肺高血压的最新临床分类和血液动力学定义及其临床影响
Mithum Kularatne1, Christian Gerges2, Mitja Jevnikar3,4,5
1Division of Respiratory Medicine, Department of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
Journal of cardiovascular development and disease
|March 27, 2024
概括
2022年的指导方针重新定义了肺高血压 (PH) 以较低的压力值. 引入了前毛细血管PH和运动PH的新定义,影响了诊断,但没有影响当前的治疗方法.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 临床医学 临床医学
背景情况:
- 肺高血压 (PH) 是一种严重的疾病,肺动脉压力升高,增加了发病率和死亡率.
- 准确的分类和血液动力学分析对于管理各种PH状况至关重要.
研究的目的:
- 审查2022年ESC/ERS关于PH的指南中更新的血液动力学定义背后的证据.
- 讨论这些变化对PH诊断和患者管理的影响.
主要方法:
- 对2022年ESC/ERS肺高血压指南的分析.
- 对影响血液动力学值调整的规范和预后数据的审查.
主要成果:
- 肺高血压 (PH) 现在被定义为平均肺动脉压 (mPAP) >20 mmHg (以前≥25 mmHg).
- 肺血管阻力 (PVR) >2木单位 (WU) 包含在毛囊前PH定义中.
- 重新引入运动PH,定义为mPAP/心脏输出斜率>3 mmHg/L/min.
结论:
- 更新的血液动力学定义显著改变PH诊断.
- 目前基于证据的治疗方法对于特定的新定义的PH类别 (例如,mPAP 21-24 mmHg,PVR 2-3 WU,运动PH) 缺乏.
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