European Respiratory Review最新文献_第10页

Towards the adoption of quantitative computed tomography in the management of interstitial lung disease. 在间质性肺病的治疗中采用定量计算机断层扫描技术。

IF 7.5 1区医学

European Respiratory Review Pub Date : 2024-03-27 Print Date: 2024-01-31 DOI: 10.1183/16000617.0055-2023

Simon L F Walsh, Jan De Backer, Helmut Prosch, Georg Langs, Lucio Calandriello, Vincent Cottin, Kevin K Brown, Yoshikazu Inoue, Vasilios Tzilas, Elizabeth Estes

{"title":"Towards the adoption of quantitative computed tomography in the management of interstitial lung disease.","authors":"Simon L F Walsh, Jan De Backer, Helmut Prosch, Georg Langs, Lucio Calandriello, Vincent Cottin, Kevin K Brown, Yoshikazu Inoue, Vasilios Tzilas, Elizabeth Estes","doi":"10.1183/16000617.0055-2023","DOIUrl":"10.1183/16000617.0055-2023","url":null,"abstract":"The shortcomings of qualitative visual assessment have led to the development of computer-based tools to characterise and quantify disease on high-resolution computed tomography (HRCT) in patients with interstitial lung diseases (ILDs). Quantitative CT (QCT) software enables quantification of patterns on HRCT with results that are objective, reproducible, sensitive to change and predictive of disease progression. Applications developed to provide a diagnosis or pattern classification are mainly based on artificial intelligence. Deep learning, which identifies patterns in high-dimensional data and maps them to segmentations or outcomes, can be used to identify the imaging patterns that most accurately predict disease progression. Optimisation of QCT software will require the implementation of protocol standards to generate data of sufficient quality for use in computerised applications and the identification of diagnostic, imaging and physiological features that are robustly associated with mortality for use as anchors in the development of algorithms. Consortia such as the Open Source Imaging Consortium have a key role to play in the collation of imaging and clinical data that can be used to identify digital imaging biomarkers that inform diagnosis, prognosis and response to therapy.","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"33 171","pages":""},"PeriodicalIF":7.5,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10966471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

"Phosphodiesterase 4B inhibition: a potential novel strategy for treating pulmonary fibrosis." M. Kolb, B. Crestani and T.M. Maher. Eur Respir Rev 2023; 32: 220206. "磷酸二酯酶 4B 抑制：治疗肺纤维化的潜在新策略"。M. Kolb、B. Crestani 和 T.M. Maher。Eur Respir Rev 2023; 32: 220206.

IF 7.5 1区医学

European Respiratory Review Pub Date : 2024-03-27 Print Date: 2024-01-31 DOI: 10.1183/16000617.5206-2022

引用次数: 0

The persistent inflammation in COPD: is autoimmunity the core mechanism? 慢性阻塞性肺病的持续炎症：自身免疫是核心机制吗？

IF 7.5 1区医学

European Respiratory Review Pub Date : 2024-03-27 Print Date: 2024-01-31 DOI: 10.1183/16000617.0137-2023

Ling-Ling Dong, Zheng-Yuan Liu, Kai-Jun Chen, Zhou-Yang Li, Jie-Sen Zhou, Hua-Hao Shen, Zhi-Hua Chen

{"title":"The persistent inflammation in COPD: is autoimmunity the core mechanism?","authors":"Ling-Ling Dong, Zheng-Yuan Liu, Kai-Jun Chen, Zhou-Yang Li, Jie-Sen Zhou, Hua-Hao Shen, Zhi-Hua Chen","doi":"10.1183/16000617.0137-2023","DOIUrl":"10.1183/16000617.0137-2023","url":null,"abstract":"COPD poses a significant global public health challenge, primarily characterised by irreversible airflow restriction and persistent respiratory symptoms. The hallmark pathology of COPD includes sustained airway inflammation and the eventual destruction of lung tissue structure. While multiple risk factors are implicated in the disease's progression, the underlying mechanisms remain largely elusive. The perpetuation of inflammation is pivotal to the advancement of COPD, emphasising the importance of investigating these self-sustaining mechanisms for a deeper understanding of the pathogenesis. Autoimmune responses constitute a critical mechanism in maintaining inflammation, with burgeoning evidence pointing to their central role in COPD progression; yet, the intricacies of these mechanisms remain inadequately defined. This review elaborates on the evidence supporting the presence of autoimmune processes in COPD and examines the potential mechanisms through which autoimmune responses may drive the chronic inflammation characteristic of the disease. Moreover, we attempt to interpret the clinical manifestations of COPD through autoimmunity.","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"33 171","pages":""},"PeriodicalIF":7.5,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10966473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140305351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nocturnal oxygen therapy in obstructive sleep apnoea: a systematic review and meta-analysis 阻塞性睡眠呼吸暂停的夜间氧气疗法：系统回顾和荟萃分析

