Heart Failure with Preserved Ejection Fraction

To the Editor: Owan et al. 1 and Bhatia et al. 2 (July 20 issue) suggest that the rate of survival among patients who have heart failure with preserved ejection fraction may be similar to that among patients with systolic heart failure. Although neither study was designed to identify the specific causes of death in such patients, the potential contribution of pulmonary hypertension should be considered. Both pulmonary hypertension 3 and right ventricular function 4 have been shown to predict death in patients with systolic heart failure. Despite growing recognition that heart failure with preserved ejection fraction can also lead to pulmonary hypertension, its . . .