Pulmonary Hypertension

Pulmonary Hypertension

Two blood flow patterns of PH with different prognoses have been reported in patients with heart failure. In the most common, called post-capillary PH (IpcPH), PH is solely caused by increased left-sided filling pressures. However, 10-15% of patients have both pre- and post-capillary PH (CpcPH), characterized by high filling pressures and a pulmonary vascular component.

This form of PH has similarities with pulmonary arterial hypertension, and is defined by a combined elevation of mean pulmonary artery wedge pressure (mPAWP), a measure of pressure in the upper left heart chamber, or atrium; pulmonary vascular resistance (PVR), reflecting changes in arteries that supply blood to the lungs; and/or diastolic pressure gradient (DPG), which is the difference between pulmonary artery diastolic pressure and mean pulmonary capillary wedge pressure.


Old
Transpulmonary pressure gradient（TPG：mean PAP － mean PAWP)
12<  CpcPH,  12>  IpcPH

New
Diastolic pressure gradient (DPG : diastolic PAP - mean PAWP)
7<  CpcPH,  7>  IpcPH

PVR ＞ 3.0 Wood CpcPH, PVR ≦ 3.0 Wood  IpcPH


Prognosis
CpcPH BAD
IpcPH better