IF 7.5 1区医学

European Respiratory Review Pub Date : 2024-03-20 DOI: 10.1183/16000617.0173-2023

Su Latt Phyu, Selin Ercan, Eli Harriss, Christopher Turnbull

{"title":"Nocturnal oxygen therapy in obstructive sleep apnoea: a systematic review and meta-analysis","authors":"Su Latt Phyu, Selin Ercan, Eli Harriss, Christopher Turnbull","doi":"10.1183/16000617.0173-2023","DOIUrl":"https://doi.org/10.1183/16000617.0173-2023","url":null,"abstract":"Obstructive sleep apnoea is characterised by recurrent reduction of airflow during sleep leading to intermittent hypoxia. Continuous positive airway pressure is the first-line treatment but is limited by poor adherence. Nocturnal oxygen therapy may be an alternative treatment for obstructive sleep apnoea but its effects remain unclear. This meta-analysis evaluates the effects of nocturnal oxygen therapy on both obstructive sleep apnoea severity and blood pressure.\u0000A literature search was performed based on the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. Peer-reviewed, randomised studies that compared the effect of nocturnal oxygen therapy to sham in obstructive sleep apnoea patients were included. The main outcomes were the apnoea–hypopnoea index and systolic and diastolic blood pressure.\u0000The search strategy yielded 1295 citations. Nine studies with 502 participants were included. When nocturnal oxygen therapy was compared to sham/air, it significantly reduced the apnoea–hypopnoea index (mean difference (MD) –15.17 events·h–1, 95% CI –19.95– –10.38 events·h–1, p<0.00001). Nocturnal oxygen therapy had no significant effect on blood pressure at follow-up without adjustment for baseline values, but did, where available, significantly attenuate the change in blood pressure from baseline to follow-up for both systolic blood pressure (MD –2.79 mmHg, 95% CI –5.45– –0.14 mmHg, p=0.040) and diastolic blood pressure (MD –2.20 mmHg, 95% CI –3.83– –0.57 mmHg, p=0.008).\u0000Nocturnal oxygen therapy reduced the apnoea–hypopnoea index severity and the change in (but not absolute) systolic and diastolic blood pressure, compared to sham. This suggests that nocturnal oxygen therapy may be a treatment option for obstructive sleep apnoea. Further studies with longer-term follow-up and standardised measurements are needed.","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"37 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140165569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Resectable non-stage IV nonsmall cell lung cancer: the surgical perspective 可切除的非 IV 期非小细胞肺癌：外科视角

IF 7.5 1区医学

European Respiratory Review Pub Date : 2024-03-20 DOI: 10.1183/16000617.0195-2023

Clemens Aigner, Hasan Batirel, Rudolf M. Huber, David R. Jones, Alan D.L. Sihoe, Tomaž Štupnik, Alessandro Brunelli

