Clinic for Respiratory Medicine, Hannover Medical School, Hannover, Germany.
Int J Cardiol. 2011 Dec;154 Suppl 1:S45-53. doi: 10.1016/S0167-5273(11)70492-2.
The 2009 European Guidelines on Pulmonary Hypertension did not cover only pulmonary arterial hypertension (PAH) but also some aspects of pulmonary hypertension (PH) in chronic lung disease. These guidelines point out that the drugs currently used to treat patients with PAH (prostanoids, endothelin receptor antagonists and phosphodiesterase type-5 inhibitors) have not been sufficiently investigated in other forms of PH. Therefore, the use of these drugs in patients with chronic lung disease and PH is not recommended. This recommendation, however, is not always in agreement with medical needs as physicians feel sometimes inclined to also treat other forms of pulmonary hypertension which may affect the quality of life and survival of these patients in a similar manner as in PAH. In June 2010, a consensus conference was held in Cologne, Germany, to discuss open and controversial issues surrounding the practical implementation of the European Guidelines. The conference was sponsored by the German Society of Cardiology, the German Society of Respiratory Medicine and the German Society of Pediatric Cardiology (DGK, DGP and DGPK). To this end, a number of working groups were initiated, one of which was specifically dedicated to the diagnosis and treatment of PH due to chronic lung disease. This manuscript describes in detail the results and recommendations of this working group which were last updated in October 2011.
2009 年欧洲肺动脉高压指南不仅涵盖了肺动脉高压（PAH），还涉及了慢性肺部疾病中的一些肺动脉高压（PH）方面。这些指南指出，目前用于治疗 PAH 患者的药物（前列腺素、内皮素受体拮抗剂和磷酸二酯酶-5 抑制剂）在其他形式的 PH 中尚未得到充分研究。因此，不建议在患有慢性肺部疾病和 PH 的患者中使用这些药物。然而，这一建议并不总是符合医疗需求，因为医生有时倾向于治疗其他形式的肺动脉高压，这些疾病可能以类似于 PAH 的方式影响患者的生活质量和生存。2010 年 6 月，在德国科隆举行了一次共识会议，讨论围绕欧洲指南实际实施的公开和有争议的问题。该会议由德国心脏病学会、德国呼吸学会和德国儿科心脏病学会（DGK、DGP 和 DGPK）赞助。为此，发起了多个工作组，其中一个专门致力于诊断和治疗慢性肺部疾病引起的 PH。本手稿详细描述了该工作组的结果和建议，这些建议于 2011 年 10 月进行了最后更新。
