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Limited progress has been made towards specific therapies for PH-LHD, and management focuses on addressing the underlying cause of the disease with supportive therapies, surgery and pharmacological treatments. Clinical trials of therapies for pulmonary arterial hypertension in patients with PH-LHD have thus far been limited and have provided disappointing or conflicting results. Robust, long-term clinical studies in appropriate target populations have the potential to improve the outlook for patients with PH-LHD. Herein, we discuss the knowledge gaps in our understanding of PH-LHD, and describe the current unmet needs and challenges that are faced by clinicians when identifying and managing patients with this disease.<\/jats:p>","DOI":"10.1183\/16000617.0059-2015","type":"journal-article","created":{"date-parts":[[2015,12,1]],"date-time":"2015-12-01T02:04:31Z","timestamp":1448935471000},"page":"665-673","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":30,"title":["Under pressure: pulmonary hypertension associated with left heart disease"],"prefix":"10.1183","volume":"24","author":[{"given":"Harrison 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