{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T11:46:03Z","timestamp":1793965563676,"version":"4.8.0"},"reference-count":44,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T00:00:00Z","timestamp":1734048000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"German Center for Lung Research","award":["FKZ 82DZL002C1"],"award-info":[{"award-number":["FKZ 82DZL002C1"]}]},{"name":"German Center for Lung Research","award":["FKZ 82DZL002B1"],"award-info":[{"award-number":["FKZ 82DZL002B1"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The current classification of pulmonary hypertension (PH) distinguishes between pre-capillary (PAWP \u2264 15 mmHg) and post-capillary (PAWP &gt; 15 mmHg) forms, with left heart disease, especially heart failure with preserved ejection fraction (HFpEF), being a common cause of PH. We investigated the suitability of an HFpEF diagnosis instead of PAWP in diagnosing PH associated with HFpEF. Methods: In a retrospective, single-center analysis, we reviewed diagnoses from our database, focusing on patients initially diagnosed with idiopathic pulmonary arterial hypertension (IPAH) or PH associated with HFpEF (PH-HFpEF) based on their PAWP. These patients were reclassified, distinguishing between HFpEF and non-HFpEF cases. Patients with PH-HFpEF were further stratified by PAWP (\u226415 mmHg or &gt;15 mmHg). Results: The study included 350 patients: 214 (61.1%) with PAWP \u2264 15 mmHg and 136 (38.9%) with PAWP &gt; 15 mmHg. Replacing the PAWP criterion with the HFpEF criterion resulted in the reclassification of 121 of 350 (34.6%) patients (115 of 214 [53.7%] from IPAH to PH-HFpEF and 6 of 136 [4.4%] from PH-HFpEF to IPAH). The final disposition was IPAH (n = 105, 30%), PH-HFpEF with PAWP \u2264 15 mmHg (n = 115, 32.9%), and PH-HFpEF with PAWP &gt; 15 mmHg (n = 130, 37.1%). Characteristics such as age distribution, functional impairment, co-morbidities, echocardiographic indices of HFpEF, pulmonary vascular resistance, response to PH medications, and unadjusted survival were comparable between the two HFpEF cohorts but differed substantially from those with IPAH. Conclusions: PH-HFpEF patients with PAWP \u2264 15 mmHg resemble those with PAWP &gt; 15 mmHg but differ from IPAH cases. Incorporating non-invasive HFpEF criteria could refine PH diagnostic classification.<\/jats:p>","DOI":"10.3390\/jcm13247582","type":"journal-article","created":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T05:55:45Z","timestamp":1734069345000},"page":"7582","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Reassessing Pulmonary Hypertension Classification: Utilizing Criteria for Heart Failure with Preserved Ejection Fraction Instead of Pulmonary Arterial Wedge Pressure"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0902-4773","authenticated-orcid":false,"given":"Da-Hee","family":"Park","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany"},{"name":"Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2926-3608","authenticated-orcid":false,"given":"Jan","family":"Fuge","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany"},{"name":"Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5002-409X","authenticated-orcid":false,"given":"Jan Christopher","family":"Kamp","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany"},{"name":"Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Britta","family":"Harrigfeld","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Berliner","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9086-2293","authenticated-orcid":false,"given":"Marius M.","family":"Hoeper","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany"},{"name":"Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen M.","family":"Olsson","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine and Infectious Diseases, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany"},{"name":"Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), German Center for Lung Research (DZL), 30625 Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2200879","DOI":"10.1183\/13993003.00879-2022","article-title":"2022 ESC\/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension","volume":"61","author":"Humbert","year":"2022","journal-title":"Eur. 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