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The precise pathophysiological mechanisms behind <jats:styled-content style=\"fixed-case\">PH<\/jats:styled-content> due to left heart failure are, however, still unclear. In its early course, <jats:styled-content style=\"fixed-case\">PH<\/jats:styled-content> is caused by increased left ventricular filling pressures, without pulmonary vessel abnormalities. Conventional treatment for heart failure may partly reverse such passive <jats:styled-content style=\"fixed-case\">PH<\/jats:styled-content> by optimizing left ventricular function. However, if increased pulmonary pressures persist, endothelial damage, excessive vasoconstriction and structural changes in the pulmonary vasculature may occur. There is, at present, no recommended medical treatment for this active component of <jats:styled-content style=\"fixed-case\">PH<\/jats:styled-content> due to left heart failure. However, as the vascular changes in <jats:styled-content style=\"fixed-case\">PH<\/jats:styled-content> due to left heart failure may be similar to those in pulmonary arterial hypertension (<jats:styled-content style=\"fixed-case\">PAH<\/jats:styled-content>), a selected group of these patients may benefit from <jats:styled-content style=\"fixed-case\">PAH<\/jats:styled-content> treatment targeting the endothelin, nitric oxide or prostacyclin pathways. Such potent pulmonary vasodilators could, however, be detrimental in patients with left heart failure without pulmonary vascular pathology, as selective pulmonary vasodilatation may lead to further congestion in the pulmonary circuit, resulting in pulmonary oedema. The use of <jats:styled-content style=\"fixed-case\">PAH<\/jats:styled-content> therapies is therefore currently not recommended and would require the selection of suitable patients based on the underlying causes of the disease and careful monitoring of their progress. The present review focuses on the following: (i) the pathophysiology behind <jats:styled-content style=\"fixed-case\">PH<\/jats:styled-content> resulting from systolic left heart failure, and (ii) the current evidence for medical treatment of this condition, especially the role of <jats:styled-content style=\"fixed-case\">PAH<\/jats:styled-content>\u2010targeted therapies in systolic left heart failure.<\/jats:p>","DOI":"10.1111\/apha.12295","type":"journal-article","created":{"date-parts":[[2014,4,5]],"date-time":"2014-04-05T08:53:17Z","timestamp":1396687997000},"page":"314-333","source":"Crossref","is-referenced-by-count":15,"title":["Pathophysiology and potential treatments of pulmonary hypertension due to systolic left heart failure"],"prefix":"10.1111","volume":"211","author":[{"given":"J.","family":"Lundgren","sequence":"first","affiliation":[{"name":"The Haemodynamic Laboratory The Clinic for Heart Failure and Valvular Disease Sk\u00e5ne University Hospital Lund 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