Pulmonary hypertension in hereditary hemorrhagic telangiectasia: A clinical review.

Publisher: Wiley Country of Publication: United States NLM ID: 101557243 Publication Model: eCollection Cited Medium: Print ISSN: 2045-8932 (Print) Linking ISSN: 20458932 NLM ISO Abbreviation: Pulm Circ Subsets: PubMed not MEDLINE

Publication: 2022- : [Hoboken, NJ] : Wiley
Original Publication: Mumbai : Medknow Publications

Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal dominant hereditary disorder characterized by recurrent spontaneous epistaxis, mucocutaneous telangiectasias, and solid organ arteriovenous malformations (AVMs). Pulmonary hypertension (PH) is an increasingly recognized complication in patients with HHT, most often precipitated by high-output heart failure in the presence of hepatic AVMs as well as pulmonary arterial hypertension in the form of a proliferative vasculopathy. The presence of PH in patients with HHT is associated with significant elevations in rates of morbidity and mortality. Additionally, there is growing recognition of a thromboembolic propensity in this population that increases the risk of chronic thromboembolic PH, posing unique clinical considerations regarding the use of anticoagulation. Patients with HHT are also at risk of PH due to disorders commonly seen in the general population, including left-sided heart and lung disease. The etiology of PH in HHT is multifaceted and complex; the diagnostic approach and treatment strategies must consider the underlying pathophysiology of HHT. This comprehensive review summarizes current knowledge of PH in HHT, detailing the pathogenesis of known etiologies, diagnostic evaluation, and suggested treatment modalities as well as emerging therapies that may be of future interest.
Competing Interests: The authors declare no conflict of interest.
(© 2023 The Authors. Pulmonary Circulation published by John Wiley & Sons Ltd on behalf of Pulmonary Vascular Research Institute.)

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Keywords: chronic thromboembolic pulmonary hypertension; hereditary hemorrhagic telangiectasia; high‐output heart failure; pulmonary arterial hypertension; pulmonary hypertension

Date Created: 20231023 Latest Revision: 20240927

20240927

PMC10585978

10.1002/pul2.12301

37868718