severe phenotype of PH-LHD, for which the increase in pulmonary artery pressure cannot be accounted for by the increase in LAP, and described as combined post-capillary PH with a pre-capillary component, or CpcPH [1–3]. The latter haemodynamic phenotype may potentially expose patients to a higher risk of right ventricular failure and a poorer outcome [4, 5]. However, since the last World Symposium in 2013, how to define the pre-capillary component in PH-LHD has been a matter of debate, as pathophysiological arguments have been suggested to potentially contrast with clinical and prognostic evidences [1].