{"title":"Resectable non-stage IV nonsmall cell lung cancer: the surgical perspective","authors":"Clemens Aigner, Hasan Batirel, Rudolf M. Huber, David R. Jones, Alan D.L. Sihoe, Tomaž Štupnik, Alessandro Brunelli","doi":"10.1183/16000617.0195-2023","DOIUrl":"https://doi.org/10.1183/16000617.0195-2023","url":null,"abstract":"Surgery remains an essential element of the multimodality radical treatment of patients with early-stage nonsmall cell lung cancer. In addition, thoracic surgery is one of the key specialties involved in the lung cancer tumour board. The importance of the surgeon in the setting of a multidisciplinary panel is ever-increasing in light of the crucial concept of resectability, which is at the base of patient selection for neoadjuvant/adjuvant treatments within trials and in real-world practice. This review covers some of the topics which are relevant in the daily practice of a thoracic oncological surgeon and should also be known by the nonsurgical members of the tumour board. It covers the following topics: the pre-operative selection of the surgical candidate in terms of fitness in light of the ever-improving nonsurgical treatment alternatives unfit patients may benefit from; the definition of resectability, which is so important to include patients into trials and to select the most appropriate radical treatment; the impact of surgical access and surgical extension with the evolving role of minimally invasive surgery, sublobar resections and parenchymal-sparing sleeve resections to avoid pneumonectomy.","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"25 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140165566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The nitric oxide–soluble guanylate cyclase–cGMP pathway in pulmonary hypertension: from PDE5 to soluble guanylate cyclase 肺动脉高压中的一氧化氮-可溶性鸟苷酸环化酶-GMP途径：从PDE5到可溶性鸟苷酸环化酶

IF 7.5 1区医学

European Respiratory Review Pub Date : 2024-03-20 DOI: 10.1183/16000617.0183-2023

Raymond L. Benza, Ekkehard Grünig, Peter Sandner, Johannes-Peter Stasch, Gérald Simonneau

{"title":"The nitric oxide–soluble guanylate cyclase–cGMP pathway in pulmonary hypertension: from PDE5 to soluble guanylate cyclase","authors":"Raymond L. Benza, Ekkehard Grünig, Peter Sandner, Johannes-Peter Stasch, Gérald Simonneau","doi":"10.1183/16000617.0183-2023","DOIUrl":"https://doi.org/10.1183/16000617.0183-2023","url":null,"abstract":"The nitric oxide (NO)–soluble guanylate cyclase (sGC)–cyclic guanosine monophosphate (cGMP) pathway plays a key role in the pathogenesis of pulmonary hypertension (PH). Targeted treatments include phosphodiesterase type 5 inhibitors (PDE5i) and sGC stimulators. The sGC stimulator riociguat is approved for the treatment of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). sGC stimulators have a dual mechanism of action, enhancing the sGC response to endogenous NO and directly stimulating sGC, independent of NO. This increase in cGMP production via a dual mechanism differs from PDE5i, which protects cGMP from degradation by PDE5, rather than increasing its production. sGC stimulators may therefore have the potential to increase cGMP levels under conditions of NO depletion that could limit the effectiveness of PDE5i. Such differences in mode of action between sGC stimulators and PDE5i could lead to differences in treatment efficacy between the classes. In addition to vascular effects, sGC stimulators have the potential to reduce inflammation, angiogenesis, fibrosis and right ventricular hypertrophy and remodelling. In this review we describe the evolution of treatments targeting the NO–sGC–cGMP pathway, with a focus on PH.","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"21 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140165668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Inhaled versus systemic corticosteroids for acute exacerbations of COPD: a systematic review and meta-analysis. 慢性阻塞性肺疾病急性加重期吸入与全身使用皮质类固醇的比较：系统综述和荟萃分析。

IF 9 1区医学

European Respiratory Review Pub Date : 2024-03-20 Print Date: 2024-01-31 DOI: 10.1183/16000617.0151-2023

Efthymia Papadopoulou, Sulaiman Bin Safar, Ali Khalil, Jan Hansel, Ran Wang, Alexandru Corlateanu, Konstantinos Kostikas, Stavros Tryfon, Jørgen Vestbo, Alexander G Mathioudakis

