Abstract Among the inotropic agents used in the management of heart failure, levosimendan, in particular, has a selective venodilator property that appears to explain its clinical benefit during pulmonary hypertension (PH). Most of the evidence refers to patients with group 2 PH and consequent right ventricular (RV) dysfunction. In this scenario, the observed benefits may be due to the effect of levosimendan on RV contractility and pulmonary vessel dilation, or to the improvement of left ventricular function and consequent reduction […]

Pulmonary hypertension (PH) associated with left heart disease is classified as group 2, and it encompasses both heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF).1 In both diseases, the development of PH is associated with an unfavorable clinical course in the natural history of the disease, and knowledge about its pathophysiology is still uncertain, which may have practical implications from the diagnosis to the treatment of heart failure.2,3 […]

Abstract Invasive cardiopulmonary hemodynamic assessment by means of a pulmonary artery catheter is an important tool for evaluating patients with advanced heart failure. It makes it possible to definitively diagnose pulmonary hypertension and, when pulmonary hypertension is present, to classify it as isolated post-capillary or combined pre- and post-capillary. Its use is mandatory in evaluation for heart transplantation and mechanical circulatory assist device implantation. Furthermore, it can be very useful in the management of cardiogenic shock.