肺动脉高压的最新临床分类。
Updated clinical classification of pulmonary hypertension.
机构信息
Assistance publique-Hôpitaux de Paris, Service de Pneumologie, Hôpital Universitaire de Bicêtre, Université Paris-Sud, Laboratoire d'excellence en recherche sur le médicament et innovation thérapeutique, and INSERM, Unité 999, Le Kremlin Bicêtre, France.
Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital and the National Heart and Lung Institute, Imperial College, London, United Kingdom.
出版信息
J Am Coll Cardiol. 2013 Dec 24;62(25 Suppl):D34-41. doi: 10.1016/j.jacc.2013.10.029.
In 1998, a clinical classification of pulmonary hypertension (PH) was established, categorizing PH into groups which share similar pathological and hemodynamic characteristics and therapeutic approaches. During the 5th World Symposium held in Nice, France, in 2013, the consensus was reached to maintain the general scheme of previous clinical classifications. However, modifications and updates especially for Group 1 patients (pulmonary arterial hypertension [PAH]) were proposed. The main change was to withdraw persistent pulmonary hypertension of the newborn (PPHN) from Group 1 because this entity carries more differences than similarities with other PAH subgroups. In the current classification, PPHN is now designated number 1. Pulmonary hypertension associated with chronic hemolytic anemia has been moved from Group 1 PAH to Group 5, unclear/multifactorial mechanism. In addition, it was decided to add specific items related to pediatric pulmonary hypertension in order to create a comprehensive, common classification for both adults and children. Therefore, congenital or acquired left-heart inflow/outflow obstructive lesions and congenital cardiomyopathies have been added to Group 2, and segmental pulmonary hypertension has been added to Group 5. Last, there were no changes for Groups 2, 3, and 4.
1998 年,建立了肺动脉高压(PH)的临床分类,将 PH 分为具有相似病理和血液动力学特征及治疗方法的组。在 2013 年于法国尼斯举行的第 5 届世界研讨会上,达成了共识,即保留以前临床分类的总体方案。然而,对第 1 组(肺动脉高压[PAH])患者提出了修改和更新建议。主要变化是将新生儿持续性肺动脉高压(PPHN)从第 1 组中撤出,因为它与其他 PAH 亚组的差异大于相似性。在目前的分类中,PPHN 现在被指定为 1 号。慢性溶血性贫血相关性肺动脉高压已从第 1 组 PAH 转移到第 5 组,其发病机制不明/多因素。此外,决定添加与儿科肺动脉高压相关的特定项目,以便为成人和儿童创建一个全面、通用的分类。因此,先天性或获得性左心流入/流出梗阻性病变和先天性心肌病已被添加到第 2 组,节段性肺动脉高压已被添加到第 5 组。最后,第 2、3 和 4 组没有变化。