与左心病相关的肺高血压:挑战,新兴策略和未来方向
Muhammad Shahzeb Khan1, Barry A Borlaug2, Javed Butler3
1Baylor Scott and White Research Institute, Dallas, Texas, USA; Baylor Scott and White The Heart Hospital, Plano, Texas, USA; Department of Medicine, Baylor College of Medicine, Temple, Texas, USA.
Journal of the American College of Cardiology
|March 11, 2026
概括
肺高血压与左心病 (PH-LHD) 是常见的,难以诊断的. 目前的治疗方法有限,但正在研究新的药物和设备疗法,以改善患者的治疗结果.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 临床试验 临床试验
背景情况:
- 与左心病 (LHD) 相关的肺高血压 (PH) 是最常见的PH类型,具有显著的健康风险.
- 诊断PH-LHD是复杂的,因为类似的症状,不准确的心声回声图和需要进行侵入性测试.
- 现有的肺动脉高血压药物对PH-LHD患者无效,可能有害.
研究的目的:
- 审查关于PH-LHD的当前知识.
- 突出研究中的新药学和侵入性治疗方法.
- 讨论临床试验设计的挑战,并为未来的研究提出一个框架.
主要方法:
- 关于PH-LHD的当前知识的文献综述.
- 新兴药理学药物的总结 (例如,sotatercept,放松类同类药物,levosimendan).
- 基于设备的研究策略的概述 (例如,肺动脉缩,透导管心房转移).
主要成果:
- 除了治疗LHD之外,还没有专门针对PH-LHD的经批准的药理或干预疗法.
- 几种有前途的代理和设备策略处于早期调查阶段.
- 临床试验的进展受到招募挑战,患者变化和结果测量问题的阻碍.
结论:
- PH-LHD需要专门的诊断和治疗方法.
- 新兴疗法显示出潜力,但需要严格的临床验证.
- 克服试验设计障碍对于推进PH-LHD治疗至关重要.
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