{"title":"Inhaled versus systemic corticosteroids for acute exacerbations of COPD: a systematic review and meta-analysis.","authors":"Efthymia Papadopoulou, Sulaiman Bin Safar, Ali Khalil, Jan Hansel, Ran Wang, Alexandru Corlateanu, Konstantinos Kostikas, Stavros Tryfon, Jørgen Vestbo, Alexander G Mathioudakis","doi":"10.1183/16000617.0151-2023","DOIUrl":"10.1183/16000617.0151-2023","url":null,"abstract":"This meta-analysis compares the efficacy and safety of inhaled versus systemic corticosteroids for COPD exacerbations.Following a pre-registered protocol, we appraised eligible randomised controlled trials (RCTs) according to Cochrane methodology, performed random-effects meta-analyses for all outcomes prioritised in the European Respiratory Society COPD core outcome set and rated the certainty of evidence as per Grading of Recommendations Assessment, Development and Evaluation methodology.We included 20 RCTs totalling 2140 participants with moderate or severe exacerbations. All trials were at high risk of methodological bias. Low-certainty evidence did not reveal significant differences between inhaled and systemic corticosteroids for treatment failure rate (relative risk 1.75, 95% CI 0.76-4.02, n=569 participants); breathlessness (mean change: standardised mean difference (SMD) -0.11, 95% CI -0.36-0.15, n=239; post-treatment scores: SMD -0.18, 95% CI -0.41-0.05, n=293); serious adverse events (relative risk 1.47, 95% CI 0.56-3.88, n=246); or any other efficacy outcomes. Moderate-certainty evidence implied a tendency for fewer adverse events with inhaled compared to systemic corticosteroids (relative risk 0.80, 95% CI 0.64-1.0, n=480). Hyperglycaemia and oral fungal infections were observed more frequently with systemic and inhaled corticosteroids, respectively.Limited available evidence suggests potential noninferiority of inhaled to systemic corticosteroids in COPD exacerbations. Appropriately designed and powered RCTs are warranted to confirm these findings.","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"33 171","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10951861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140179559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

20 years of neuromuscular electrical stimulation in COPD 神经肌肉电刺激治疗慢性阻塞性肺病 20 年

IF 7.5 1区医学

European Respiratory Review Pub Date : 2024-03-20 DOI: 10.1183/16000617.0247-2022

Antonella LoMauro, Fabrizio Gervasoni

{"title":"20 years of neuromuscular electrical stimulation in COPD","authors":"Antonella LoMauro, Fabrizio Gervasoni","doi":"10.1183/16000617.0247-2022","DOIUrl":"https://doi.org/10.1183/16000617.0247-2022","url":null,"abstract":"Although a lung disease, COPD is also associated with extrapulmonary manifestations including, among others, limb muscle dysfunction. Limb muscle dysfunction is a key systemic consequence of COPD that impacts patients' physical activity, exercise tolerance, quality of life and survival. Deconditioning is the main mechanism underlying the development of limb muscle dysfunction in COPD, which can be partially improved with exercise. However, some patients may not be able to tolerate exercise because of incapacitating breathlessness or unwillingness to undertake whole-body exercise. Alternative training modalities that do not give rise to dyspnoea, such as neuromuscular electrical stimulation (NMES), are urged. Over the past 20 years, NMES in COPD has presented conflicting conclusions in meta-analysis. In this review, we try to understand the reason for this result by analysing possible biases and factors that brought conflicting conclusions. We discuss the population (the intervention group, but also the control group), the outcome measures, the frequency of stimulation, the rehabilitation protocol (i.e. NMES alone versus standard care/rehabilitation or NMES plus conventional exercise training versus conventional exercise training alone or NMES versus sham treatment) and the trial design. The main reason for this discrepancy is the lack of dedicated guidelines for NMES. Further research is urged to determine the optimal parameters for an NMES programme. Despite this, NMES appears to be an effective means of enhancing quadriceps strength and exercise capacity in COPD with the potential to break the vicious circle induced by the disease and COPD patients’ lifestyle.","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"218 1","pages":""},"PeriodicalIF":7.5,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140165252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preclinical models of maternal asthma and progeny outcomes: a scoping review. 母体哮喘与后代结局的临床前模型：范围综述。

IF 7.5 1区医学

European Respiratory Review Pub Date : 2024-02-28 Print Date: 2024-01-31 DOI: 10.1183/16000617.0174-2023

Joshua L Robinson, Kathryn L Gatford, Danielle N Bailey, Andrea J Roff, Vicki L Clifton, Janna L Morrison, Michael J Stark

