Pulmonary Hypertension in Heart Failure With Preserved Ejection Fraction

Pulmonary hypertension (PH) is common in patients with heart failure with preserved ejection fraction (HFpEF), occurring in up to 80% with the presence and severity of PH associated with worse prognosis. There are two distinct phenotypes: one with relatively modest PH that is proportional to the degree of left ventricular filling pressure elevation and a second with a mixed hemodynamic profile with features of both postcapillary (elevated wedge pressure) and precapillary PH (elevated pulmonary vascular resistance). In this chapter we review the pathophysiology, diagnosis, and management of this challenging disorder.