Defining the phenotypes for pulmonary hypertension associated with diastolic heart failure.

Pulmonary hypertension (PH) is well known to be associated with left heart failure, which is probably the single most common cause of abnormally elevated pulmonary arterial pressure ( 25 mm Hg by consensus).1–3 Estimates range up to 250 000 patients with PH associated with heart failure in the United States today,3,4 making it far more prevalent than other forms of PH. Consistent with this, more than three-quarters of unselected patients referred for cardiac ultrasound to a single community-based center and found to have an elevated estimated pulmonary arterial (PA) systolic pressure were subsequently determined to have a left ventricular (LV) cause.5 Despite its prevalence, though, the pathophysiology and phenotypic characteristics of PH associated with left heart failure are not well understood.