• Jean-Luc Vachiéry, Yochai Adir, Joan Albert Barberà, Hunter Champion, John Gerard Coghlan, Vincent Cottin, Teresa De Marco, Nazzareno Galiè, Stefano Ghio, J Simon R Gibbs, Fernando Martinez, Marc Semigran, Gerald Simonneau, Athol Wells, and Werner Seeger.
• Department of Cardiology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium. Electronic address: jvachier@ulb.ac.be.
• J. Am. Coll. Cardiol. 2013 Dec 24;62(25 Suppl):D100-8.

AbstractPulmonary hypertension (PH), a common complication of left heart diseases (LHD), negatively impacts symptoms, exercise capacity, and outcome. Although the true prevalence of PH-LHD is unknown, a subset of patients might present significant PH that cannot be explained by a passive increase in left-sided filling pressures. The term "out-of-proportion" PH has been used to identify that population without a clear definition, which has been found less than ideal and created confusion. We propose a change in terminology and a new definition of PH due to LHD. We suggest to abandon "out-of-proportion" PH and to distinguish "isolated post-capillary PH" from "post-capillary PH with a pre-capillary component" on the basis of the pressure difference between diastolic pulmonary artery pressure and pulmonary artery wedge pressure. Although there is no validated treatment for PH-LHD, we provide insights into management and discuss completed and randomized trials in this condition. Finally, we provide recommendations for future clinical trials to establish safety and efficacy of novel compounds to target this area of unmet medical need.Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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