保留射血分数的心力衰竭患者肺动脉高压药物治疗的最新进展。

Fernando Segovia, Hernando Garcia, Haider Alkhateeb, Debabrata Mukherjee, Nils Nickel
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引用次数: 0

摘要

与左心疾病(LHD)相关的肺动脉高压(PH)是一种复杂的心肺疾病,不同程度的肺充血、动脉血管收缩和血管重塑会导致肺动脉高压和右心劳损。右心功能不全对这些患者的预后有重要影响。因此,保留右心室(RV)功能是一个重要的治疗目标。然而,左心病患者PH的治疗产生了相互矛盾的证据。从纯LHD到带PH的LHD的转变是一个连续的过程,在临床上具有挑战性。射血分数保留的心力衰竭(HFpEF)患者群体在PH和RV功能方面是异质性的。HFpEF和伴发PH患者的适当临床和血液动力学表型对于做出适当的治疗决定至关重要。本文将总结目前在HFpEF患者中使用肺动脉血管舒张剂的证据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Updates in the Pharmacotherapy of Pulmonary Hypertension in Patients with Heart Failure with Preserved Ejection Fraction.

Pulmonary hypertension (PH) associated with left heart disease (LHD) is a complex cardiopulmonary condition where a variable degree of pulmonary congestion, arterial vasoconstriction and vascular remodeling can lead to PH and right heart strain. Right heart dysfunction has a significant prognostic impact on these patients. Therefore, preserving right ventricular (RV) function is an important treatment goal. However, the treatment of PH in patients with left heart disease has produced conflicting evidence. The transition from pure LHD to LHD with PH is a continuum and clinically challenging. The heart failure with preserved ejection fraction (HFpEF) patient population is heterogeneous when it comes to PH and RV function. Appropriate clinical and hemodynamic phenotyping of patients with HFpEF and concomitant PH is paramount to making the appropriate treatment decision. This manuscript will summarize the current evidence for the use of pulmonary arterial vasodilators in patients with HFpEF.

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