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 &amp; Right Ventricular Function

Ameri, P; Mercurio, V; Pollesello, P; Anker, MS; Backs, J; Bayes-Genis, A; Borlaug, BA; Burkhoff, D; Caravita, S; Chan, SY; de, Man, F; Giannakoulas, G; Gonzalez, A; Guazzi, M; Hassoun, PM; Hemnes, AR; Maack, C; Madden, B; Melenovsky, V; Muller, OJ; Papp, Z; Pullamsetti, SS; Rainer, PP; Redfield, MM; Rich, S; Schiattarella, GG; Skaara, H; Stellos, K; Tedford, RJ; Thum, T; Vachiery, JL; van, der, Meer, P; Van, Linthout, S; Pruszczyk, P; Seferovic, P; Coats, AJS; Metra, M; Rosano, G; Rosenkranz, S; Tocchetti, CG

doi:10.1002/ejhf.3236

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

Lookup NU author(s): Professor Konstantinos Stellos ORCiD

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Abstract

© 2024 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.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.

Publication metadata

Author(s): Ameri P, Mercurio V, Pollesello P, Anker MS, Backs J, Bayes-Genis A, Borlaug BA, Burkhoff D, Caravita S, Chan SY, de Man F, Giannakoulas G, Gonzalez A, Guazzi M, Hassoun PM, Hemnes AR, Maack C, Madden B, Melenovsky V, Muller OJ, Papp Z, Pullamsetti SS, Rainer PP, Redfield MM, Rich S, Schiattarella GG, Skaara H, Stellos K, Tedford RJ, Thum T, Vachiery JL, van der Meer P, Van Linthout S, Pruszczyk P, Seferovic P, Coats AJS, Metra M, Rosano G, Rosenkranz S, Tocchetti CG

Publication type: Article

Publication status: Published

Journal: European Journal of Heart Failure

Year: 2024

Volume: 26

Issue: 4

Pages: 7007-729

Online publication date: 19/04/2024

Acceptance date: 28/03/2024

Date deposited: 08/05/2024

ISSN (print): 1388-9842

ISSN (electronic): 1879-0844

Publisher: John Wiley and Sons Ltd

URL: https://doi.org/10.1002/ejhf.3236

DOI: 10.1002/ejhf.3236

PubMed id: 38639017

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Funding

Funder reference	Funder name
National Institutes of Health (grants R01 HL128526, R01 HL162828 and U01 HL160226

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