Humbert Marc, Montani David, Evgenov Oleg V, Simonneau Gérald
Faculté de Médecine, Univ Paris-Sud, Le Kremlin-Bicêtre, France,
Handb Exp Pharmacol. 2013;218:3-29. doi: 10.1007/978-3-642-38664-0_1.
Pulmonary hypertension is defined as an increase of mean pulmonary arterial pressure ≥25 mmHg at rest as assessed by right heart catheterization. According to different combinations of values of pulmonary wedge pressure, pulmonary vascular resistance and cardiac output, a hemodynamic classification of pulmonary hypertension has been proposed. Of major importance is the pulmonary wedge pressure which allows to distinguish pre-capillary (pulmonary wedge pressure ≤15 mmHg) and post-capillary (pulmonary wedge pressure >15 mmHg) pulmonary hypertension. Pre-capillary pulmonary hypertension includes the clinical groups 1 (pulmonary arterial hypertension), 3 (pulmonary hypertension due to lung diseases and/or hypoxia), 4 (chronic thrombo-embolic pulmonary hypertension) and 5 (pulmonary hypertension with unclear and/or multifactorial mechanisms). Post-capillary pulmonary hypertension corresponds to the clinical group 2 (pulmonary hypertension due to left heart diseases).
通过右心导管检查评估，静息时平均肺动脉压升高≥25 mmHg。根据肺楔压、肺血管阻力和心输出量的不同组合，已提出肺动脉高压的血流动力学分类。其中至关重要的是肺楔压，它有助于区分毛细血管前性（肺楔压≤15 mmHg）和毛细血管后性（肺楔压>15 mmHg）肺动脉高压。毛细血管前性肺动脉高压包括临床组1（肺动脉高压）、3（肺部疾病和/或缺氧所致肺动脉高压）、4（慢性血栓栓塞性肺动脉高压）和5（机制不明和/或多因素所致肺动脉高压）。毛细血管后性肺动脉高压对应临床组2（左心疾病所致肺动脉高压）。