{"title":"Preclinical models of maternal asthma and progeny outcomes: a scoping review.","authors":"Joshua L Robinson, Kathryn L Gatford, Danielle N Bailey, Andrea J Roff, Vicki L Clifton, Janna L Morrison, Michael J Stark","doi":"10.1183/16000617.0174-2023","DOIUrl":"10.1183/16000617.0174-2023","url":null,"abstract":"There is an increased risk of adverse perinatal outcomes in the ∼17% of women with asthma during pregnancy. The mechanisms linking maternal asthma and adverse outcomes are largely unknown, but reflect joint effects of genetics and prenatal exposure to maternal asthma. Animal models are essential to understand the underlying mechanisms independent of genetics and comorbidities, and enable safe testing of interventions. This scoping review aimed to explore the methodology, phenotype, characteristics, outcomes and quality of published studies using preclinical maternal asthma models. MEDLINE (PubMed), Embase (Elsevier) and Web of Science were systematically searched using previously validated search strings for maternal asthma and for animal models. Two reviewers independently screened titles and abstracts, full texts, and then extracted and assessed the quality of each study using the Animal Research: Reporting of In Vivo Experiments (ARRIVE) 2.0 guidelines. Out of 3618 studies identified, 39 were eligible for extraction. Most studies were in rodents (86%) and all were models of allergic asthma. Maternal and progeny outcomes included airway hyperresponsiveness, airway resistance, inflammation, lung immune cells, lung structure and serum immunoglobulins and cytokines. Experimental design (100%), procedural details (97%) and rationale (100%) were most often reported. Conversely, data exclusion (21%), blinding (18%) and adverse events (8%) were reported in a minority of studies. Species differences in physiology and timing of development, the use of allergens not relevant to humans and a lack of comparable outcome measures may impede clinical translation. Future studies exploring models of maternal asthma should adhere to the minimum core outcomes set presented in this review.","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"33 171","pages":""},"PeriodicalIF":7.5,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10900068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical-imaging-pathological correlation in pulmonary hypertension associated with left heart disease. 与左心疾病相关的肺动脉高压的临床-影像-病理相关性。

IF 7.5 1区医学

European Respiratory Review Pub Date : 2024-02-28 Print Date: 2024-01-31 DOI: 10.1183/16000617.0144-2023

Marielle C van de Veerdonk, Lize Roosma, Pia Trip, Deepa Gopalan, Anton Vonk Noordegraaf, Peter Dorfmüller, Esther J Nossent

{"title":"Clinical-imaging-pathological correlation in pulmonary hypertension associated with left heart disease.","authors":"Marielle C van de Veerdonk, Lize Roosma, Pia Trip, Deepa Gopalan, Anton Vonk Noordegraaf, Peter Dorfmüller, Esther J Nossent","doi":"10.1183/16000617.0144-2023","DOIUrl":"10.1183/16000617.0144-2023","url":null,"abstract":"Pulmonary hypertension (PH) is highly prevalent in patients with left heart disease (LHD) and negatively impacts prognosis. The most common causes of PH associated with LHD (PH-LHD) are left heart failure and valvular heart disease. In LHD, passive backward transmission of increased left-sided filling pressures leads to isolated post-capillary PH. Additional pulmonary vasoconstriction and remodelling lead to a higher vascular load and combined pre- and post-capillary PH. The increased afterload leads to right ventricular dysfunction and failure. Multimodality imaging of the heart plays a central role in the diagnostic work-up and follow-up of patients with PH-LHD. Echocardiography provides information about the estimated pulmonary artery pressure, morphology and function of the left and right side of the heart, and valvular abnormalities. Cardiac magnetic resonance imaging is the gold standard for volumetric measurements and provides myocardial tissue characterisation. Computed tomography of the thorax may show general features of PH and/or LHD and is helpful in excluding other PH causes. Histopathology reveals a spectrum of pre- and post-capillary vasculopathy, including intimal fibrosis, media smooth muscle cell hyperplasia, adventitial fibrosis and capillary congestion. In this paper, we provide an overview of clinical, imaging and histopathological findings in PH-LHD based on three clinical cases.","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":"33 171","pages":""},"PeriodicalIF":7.5,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10900069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0