肺高血压是因为肺高血压
1Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois 60611, USA. sanjiv.shah@northwestern.edu
肺高血压 (PH) 需要仔细诊断,使其与肺动脉高血压 (PAH) 区别开来. 有效的管理涉及理解心声回声学,侵入性检测和量身定制的治疗策略,以获得更好的患者结果.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 肺高血压 (PH),其特点是肺动脉压力升高,是普遍存在的,并与死亡率增加有关.
- 医生经常看到患有呼吸障碍和右心力衰竭等症状的患者,在心声图上经常显示肺动脉静脉压升高 (PASP).
- 肺动脉血管扩张剂通常在肺动脉高血压 (PAH) 患者中进行测试,但仅仅 PASP 的升高并不能证实 PAH.
研究的目的:
- 要强调区分PAH与PH的重要性,因为左心脏病更常见.
- 强调需要准确的诊断方法,包括心声回声和侵入性血液动力学测试.
- 引导PH和相关的右心力衰竭的适当治疗策略.
主要方法:
- 对PH的诊断标准和成像方法的审查.
- 对侵入性血液动力学参数进行分析,以准确诊断.
- 对不同类型PH的治疗策略进行比较.
主要成果:
- 在心声回声学上PASP升高不足以诊断PAH;二次原因,特别是左心病,更为普遍.
- 由于左心病,不正确地用血管扩展剂治疗PH,可能会使症状恶化.
- 由于左心病导致的PAH和PH之间的准确区分对于有效的管理至关重要.
结论:
- 对于PH的最佳管理,需要对心声回声和侵入性血液动力学检测有充分的了解.
- 区分PAH和PH二级到左心病对于选择适当的疗法至关重要.
- 开发基于证据的PH和右心衰竭治疗策略仍然是一个重大的临床挑战.
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