Pulmonary Hypertension Caused by Systolic Heart Failure

Every time a healthy heart pumps oxygen-rich blood from the lungs into the rest of the body, it goes through two phases — a contracting or pumping phase (called systolic function) and a relaxing phase (called diastolic function).

When a weakened heart can't pump efficiently, that's known as systolic dysfunction. Just like a kink in a garden hose, blood begins to back up into the lungs and causes pulmonary hypertension (PH).

Systolic Heart Dysfunction Symptoms and Causes

The symptoms of systolic heart dysfunction are similar to those caused by many other types of heart failure, including:

• Shortness of breath with exertion or at rest
• Excessive fatigue
• Swelling of the lower extremities or belly (edema)

Causes of systolic heart dysfunction can be:

• Heart attack or coronary artery disease — these can cause permanent scarring that weakens the heart's pumping ability. Coronary artery disease is often caused by smoking, diabetes, high blood pressure or high cholesterol.
• Genetic or unknown reasons — the pumping function of the heart can be weakened by genetic causes or viruses, but in some cases the reasons are unknown.

Systolic Heart Failure and PH Treatment Approach

Each of our physicians in the UPMC Comprehensive Pulmonary Hypertension Program have deep expertise in their specialty, but they also work closely with other cardiologists, cardiac surgeons and experts within the UPMC Heart and Vascular Institute.

That cross-disciplinary approach means that patients get coordinated care from the best minds in systolic dysfunction and resulting pulmonary hypertension.

Pulmonary hypertension and systolic heart dysfunction can't be cured, but their symptoms can be managed. Our treatment approach focuses on improving a person's quality of life and helping them maintain an independent lifestyle.

• Medications — many people respond well to medications that lower blood pressure and make the heart's pumping function easier.
• Defibrillators — also known as a pacemaker, an implantable defibrillator can be combined with medical therapies to synchronize the heart's pumping motions and even improve the condition of the heart muscle itself.
• Left Ventricular Assist Devices (LVAD) — UPMC cardiologists have been on the leading edge of LVAD treatment since the technology was introduced in the 1980s, and have been leaders in improving the technology since then. These implantable devices pump blood into the body just as a healthy heart would. LVADs can be used:
  • When a person is waiting for a heart transplant. LVADs are used as a "bridge" to heart transplantation, meaning that they do the work of the heart until a human heart becomes available.
  • As a permanent valve replacement. Today's LVADs are now fully implantable, small enough to fit in most adult chests and durable enough for long-term use.
• Heart Transplant — our doctors are leading experts in heart transplantation as part of the UPMC Thomas E. Starzl Transplantation Institute, a nationally regarded center of excellence in transplantation.
• New Stem Cell Therapies — UPMC researchers are working on new therapies for systolic heart dysfunction that involve injecting healthy stem cells into failing hearts to improve their function.