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Correspondence |

Pulmonary HypertensionPulmonary Hypertension FREE TO VIEW

Fady Jamous, MD, FCCP
Author and Funding Information

From the Avera Medical Group.

Correspondence to: Fady Jamous, MD, FCCP, Avera Medical Group, 1301 S Cliff Ave, Ste 601, Sioux Falls, SD 57108; e-mail: fjamous@hotmail.com


Financial/nonfinancial disclosures: The author has reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(2):432-433. doi:10.1378/chest.13-2359
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To the Editor:

I read with great interest the article by Hansdottir et al1 in CHEST (August 2013) regarding pulmonary hypertension (PH) in left-sided heart disease and, more specifically, in heart failure with preserved ejection fraction. Would the authors please comment on the right-sided heart catheterization criteria needed to finalize the diagnosis of “fixed mixed” PH in the setting of heart failure with preserved ejection fraction? Is it based mostly on response to nitroprusside or is it recommended to repeat a right-sided heart catheterization after a period of adequate medical therapy and diuresis?

Furthermore, do the authors see a role in vasodilator testing (with epoprostenol, adenosine, or nitric oxide) prior to possible initiation of any of the vasodilators traditionally used in pulmonary arterial hypertension? Would these classes of medication be withheld in the fixed mixed PH if vasodilator testing demonstrated a rise in pulmonary capillary wedge pressure?

References

Hansdottir S, Groskreutz DJ, Gehlbach BK. WHO’s in second? A practical review of World Health Organization group 2 pulmonary hypertension. Chest. 2013;144(2):638-650. [CrossRef] [PubMed]
 

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References

Hansdottir S, Groskreutz DJ, Gehlbach BK. WHO’s in second? A practical review of World Health Organization group 2 pulmonary hypertension. Chest. 2013;144(2):638-650. [CrossRef] [PubMed]
 
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