The difficult diagnosis of pulmonary vascular disease in heart failure

Pulmonary hypertension (PH), defined as a mean pulmonary arterial pressure (PAP) ≥25 mmHg, is a well-recognised complication of left heart disease (LHD). PH prevalence is variable ranging from 25% to 80% of LHD patients according to the methods of assessment, cut-off values and characteristics of the patient population [1–3]. All aetiological types of LHD are affected, including heart failure with reduced (HFrEF) or preserved (HFpEF) left ventricular ejection fraction, and valvular LHD. The presence of PH-LHD is associated with advanced symptoms, reduced exercise capacity and impaired outcome after medical, interventional or surgical therapy [1, 3, 4]. Definition and diagnosis of pulmonary vascular disease in heart failure: still an unclear rebus <http://ow.ly/qp1L300x6yY>