肺动脉高血压和心血管并发症患者的初始治疗
Athénaïs Boucly1,2,3, David Montani1,2,3, Fabrice Bauer4
1INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France.
与单一治疗相比,肺动脉高血压 (PAH) 患者患有心血管并发症的初始双重口服治疗显示症状和运动能力有所改善. 这种方法似乎是有益的,并且在这个患者群体中被很好地容忍.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 欧洲指导方针建议在肺动脉高血压 (PAH) 患者的初始单一治疗心血管并发症由于有限的组合治疗证据.
- 这种方法受到越来越多的伴随性疾病的PAH患者的挑战.
- 心血管并发症包括高血压,肥胖,糖尿病和冠状动脉疾病.
研究的目的:
- 研究心血管并发症的PAH患者初始双重口服联合治疗与口服单疗法的疗效和耐受性.
- 基于对国家注册表的回顾性分析,分析治疗结果.
主要方法:
- 法国肺高血压注册 (2009-2020) 中发生的PAH患者的回顾性分析.
- 倾向性得分匹配用于比较最初的双重口服治疗与口服单一治疗.
- 纳入标准:至少有一种心血管并发症的PAH患者.
主要成果:
- 1784名确诊患者中有1088名患有心血管并发症;20%患有三种或更多.
- 在匹配的人群中 (n=708),初始双重治疗与单一治疗相比,在症状,运动能力,血液动力学和风险状况方面显示出更大的改善.
- 长期存活率没有显著差异;两组的停药率相似 (23%的双重治疗与24%的单一治疗).
结论:
- 最初的双重口服联合治疗可能为患有心血管并发症的PAH患者提供显著的益处.
- 这种治疗策略在被研究的人群中似乎被很好地容忍.
- 进一步的研究可能会支持关于这种特定PAH亚组组合治疗的指导方针更新.
更多相关视频
07:41A Model of Reverse Vascular Remodeling in Pulmonary Hypertension Due to Left Heart Disease by Aortic Debanding in Rats
Published on: March 1, 2022
06:10Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
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: 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...
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...
Pulmonary Hypertension: Classification and Pathogenesis
There are various classifications for PH, each relating to different underlying causes and also...
