Left ventricular assist devices (LVADs) improve survival and quality of life in patients with advanced heart failure. Despite these benefits, combined post- and precapillary pulmonary hypertension can be particularly problematic in patients on LVAD support, often exacerbating right ventricular (RV) dysfunction. Both persistently elevated pulmonary vascular resistance and RV dysfunction are associated with adverse outcomes, including death after LVAD. These observations have led to significant interest in the use of pulmonary vasodilators to treat pulmonary hypertension and preserve RV function among LVAD-supported patients. Although pulmonary vasodilators are commonly used for the treatment of pulmonary hypertension and RV dysfunction in LVADs, the benefits of this practice remain unclear. The purpose of this review is to highlight the current challenges in managing pulmonary vascular disease and RV dysfunction in patients with heart failure on LVAD support.

中文翻译：

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左心室辅助装置支持下患者的肺动脉高压和右心室功能障碍的相交：肺血管扩张药是否起作用？

左心室辅助设备（LVAD）可改善晚期心力衰竭患者的生存率和生活质量。尽管有这些好处，但在接受LVAD支持的患者中，合并毛细血管后和毛细血管前肺动脉高压可能尤其成问题，通常会加重右心室（RV）功能障碍。持续升高的肺血管阻力和RV功能障碍均与不良结局相关，包括LVAD后死亡。这些观察结果引起了在LVAD支持的患者中使用肺血管扩张剂治疗肺动脉高压和保持RV功能的极大兴趣。尽管肺血管扩张剂通常用于治疗LVAD中的肺动脉高压和RV功能障碍，但这种做法的益处仍不清楚。