Pulmonary hypertension (PH) due to left heart disease (PH-LHD; group 2) is the most frequent form of PH and is a growing public health problem with associated high morbidity and mortality. PH often complicates heart failure with preserved or reduced ejection fraction (HFpEF or HFrEF) and negatively impacts outcomes, especially in patients with progressive pulmonary vascular remodelling (the pre-capillary component). As most drugs that target only the pulmonary vasculature have failed to demonstrate significant benefit in PH-LHD, the 6th World Symposium in Pulmonary Hypertension task force has issued a strong recommendation against all PH-specific therapies for PH-LHD patients [1]. While the US Food and Drug Administration-approved sodium glucose cotransporter 2 (SGLT2) inhibitors have been reported to improve PH in patients with heart failure [2], there are no approved treatments specifically targeting PH-LHD at present. Management of PH-LHD is challenging because of incomplete understanding of the pathological processes/mechanisms leading to the development of the pre-capillary component, heterogenous patient population with a variety of comorbidities/complex factors, variations in haemodynamic phenotyping definitions, and lack of lung biopsies from patients with PH-LHD.

左心病引起的肺动脉高压 （PH-LHD;第 2 组） 是最常见的 PH 形式，是一个日益严重的公共卫生问题，相关的并发症发生率和死亡率很高。PH 通常会使射血分数保留或降低（HFpEF 或 HFrEF）的心力衰竭复杂化，并对结果产生负面影响，尤其是在进行性肺血管重塑 （毛细血管前成分） 患者中。由于大多数仅针对肺血管系统的药物未能证明对 PH-LHD 有显著益处，因此第 6 届世界肺动脉高压研讨会工作组强烈推荐不要对 PH-LHD 患者进行所有 PH 特异性治疗 [1]。虽然据报道，美国食品药品监督管理局批准的钠葡萄糖协同转运蛋白 2 （SGLT2） 抑制剂可改善心力衰竭患者的 PH [2]，但目前尚无专门针对 PH-LHD 的已批准治疗方法。PH-LHD 的管理具有挑战性，因为对导致毛细血管前成分发展的病理过程/机制不完全了解、具有各种合并症/复杂因素的异质性患者群体、血流动力学表型定义的变化以及缺乏 PH-LHD 患者的肺活检。