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>
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~50% of patients with heart failure & preserved ejection fraction (HFpEF) develop pulmonary hypertension (PH)</p>
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HFpEF with PH portends reduced survival and increased hospitalization rates compared to those without PH</p>
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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>
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<td style="width:211px;">
<p>
</p>
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<td style="width:192px;">
<p>
<strong>PAH</strong></p>
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<td style="width:389px;">
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<strong>HFpEF </strong></p>
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<td colspan="3" style="width:792px;">
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<strong>Clinical parameters:</strong></p>
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Age</p>
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Typically 3rd–5th decade</p>
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Typically 6th–8th decade</p>
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Comorbidities (HTN, HLD, DM, CAD)</p>
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<td style="width:192px;">
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Rare</p>
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Common</p>
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Atrial arrhythmias</p>
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Rare</p>
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Common</p>
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Obstructive sleep apnea</p>
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Rare</p>
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<td style="width:389px;">
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Common</p>
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<strong>Echocardiographic parameters:</strong></p>
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LA size/volume</p>
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Normal</p>
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Increased</p>
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LV diastolic function</p>
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Normal to mildly abnormal</p>
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Moderate to severely abnormal</p>
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<strong>Hemodynamic parameters:</strong></p>
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Resting PAWP</p>
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Always <15 mmHg</p>
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<td style="width:389px;">
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May be < or >15 mmHg</p>
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Response to volume</p>
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PAWP <15 mmHg (increase ≤5 mmHg)</p>
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<td style="width:389px;">
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PAWP >15 mmHg (increase >5 mmHg)</p>
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<td style="width:211px;">
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Response to exercise</p>
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PAWP <15 mmHg (increase ≤5 mmHg)</p>
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<td style="width:389px;">
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PAWP >15 mmHg (increase >5 mmHg)</p>
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</tbody>
</table>
<p>
(Table reproduced from article)</p>
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</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>