Milan Luknár, Peter Lesný, Eva Goncalvesová
Pulmonary hypertension (PH) is an etiologically, clinically, and prognostically heterogeneous condition with an increased
blood pressure in the pulmonary vascular bed. Treatment of individual PH groups varies. With the widespread
use of echocardiographic examination, the suspicion of PH is frequent and PH due to left ventricular (LV) dysfunction is
the most prevalent group. Increase of the LV filling pressure is considered the basic pathogenetic factor. This increased
pressure is passively transmitted to the pulmonary vascular bed, and it may be followed by additional reactive pre-capillary
vascular changes. Eventually, PH due to LV dysfunction contributes to the right ventricular dysfunction and failure.
PH has a negative prognostic impact in patients with both reduced and preserved LV ejection fractions. Echocardiography
is an essential diagnostic tool, but the presence and nature of PH are definitely confirmed by right heart catheterization.
PH deserves special attention in specific subsets of patients - selected patients with LV systolic dysfunction,
heart transplant candidates, and patients with a suspicion of other PH groups. Management of PH due to LV dysfunction
is based on the treatment of heart failure and targeted PH therapy is not indicated. Further treatment options may
be considered in particular situations.