TY - JOUR
T1 - 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
AU - Ameri, Pietro
AU - Mercurio, Valentina
AU - Pollesello, Piero
AU - Anker, Markus S.
AU - Backs, Johannes
AU - Bayes-Genis, Antoni
AU - Borlaug, Barry A.
AU - Burkhoff, Daniel
AU - Caravita, Sergio
AU - Chan, Stephen Y.
AU - de Man, Frances
AU - Giannakoulas, George
AU - González, Aránzazu
AU - Guazzi, Marco
AU - Hassoun, Paul M.
AU - Hemnes, Anna R.
AU - Maack, Cristoph
AU - Madden, Brendan
AU - Melenovsky, Vojtech
AU - Müller, Oliver J.
AU - Papp, Zoltan
AU - Pullamsetti, Soni Savai
AU - Rainer, Peter P.
AU - Redfield, Margaret M.
AU - Rich, Stuart
AU - Schiattarella, Gabriele G.
AU - Skaara, Hall
AU - Stellos, Kostantinos
AU - Tedford, Ryan J.
AU - Thum, Thomas
AU - Vachiery, Jean Luc
AU - van der Meer, Peter
AU - Van Linthout, Sophie
AU - Pruszczyk, Piotr
AU - Seferovic, Petar
AU - Coats, Andrew J.S.
AU - Metra, Marco
AU - Rosano, Giuseppe
AU - Rosenkranz, Stephan
AU - Tocchetti, Carlo Gabriele
N1 - Publisher Copyright:
© 2024 European Society of Cardiology.
PY - 2024/4
Y1 - 2024/4
N2 - 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.
AB - 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.
KW - Drug
KW - Heart failure
KW - Pulmonary hypertension
KW - Therapy
KW - Translational
UR - http://www.scopus.com/inward/record.url?scp=85191357998&partnerID=8YFLogxK
U2 - 10.1002/ejhf.3236
DO - 10.1002/ejhf.3236
M3 - Article
C2 - 38639017
AN - SCOPUS:85191357998
SN - 1388-9842
VL - 26
SP - 707
EP - 729
JO - European Journal of Heart Failure
JF - European Journal of Heart Failure
IS - 4
ER -