肺高血压和慢性病:患病率,病理生理学和结果
Katarina Zeder1,2,3,4,5, Edward D Siew6, Gabor Kovacs2,4
1Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Nature reviews. Nephrology
|June 18, 2024
概括
肺高血压 (PH) 在慢性病 (CKD) 患者中很常见. 在CKD中早期发现和管理PH可能会改善患者的结果,但需要更多的研究.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
背景情况:
- 肺高血压 (PH) 影响高达78%的慢性病 (CKD) 患者.
- 在CKD中,PH是不良结果的独立预测因素.
- 慢性瘤在PH患者中很普遍,也预测了不良结果.
研究的目的:
- 描述CKD-PH复杂的病理生理学和临床特征.
- 了解PH对置换治疗决策的影响.
- 突出需要进一步研究的知识差距.
主要方法:
- 文献综述和对CKD-PH.现有数据的综合.
- 分析脏和肺血液动力学之间的相互作用.
- 讨论临床决策的挑战.
主要成果:
- CKD-PH呈现异质,由体积过载引起的毛囊后PH或具有高肺血管抵抗和右心室功能障碍的独特子组.
- CKD通过诸如左心室填充压力升高和体积过载等机制对PH作出贡献.
- 一部分高风险患者可能患有右侧心综合征.
结论:
- CKD-PH的病理生理学是复杂的,需要进一步阐明.
- 在指导置换治疗决策中的PH的作用仍然不清楚.
- 迫切需要进行研究,以改善CKD-PH患者或有CKD-PH风险的患者的治疗结果.
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