Cardiology Division, Department of Medicine, Weill Cornell Medical College, New York, NY.
Prog Cardiovasc Dis. 2012 Sep-Oct;55(2):104-18. doi: 10.1016/j.pcad.2012.07.007.
Group 2 pulmonary hypertension is most frequently caused by left heart disease, a heterogeneous set of disorders. These processes include left ventricular systolic dysfunction, left ventricular dysfunction with preserved ejection fraction and valvular (mitral and/or aortic) diseases. Left heart disease may cause passive backward transmission of pressure leading to elevated left atrial and pulmonary arterial pressures due to a myriad of processes. Increasingly, it has been recognized that some patients may develop pulmonary arterial pressure out of proportion from what is expected. This is believed to be due to increases in vasomotor tone and/or vascular remodeling. Over time patients may go on to develop progressive right ventricular dysfunction, a marker for poor prognosis. This review will explore the different characteristics of these conditions including the incidence, pathophysiology, clinical implications, prognosis and current state of available medical therapies.
2 型肺动脉高压最常由左心疾病引起，这是一组异质性疾病。这些过程包括左心室收缩功能障碍、射血分数保留的左心室功能障碍和瓣膜（二尖瓣和/或主动脉瓣）疾病。左心疾病可能导致压力的被动反向传递，由于多种过程导致左心房和肺动脉压力升高。越来越多的人认识到，一些患者可能会出现肺动脉压不成比例的升高。据信这是由于血管舒缩张力和/或血管重塑的增加所致。随着时间的推移，患者可能会逐渐出现进行性右心室功能障碍，这是预后不良的标志。这篇综述将探讨这些疾病的不同特征，包括发病率、病理生理学、临床意义、预后和现有的医学治疗方法。
