Abstract：
Pulmonary hypertension associated with left heart disease (PH-LHD) remains the most common cause of pulmonary hypertension globally. Etiologies include heart failure with reduced and preserved ejection fraction and left-sided valvular heart diseases. Despite the increasing prevalence of PH-LHD, there remains a paucity of knowledge about the hemodynamic definition, diagnosis, treatment modalities, and prognosis among clinicians. Moreover, clinical trials have produced mixed results on the usefulness of pulmonary vasodilator therapies for PH-LHD. In this expert review, we have outlined the critical role of meticulous hemodynamic evaluation and provocative testing for cases of diagnostic uncertainty. Therapeutic strategies-pharmacologic, device-based, and surgical therapies used for managing PH-LHD-are also outlined. PH-LHD in advanced heart failure, and the role of mechanical circulatory support in PH-LHD is briefly explored. An in-depth understanding of PH-LHD by all clinicians is needed for improved recognition and outcomes among patients with PH-LHD.
摘要：
与左心疾病相关的肺动脉高压(PH-LHD)仍然是全球肺动脉高压的最常见原因。病因包括射血分数降低和保留的心力衰竭和左侧瓣膜性心脏病。尽管PH-LHD的患病率越来越高,关于血液动力学定义的知识仍然很少，诊断,治疗方式，和临床医生的预后。此外，关于肺血管扩张剂治疗PH-LHD的有效性,临床试验产生了不同的结果.在这次专家审查中，我们概述了细致的血流动力学评估和挑衅性检测对诊断不确定病例的关键作用.治疗策略-药理学，基于设备，还概述了用于管理PH-LHD的手术疗法。PH-LHD在晚期心力衰竭中，简要探讨了机械循环支持在PH-LHD中的作用。需要所有临床医生对PH-LHD的深入了解，以改善PH-LHD患者的认识和预后。
