肺动脉扩张在肺高血压的不同原因
Qunying Xi1, Zhihong Liu2, Changming Xiong2
1Pulmonary Vascular Diseases Ward, Fuwai Hospital Chinese Academy of Medical Sciences Shenzhen China.
Pulmonary circulation
|December 11, 2023
概括
肺动脉 (PA) 扩张在肺高血压 (PH) 中很常见,但其临床意义因PH类型而异. 在PH患者中,PA扩张并不能独立预测PH患者的死亡率.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 放射学 放射学是一门学科.
背景情况:
- 肺动脉 (PA) 扩张经常在肺高血压 (PH) 中观察到.
- 跨多种PH病因的PA扩张的临床影响尚不清楚.
- 了解这些变异对于患者管理至关重要.
研究的目的:
- 在肺动脉高血压 (PAH) 和慢性血栓栓塞性肺高血压 (CTEPH) 的各种亚型中研究PA扩张的临床和成像特征.
- 确定这些患者队伍中所有原因死亡的独立预测因素.
主要方法:
- 对1018名患有PAH和CTEPH的患者的回顾性分析.
- 评估PA直径及其与上升大动脉直径的比例.
- 用单变量和多变量考克斯比例危险模型来确定所有死因的决定因素.
主要成果:
- 在88.8%的患者中存在PA扩张; 27.2%的患者有PA/上升大动脉直径比>1.5.
- PA直径与血动力学参数和异常性PAH症状持续时间相关.
- 在不同PH亚型 (PAH-CHD,CTEPH,PAH-CTD) 中,PA直径与临床和成像参数的相关性各不相同.
- 只有6分钟的步行距离,而不是PA扩张,独立预测了所有原因的死亡.
结论:
- 在PH患者中,PA扩张是常见的发现,其临床特征因PH类型而异.
- 胰腺张本身并不是PH患者全因死亡率的独立预测因子.
相关概念视频
Pulmonary Hypertension: Classification and Pathogenesis
188
Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
There are various classifications for PH, each relating to different underlying causes and also...
There are various classifications for PH, each relating to different underlying causes and also...
188
Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
225
Oxygen therapy has emerged as a significant tool in enhancing the quality of life for patients suffering from pulmonary arterial hypertension (PAH). While this therapy has principally been studied on patients with significant hypoxemia, this therapeutic approach helps prevent potential organ damage and can be administered in the comfort of one's home.
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
225
Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors
161
Phosphodiesterase 5 (PDE5) inhibitors are potent enzymes that function to hydrolyze cyclic nucleotides to their corresponding 5' monophosphates. Their unique biochemical properties have been applied in treating Pulmonary Arterial Hypertension (PAH).
Among the PDE5 inhibitors, sildenafil (Revatio) stands out as a competitive and selective inhibitor. It operates by elevating cellular levels of cGMP and augmenting signaling through the cGMP-PKG pathway, promoting vasodilation. Upon oral...
Among the PDE5 inhibitors, sildenafil (Revatio) stands out as a competitive and selective inhibitor. It operates by elevating cellular levels of cGMP and augmenting signaling through the cGMP-PKG pathway, promoting vasodilation. Upon oral...
161
Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
174
Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
174
Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
170
Endothelins (ETs) are potent vasoactive peptides critical in the human body's various physiological and pathological processes. One of the most promising therapeutic strategies for treating pulmonary arterial hypertension (PAH) involves counteracting the effects of these endothelins using a class of drugs known as endothelin receptor antagonists.
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
170
Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
187
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
187


