[与左心病相关的肺高血压:病理生理学,诊断,治疗]
Sergio Caravita1, Mauro Gori2, Andrea Garascia3
1Dipartimento di Cardiologia, Ospedale San Luca IRCCS Istituto Auxologico Italiano, Milano - Dipartimento di Ingegneria Gestionale, dell'Informazione e della Produzione, Università degli Studi di Bergamo, Dalmine (BG).
肺高血压 (PH) 复杂化左心脏病是由左心房高血压驱动的. 将其与肺动脉高血压 (PAH) 区分开来需要仔细的表型化,因为治疗方法有很大差异.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 内部医学 内部医学
背景情况:
- 肺高血压 (PH) 经常复杂化左心脏病,特别是心力衰竭.
- 左心房高血压开始后毛细血管PH,但前毛细血管的变化可以发展在一些患者.
- 右心室功能障碍是常见的后果,使患者的预后恶化.
研究的目的:
- 突出诊断的挑战在区分PH与肺动脉高血压 (PAH) 的左心脏病与肺动脉高血压相关.
- 强调需要进行多维临床表型和血液动力学评估.
- 为了强调治疗潜在的左心病的重要性,而不是使用PAH特定疗法.
主要方法:
- 关于左心病中的PH现有文献的综述.
- 讨论诊断标准和挑战.
- 重点是临床表型和血液动力学评估.
主要成果:
- 左心房高血压是左心脏病中PH的主要驱动因素.
- 在左心病中区分PH与PAH是复杂的,特别是伴随疾病.
- 由于左心病导致的PH患者的PAH特异性治疗可能是有害的.
结论:
- 在左心病和PAH中确切诊断PH至关重要.
- 多维表型和血液动力学评估对于正确的诊断至关重要.
- 治疗应针对潜在的左心病理;PAH治疗不适用,可能有害.
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