左心病中的肺高血压:病理生理学,血液动力学评估和治疗管理
Zied Ltaief1, Patrick Yerly2, Lucas Liaudet1
1Service of Adult Intensive Care Medicine, University Hospital, 1011 Lausanne, Switzerland.
International journal of molecular sciences
|June 28, 2023
概括
在左心病 (PH-LHD) 中肺高血压是常见的. 针对PH-LHD的向疗法在很大程度上失败了,它们在特定患者亚组中的潜在益处需要进一步研究.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 心脏衰竭研究研究
背景情况:
- 与左心脏病 (PH-LHD) 或2组PH相关的肺高血压是最常见的类型.
- 它是由心力衰竭 (HFpEF,HFrEF) 中左心压升高的逆向传播引起的,增加了右心室 (RV) 后负荷.
- 肺血管重塑可以导致毛囊前PH表型,提高肺血管抵抗力 (PVR),并可能导致RV衰竭.
研究的目的:
- 审查PH-LHD的病理生理学.
- 评估目前PH-LHD治疗策略的疗效.
- 探索针对特定PH-LHD患者亚组的向治疗的潜力.
主要方法:
- 文献综述和综合现有关于PH-LHD.HD的研究.
- 血液动力学表型和治疗结果的分析.
- 讨论治疗目标和患者分层.
主要成果:
- 标准治疗侧重于通过利尿剂和HF治疗来降低左侧压力.
- 旨在减少PVR的向疗法在PH-LHD中与其他毛囊前PH形式相比,表现出有限的成功.
- 已建立的肺血管改造对当前的治疗方法构成了挑战.
结论:
- 有效管理PH-LHD需要解决心脏左侧压力和HF.
- 在特定PH-LHD亚组 (例如,HFrEF与HFpEF,毛细管PH前后) 中减少PVR疗法的作用仍然不确定.
- 需要进一步的研究来确定可能受益于向肺血管治疗的患者表型.
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