Adusumalli Srinath, Mazurek Jeremy A
Department of Medicine, Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Department of Medicine, Advanced Heart Failure/Transplantation and Pulmonary Hypertension Programs, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Curr Heart Fail Rep. 2017 Dec;14(6):507-513. doi: 10.1007/s11897-017-0368-2.
The purpose of this review is to define pulmonary hypertension in the setting of left heart disease (PH-LHD), discuss its epidemiology and pathophysiology, and highlight the cause and effect relationship it has with disease progression in the setting of cardiomyopathy.
Both pulmonary hypertension (PH) and heart failure are becoming increasingly common. As such, PH-LHD is now the most common form of PH. The pathophysiology of the condition relates to backward transmission of elevated left ventricular filling pressures into the pulmonary circulation and, ultimately, right ventricular (RV) strain/dysfunction. It is evident that these pathophysiologic processes are both the effect and cause of left heart disease progression. In this review, we describe the complex relationship between disease progression in left ventricular cardiomyopathy and PH-LHD. Clinicians and researchers should take note of the importance of PH-LHD and RV dysfunction to appropriately risk stratify patients and develop therapies for the condition.
本综述旨在明确左心疾病相关肺动脉高压(PH-LHD),讨论其流行病学和病理生理学,并强调其与心肌病疾病进展之间的因果关系。
肺动脉高压(PH)和心力衰竭都日益常见。因此,PH-LHD现已成为最常见的PH类型。该病症的病理生理学与左心室充盈压升高逆向传导至肺循环,并最终导致右心室(RV)应变/功能障碍有关。很明显,这些病理生理过程既是左心疾病进展的结果,也是其原因。在本综述中,我们描述了左心室心肌病疾病进展与PH-LHD之间的复杂关系。临床医生和研究人员应注意PH-LHD和RV功能障碍对于适当进行患者风险分层及制定该病症治疗方法的重要性。