Title: Heart Failure & Pulmonary Hypertension (Part I)<br/>Author: Semhar Tewelde<br/><a href='http://umem.org/profiles/faculty/352/'>[Click to email author]</a><hr/><p>
        <strong><u>Heart Failure & Pulmonary Hypertension (Part I)</u></strong></p>
<p>
        ~50% of patients with heart failure & preserved ejection fraction (HFpEF) develop pulmonary hypertension (PH)</p>
<p>
        HFpEF with PH portends reduced survival and increased hospitalization rates compared to those without PH</p>
<p>
        HFpEF-PH is often confused with idiopathic pulmonary hypertension (IPAH) given the similar hemodynamics; differentiating them is challenging and requires careful consideration of clinical, radiologic, and hemodynamic data</p>
<p>
         </p>
<table border="1" cellpadding="0" cellspacing="0" width="594">
        <tbody>
                <tr>
                        <td style="width:211px;">
                                <p>
                                         </p>
                        </td>
                        <td style="width:192px;">
                                <p>
                                        <strong>PAH</strong></p>
                        </td>
                        <td style="width:389px;">
                                <p>
                                        <strong>HFpEF </strong></p>
                        </td>
                </tr>
                <tr>
                        <td colspan="3" style="width:792px;">
                                <p>
                                        <strong>Clinical parameters:</strong></p>
                        </td>
                </tr>
                <tr>
                        <td style="width:211px;">
                                <p>
                                         Age</p>
                        </td>
                        <td style="width:192px;">
                                <p>
                                        Typically 3rd–5th decade</p>
                        </td>
                        <td style="width:389px;">
                                <p>
                                        Typically 6th–8th decade</p>
                        </td>
                </tr>
                <tr>
                        <td style="width:211px;">
                                <p>
                                         Comorbidities (HTN, HLD, DM, CAD)</p>
                        </td>
                        <td style="width:192px;">
                                <p>
                                        Rare</p>
                        </td>
                        <td style="width:389px;">
                                <p>
                                        Common</p>
                        </td>
                </tr>
                <tr>
                        <td style="width:211px;">
                                <p>
                                         Atrial arrhythmias</p>
                        </td>
                        <td style="width:192px;">
                                <p>
                                        Rare</p>
                        </td>
                        <td style="width:389px;">
                                <p>
                                        Common</p>
                        </td>
                </tr>
                <tr>
                        <td style="width:211px;">
                                <p>
                                         Obstructive sleep apnea</p>
                        </td>
                        <td style="width:192px;">
                                <p>
                                        Rare</p>
                        </td>
                        <td style="width:389px;">
                                <p>
                                        Common</p>
                        </td>
                </tr>
                <tr>
                        <td colspan="3" style="width:792px;">
                                <p>
                                        <strong>Echocardiographic parameters:</strong></p>
                        </td>
                </tr>
                <tr>
                        <td style="width:211px;">
                                <p>
                                         LA size/volume</p>
                        </td>
                        <td style="width:192px;">
                                <p>
                                        Normal</p>
                        </td>
                        <td style="width:389px;">
                                <p>
                                        Increased</p>
                        </td>
                </tr>
                <tr>
                        <td style="width:211px;">
                                <p>
                                         LV diastolic function</p>
                        </td>
                        <td style="width:192px;">
                                <p>
                                        Normal to mildly abnormal</p>
                        </td>
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                                <p>
                                        Moderate to severely abnormal</p>
                        </td>
                </tr>
                <tr>
                        <td colspan="3" style="width:792px;">
                                <p>
                                        <strong>Hemodynamic parameters:</strong></p>
                        </td>
                </tr>
                <tr>
                        <td style="width:211px;">
                                <p>
                                         Resting PAWP</p>
                        </td>
                        <td style="width:192px;">
                                <p>
                                        Always <15 mmHg</p>
                        </td>
                        <td style="width:389px;">
                                <p>
                                        May be < or >15 mmHg</p>
                        </td>
                </tr>
                <tr>
                        <td style="width:211px;">
                                <p>
                                         Response to volume</p>
                        </td>
                        <td style="width:192px;">
                                <p>
                                        PAWP <15 mmHg (increase ≤5 mmHg)</p>
                        </td>
                        <td style="width:389px;">
                                <p>
                                        PAWP >15 mmHg (increase >5 mmHg)</p>
                        </td>
                </tr>
                <tr>
                        <td style="width:211px;">
                                <p>
                                         Response to exercise</p>
                        </td>
                        <td style="width:192px;">
                                <p>
                                        PAWP <15 mmHg (increase ≤5 mmHg)</p>
                        </td>
                        <td style="width:389px;">
                                <p>
                                        PAWP >15 mmHg (increase >5 mmHg)</p>
                        </td>
                </tr>
        </tbody>
</table>
<p>
        (Table reproduced from article)</p>
<p>
         </p>
<fieldset><legend>References</legend>

                <p>
        Kanwar M, Tedford R, et al. Management of Pulmonary Hypertension due to Heart Failure with Preserved Ejection Fraction. Current Hypertension Reports. October 16, 2014</p>
</fieldset>