Maarman Gerald J, Schulz Rainer, Sliwa Karen, Schermuly Ralph Theo, Lecour Sandrine
Hatter Institute for Cardiovascular Research in Africa (HICRA) and MRC Inter-University Cape Heart Group, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Institute of Physiology, Justus Liebig University Giessen, Giessen, Germany.
Br J Pharmacol. 2017 Apr;174(7):497-511. doi: 10.1111/bph.13721. Epub 2017 Feb 24.
Pulmonary hypertension (PH) is defined by elevated mean pulmonary artery pressure following the pathological remodelling of small pulmonary arteries. An increase in right ventricular (RV) afterload results in RV hypertrophy and RV failure. The pathophysiology of PH, and RV remodelling in particular, is not well understood, thus explaining, at least in part, why current PH therapies have a limited effect. Existing therapies mostly target the pulmonary circulation. Because the remodelled RV fails to support normal cardiac function, patients eventually succumb from RV failure. Developing novel therapies that directly target the function of the RV may therefore benefit patients with PH. In the past decade, several promising studies have investigated novel cardioprotective strategies in experimental models of PH. This review aims to comprehensively discuss and highlight these novel experimental approaches to confer, in the long-term, greater health benefit in patients with PH.
肺动脉高压(PH)的定义是在小肺动脉发生病理性重塑后平均肺动脉压升高。右心室(RV)后负荷增加会导致RV肥厚和RV衰竭。PH的病理生理学,尤其是RV重塑,尚未完全明确,这至少在一定程度上解释了为何目前的PH治疗效果有限。现有治疗大多针对肺循环。由于重塑后的RV无法维持正常心脏功能,患者最终会死于RV衰竭。因此,开发直接针对RV功能的新疗法可能会使PH患者受益。在过去十年中,一些有前景的研究在PH实验模型中探究了新的心脏保护策略。本综述旨在全面讨论并重点介绍这些新的实验方法,以期长期为PH患者带来更大的健康益处。