左心室辅助装置患者肺动脉高压的治疗与预后

Treatment and Prognosis of Pulmonary Hypertension in the Left Ventricular Assist Device Patient.

作者信息

Jensen Christopher W, Goldstone Andrew B, Woo Y Joseph

机构信息

Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA.

Department of Bioengineering, Stanford University, Falk Building CV-235, 300 Pasteur Drive, Stanford, CA, 94305-5407, USA.

出版信息

Curr Heart Fail Rep. 2016 Jun;13(3):140-50. doi: 10.1007/s11897-016-0288-6.

DOI:10.1007/s11897-016-0288-6

PMID:27241336

Abstract

This review will discuss the medical management of pulmonary hypertension in patients with left ventricular assist devices. Although much has been written on the management of primary pulmonary hypertension, also called pulmonary arterial hypertension, this review will instead focus on the treatment of pulmonary hypertension secondary to left heart disease. The relevant pharmacotherapy can be divided into medications for treating heart failure, such as diuretics and β-blockers, and medications for treating pulmonary hypertension. We also discuss important preoperative considerations in patients with pulmonary hypertension; the relationships between left ventricular assist devices, pulmonary hemodynamics, and right heart failure; as well as optimal perioperative and long-term postoperative medical management of pulmonary hypertension.

摘要

本综述将讨论左心室辅助装置患者肺动脉高压的药物治疗。尽管已有大量关于原发性肺动脉高压（也称为肺动脉高压）治疗的文献，但本综述将重点关注继发于左心疾病的肺动脉高压的治疗。相关药物治疗可分为治疗心力衰竭的药物，如利尿剂和β受体阻滞剂，以及治疗肺动脉高压的药物。我们还将讨论肺动脉高压患者重要的术前注意事项；左心室辅助装置、肺血流动力学和右心衰竭之间的关系；以及肺动脉高压的最佳围手术期和长期术后药物治疗。