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Updated: Sep 11, 2025

Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis
Published on: August 26, 2025
Successful Management of HFpEF-Related Pulmonary Hypertension With Systemic-Level Pressures Using
Bahy Abofrekha1, Mahmoud Shadi2, Jennifer Jdaidani1
1Department of Internal Medicine, Northwell, Staten Island University Hospital, New Hyde Park, New York, USA.
Background:
Pulmonary hypertension (PH) is present in over two-thirds of patients who experience heart failure with preserved ejection fraction (HFpEF), and it worsens their prognosis, particularly when combined with right ventricular dysfunction. Effective treatments for HFpEF-related PH are limited.
Case Summary:
A 70-year-old woman presented with severe exertional dyspnea and hypoxia. Echocardiography revealed a preserved ejection fraction with advanced diastolic dysfunction, as well as severe PH. Right heart catheterization showed pulmonary pressures at systemic levels and elevated left-sided filling pressures. Significant symptom improvement and normalized pulmonary pressures were noted after treatment with sacubitril-valsartan and a sodium-glucose cotransporter 2 (SGLT2) inhibitor.
Discussion:
Although sacubitril-valsartan and SGLT2 inhibitors have been proven effective in HFpEF, their specific role in HFpEF-PH remains unclear. This case highlights their potential to improve hemodynamics and symptoms in this challenging patient population.
Take-Home Message:
Sacubitril-valsartan and SGLT2 inhibitors may be effective for treating PH in HFpEF; further investigation is warranted.
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