我们应该改变治疗的目标在肺高血压吗?
Panagiotis Karyofyllis1, Eftychia Demerouti1, Pavlos Habibis2
1Cardiology Department, Onassis Cardiac Surgery Center, 17674 Athens, Greece.
Life (Basel, Switzerland)
|May 27, 2023
概括
尽管肺高血压治疗方面取得了进展,但死亡率仍然很高. 专注于降低平均肺动脉压 (mPAP) 可以改善右心室功能和生存率,可能使肺高血压成为一种慢性,可管理的疾病.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 血管生物学 血管生物学
背景情况:
- 目前的肺高血压疗法,包括积极的药物治疗方案,并没有显著降低死亡率.
- 右心室 (RV) 功能是肺高血压患者预后的关键决定因素.
- 肺动脉高血压和慢性血栓栓塞性肺高血压的现有治疗方法对长期存活的影响有限.
研究的目的:
- 突出平均肺动脉压 (mPAP) 降低作为治疗目标的意义.
- 倡导肺高血压管理的战略转变.
- 探索mPAP降低的潜力,将肺高血压转化为慢性非致命性疾病.
主要方法:
- 关于肺高血压治疗策略的现有文献的综述.
- 分析mPAP,RV重塑和患者存活率之间的关系.
- 评估当前治疗对mPAP和RV功能的影响.
主要成果:
- 通过针对性药物治疗肺动脉高血压和治疗慢性血栓栓塞性肺高血压的干预来实现有效的mPAP降低.
- 降低mPAP可以导致反向RV改造.
- 改善的RV功能与增强的患者存活率相关.
结论:
- 降低mPAP应被视为肺高血压管理中的首要治疗目标.
- 一个专注于减少mPAP的战略提供了一种有希望的方法来改善生存率和患者的结果.
- 将治疗重点转移到降低mPAP可以使肺高血压成为一种慢性,可控的疾病,而不是致命的疾病.
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