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“从右至左”:右心导管检查在左心疾病诊断与管理中的作用

"From right to left": The role of right heart catheterization in the diagnosis and management of left heart diseases.

作者信息

Kałużna-Oleksy Marta, Araszkiewicz Aleksander, Migaj Jacek, Lesiak Maciej, Straburzyńska-Migaj Ewa

机构信息

1st Department of Cardiology, Poznan University of Medical Sciences, Poland.

出版信息

Adv Clin Exp Med. 2017 Jan-Feb;26(1):135-141. doi: 10.17219/acem/61908.

Abstract

Pulmonary hypertension (PH), second only to left heart diseases (LHD), is a frequent problem in clinical practice. At the same time, left heart diseases represent the most common cause of pulmonary hypertension, and the occurrence of PH in patients with chronic heart failure is usually associated with worse functional class, and prognosis. Right heart catheterization (RHC) is the "gold standard" in the diagnosis and differentiation of PH. It is also essential in the process of qualifying for a heart transplantation. Therefore, right heart catheterization should be performed in expert centers by experienced operators and according to a strict protocol to ensure the reliability and reproducibility of results. Recommendations for pulmonary hypertension due to left heart disease are based on the European Society of Cardiology (ESC) guidelines designed in cooperation with the European Respiratory Society (ERS) and the International Society for Heart and Lung Transplantation (ISHL). The new ESC guidelines for pulmonary hypertension published in 2015 have improved the diagnostic and therapeutic process in patients with left heart diseases.

摘要

肺动脉高压(PH)在临床实践中是一个常见问题,仅次于左心疾病(LHD)。同时,左心疾病是肺动脉高压最常见的病因,慢性心力衰竭患者中PH的发生通常与更差的功能分级及预后相关。右心导管检查(RHC)是诊断和鉴别肺动脉高压的“金标准”。在心脏移植资格评估过程中它也至关重要。因此,右心导管检查应由经验丰富的操作人员在专家中心按照严格规程进行,以确保结果的可靠性和可重复性。关于左心疾病所致肺动脉高压的推荐基于与欧洲呼吸学会(ERS)和国际心肺移植学会(ISHL)合作制定的欧洲心脏病学会(ESC)指南。2015年发布的ESC肺动脉高压新指南改善了左心疾病患者的诊断和治疗流程。

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