# Therapeutic challenges and new therapeutic targets for combined capillary pulmonary hypertension: a review

## TL;DR

This review discusses the challenges in treating combined capillary pulmonary hypertension and highlights new potential therapeutic targets for better management.

## Contribution

The paper provides a comprehensive overview of the pathophysiology and potential therapeutic targets for Cpc-PH.

## Key findings

- Cpc-PH is characterized by elevated pulmonary venous and arterial pressures with increased vascular resistance.
- Current treatments for Cpc-PH are limited and not well-defined.
- Genetic factors, metabolic syndrome, oxidative stress, and fibrosis may influence Cpc-PH progression.

## Abstract

With a high frequency and a poor prognosis, combined pre-and post-capillary pulmonary hypertension (Cpc-PH) is a significant subtype of pulmonary hypertension linked to left-sided heart disease (PH-LHD). The complicated pathophysiology of Cpc-PH is primarily characterized by elevated pulmonary venous pressure leading to an increase in retrocapillary pressure, which is followed by elevated pulmonary artery pressure and a marked rise in pulmonary vascular resistance (PVR). There is currently no well-defined treatment plan for Cpc-PH, and there are numerous obstacles to overcome. In patients with Cpc-PH, the effectiveness of targeted medications for pulmonary hypertension is limited and debatable. Recent research has revealed that the prevalence and progression of Cpc-PH may be influenced by genetic factors, metabolic syndrome, oxidative stress, and fibrosis. To help doctors better manage and treat patients with Cpc-PH, this review provides a detailed description of the disease’s epidemiology, pathogenesis, diagnostic techniques, current treatment status, and potential therapeutic targets.