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A roadmap for therapeutic discovery in pulmonary hypertension associated with left heart failure. A scientific statement of the Heart Failure Association (HFA) of the ESC and the ESC Working Group on pulmonary circulation & right ventricular function

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Item Type:Article
Title:A roadmap for therapeutic discovery in pulmonary hypertension associated with left heart failure. A scientific statement of the Heart Failure Association (HFA) of the ESC and the ESC Working Group on pulmonary circulation & right ventricular function
Creators Name:Ameri, P. and Mercurio, V. and Pollesello, P. and Anker, M.S. and Backs, Jo. and Bayes-Genis, A. and Borlaug, B.A. and Burkhoff, D. and Caravita, S. and Chan, S.Y. and de Man, F. and Giannakoulas, G. and González, A. and Guazzi, M. and Hassoun, P.M. and Hemnes, A.R. and Maack, C. and Madden, B. and Melenovsky, V. and Müller, O.J. and Papp, Z. and Pullamsetti, S.S. and Rainer, P.P. and Redfield, M.M. and Rich, S. and Schiattarella, G.G. and Skaara, H. and Stellos, K. and Tedford, R.J. and Thum, T. and Vachiery, J.L. and van der Meer, P. and Van Linthout, S. and Pruszczyk, P. and Seferovic, P. and Coats, A.J.S. and Metra, M. and Rosano, G. and Rosenkranz, S. and Tocchetti, C.G.
Abstract:Pulmonary hypertension (PH) associated with left heart failure (LHF) (PH-LHF) is one of the most common causes of PH. It directly contributes to symptoms and reduced functional capacity and negatively affects right heart function, ultimately leading to a poor prognosis. There are no specific treatments for PH-LHF, despite the high number of drugs tested so far. This scientific document addresses the main knowledge gaps in PH-LHF with emphasis on pathophysiology and clinical trials. Key identified issues include better understanding of the role of pulmonary venous versus arteriolar remodelling, multidimensional phenotyping to recognize patient subgroups positioned to respond to different therapies, and conduct of rigorous pre-clinical studies combining small and large animal models. Advancements in these areas are expected to better inform the design of clinical trials and extend treatment options beyond those effective in pulmonary arterial hypertension. Enrichment strategies, endpoint assessments, and thorough haemodynamic studies, both at rest and during exercise, are proposed to play primary roles to optimize early-stage development of candidate therapies for PH-LHF.
Keywords:Pulmonary Hypertension, Heart Failure, Therapy, Translational, Drug, Animals, Mice, Rats, Swine
Source:European Journal of Heart Failure
ISSN:1388-9842
Publisher:Wiley
Date:19 April 2024
Official Publication:https://doi.org/10.1002/ejhf.3236
PubMed:View item in PubMed

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