导管切除在肺高血压患者中的好处:最近的进展
Stepan Havranek1, Zdenka Fingrova2, Milan Dusik2
12nd Department of Internal Medicine - Cardiovascular Medicine, 1st Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic. stepan.havranek@vfn.cz.
超心室性心力衰竭 (SVT) 在肺高血压 (PH) 中很常见. 导管切除在PH患者中有效治疗较不复杂的SVT,但心房动 (AF) 切除需要个性化指示.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
背景情况:
- 超心室性心跳动 (SVT) 经常使肺高血压 (PH) 复杂化.
- 在PH中常见的SVTs包括心脏动 (AF),心脏动 (AFL),心脏动 (AT) 和节点心律不整.
- 在PH患者中,SVT会加剧功能衰退和右心室衰竭.
研究的目的:
- 评估PH患者对SVTs的导管切除的疗效和安全性.
- 评估在这个人群中SVT切除的长期结果和挑战.
主要方法:
- 对PH患者各种SVT的导管切除手术现有数据的审查.
- 对急性疗效,安全性和长期结果的分析,包括心律失常的复发和不良事件.
主要成果:
- 导管切除是可行的,急性有效的,对于典型的AFL,节点心律失常症和PH中不那么复杂的焦点AT来说是安全的.
- 由于心律失常的复发和新的SVTs,长期的成功受到限制. 右心房扩张可能会导致技术困难.
- 在PH中AF切除的疗效与一般人群的疗效相似,但数据有限,脆弱患者的手术风险增加.
结论:
- 导管切除是PH患者中较不复杂的SVT的首选治疗方法.
- 在PH中进行AF切除的指示需要仔细的个性化,因为有效性有限,风险增加.
- 需要进一步的研究,以优化SVT的PH患者的切除策略和结果.
相关概念视频
Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
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...
Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
Treatment for Pulmonary Arterial Hypertension: Endothelin Receptor Antagonists
ETs are synthesized through a complex sequence of enzymatic steps, primarily involving an enzyme referred to as endothelin-converting enzyme...
Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
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...
Treatment for Pulmonary Arterial Hypertension: Phosphodiesterase Inhibitors
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...
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System


