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
Ameri, Pietro (Università degli Studi di Genova)
Mercurio, Valentina (Università degli Studi di Napoli Federico II. Dipartimento di Scienze Mediche Traslazionali)
Pollesello, Piero (Orion Pharma)
Anker, Markus S. (Charité-Universitätsmedizin Berlin)
Backs, Johannes (Heidelberg University Hospital (Alemanya))
Bayés-Genís, Antoni (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Borlaug, Barry A. (Cardiovascular Research Foundation (NY, Estats Units d'Amèrica))
Burkhoff, Daniel (Cardiovascular Research Foundation (NY, Estats Units d'Amèrica))
Caravita, Sergio (Istituto Auxologico Italiano IRCCS. University of Milan)
Chan, Stephen Y. (Pittsburgh Heart, Lung, and Blood Vascular Medicine Institute)
de Man, Frances (Vrije Universiteit Amsterdam)
Giannakoulas, George (Aristotle University of Thessaloniki (Grècia))
González, Aránzazu (Universidad de Navarra. Facultad de Medicina)
Guazzi, Marco (Università degli Studi di Milano)
Hassoun, Paul M. (Johns Hopkins School of Medicine)
Hemnes, Anna R. (Vanderbilt University Hospital)
Maack, Cristoph (University Hospital Würzburg)
Madden, Brendan (St. Georges Hospital)
Melenovsky, Vojtech (Institute for Clinical and Experimental Medicine (IKEM))
Müller, Oliver J. (University Hospital of Schleswig Holstein)
Papp, Zoltan (University of Debrecen. Faculty of Medicine. Department of Cardiology.)
Pullamsetti, Soni Savai (Justus Liebig University Giessen)
Rainer, Peter P. (St. Johann in Tirol General Hospital. Department of Medicine.)
Redfield, Margaret M. (Mayo Clinic (Rochester, Estats Units d'Amèrica))
Rich, Stuart (Northwestern University. Feinberg School of Medicine)
Schiattarella, Gabriele G. (Charité-Universitätsmedizin Berlin)
Skaara, Hall (Pulmonary Hypertension Association)
Stellos, Konstantinos (University of Heidelberg. Faculty of Medicine Mannheim)
Tedford, Ryan J. (Medical University of South Carolina)
Thum, Thomas (Hannover Medical University)
Vachiery, Jean Luc (Hopital Universitaire de Bruxelles Erasme)
van der Meer, Peter (University of Groningen. University Medical Center Groningen)
Van Linthout, Sophie (Charité-Universitätsmedizin Berlin)
Pruszczyk, Piotr (Medical University of Warsaw. Department of Internal Medicine and Cardiology)
Seferovic, Petar (University of Belgrade. Faculty of Medicine)
Coats, Andrew Justin Stewart (Heart Research Institute)
Metra, Marco (University of Brescia. Radiological Sciences and Public Health.)
Rosano, Giuseppe (IRCCS San Raffaele Roma)
Rosenkranz, Stephan (University of Cologne. Faculty of Medicine)
Tocchetti, Carlo Gabriele (Università degli Studi di Napoli Federico II. Dipartimento di Scienze Mediche Traslazionali)

Data:	2024
Resum:	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.
Ajuts:	European Commission 759248 European Commission 101045236
Nota:	B.A.B. was supported by the National Institutes of Health (grants R01HL128526, R01 HL162828 and U01 HL160226) and by the United StatesDepartment of Defense (grant W81XWH2210245). SC was supportedby the Italian Ministry of Health (5 × 1000). S.Y.C. was supported byNational Institutes of Health (grants R01 HL124021 and HL 122596)and by the American Heart Association (grant 18EIA33900027). F.d.M.was supported by the Netherlands CardioVascular Research Initiative, theDutch Heart Foundation, Dutch Federation of University Medical Cen-tres, the Netherlands Organisation for Health Research and Develop-ment, and the Royal Netherlands Academy of Sciences (CVON-2012-08PHAEDRA, CVON-2018-29 PHAEDRA-IMPACT, and CVON-2017-10Dolphin-Genesis). F.d.M. was further supported by The NetherlandsOrganization for Scientific Research (NWO-VIDI: 917.18.338) and theDutch Heart Foundation Dekker senior post-doc grant (2018T059).V.M. was supported by the Ministry of Health of the Czech Republic(grant NU22-02-00161) and by the National Institute for Research ofMetabolic and Cardiovascular Diseases (Programme EXCELES, ID ProjectNo. LX22NPO5104 - funded by the European Union - Next Genera-tion EU). G.G.S. was supported by DZHK (German Centre for Cardio-vascular Research) with JRG, SE and DHZK/BHF/DHF joint Partnershipgrants; and by Deutsche Forschungsgemeinschaft (DFG, German ResearchFoundation - SFB-1470 - A02). K.S. was supported by the EuropeanResearch Council under the European Union's Horizon 2020 research andinnovation programme (grant number 759248) and the German ResearchFoundation DFG (CRC1366 C07, project number 394046768). P.v.d.M.was supported by a grant from the HORIZON Europe ERC (ERC CoG101045236, DISSECT-HF). G.R. was supported by the Italian Ministry ofHealth (Ricerca Corrente 2023). C.G.T. is supported by the Italian Ministryof Health (PNRR-MAD-2022-12376632 and RF-2016-02362988).
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució i la comunicació pública de l'obra, sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Pulmonary hypertension ; Heart failure ; Therapy ; Translational ; Drug
Publicat a:	European Journal of Heart Failure, Vol. 26 Núm. 4 (april 2024) , p. 707-729, ISSN 1879-0844

DOI: 10.1002/ejhf.3236
PMID: 38639017

23 p, 1.2 MB

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