Balancing the positives and negatives of the diastolic pulmonary gradient

This article refers to ‘Determinants and prognostic implications of the negative diastolic pulmonary pressure gradient in patients with pulmonary hypertension due to left heart disease’ by A.I. Nagy et al., published in this issue on pages 88–97. Combined post- and pre-capillary pulmonary hypertension (CpcPH) caused by left heart disease (PH-LHD) has an undoubtedly worse prognosis compared with isolated post-capillary (IpcPH),1 yet how to best...