Division of Pulmonary and Critical Care Medicine, College of Physicians and Surgeons, Columbia University, New York, New York.
Ann Am Thorac Soc. 2018 Feb;15(Suppl 1):S42-S44. doi: 10.1513/AnnalsATS.201710-772KV.
The term cor pulmonale has traditionally been used as a synonym for right heart failure due to chronic respiratory diseases, although this condition is less frequently seen in the modern era because of the use of long-term oxygen therapy along with aggressive measures directed at optimizing ventilation and gas exchange. The mechanisms by which adaptation or maladaptation of right heart structure and function in the broader setting of pulmonary vascular disease, either intrinsic to the pulmonary circulation or due to respiratory diseases, have garnered considerable interest along with the development of medical and surgical treatments for pulmonary hypertension. Thus, the right heart is no longer considered an "innocent bystander" in pulmonary hypertension, but rather a key component in its pathophysiology. Furthermore, the status of right heart function is a major determinant of outcome. Accordingly, the right heart has become a potential, appealing target for novel therapies to treat hypertensive pulmonary vascular disease.
传统上，肺心病一词被用作慢性呼吸疾病导致的右心衰竭的同义词，尽管由于长期氧疗以及积极措施以优化通气和气体交换的应用，这种情况在现代已较少见。在更广泛的肺血管疾病背景下，右心结构和功能的适应或失调机制，无论是肺循环固有的还是由于呼吸疾病引起的，引起了相当大的兴趣，同时也为肺动脉高压的治疗提供了医疗和手术手段。因此，右心不再被视为肺动脉高压中的“无辜旁观者”，而是其病理生理学的关键组成部分。此外，右心功能状态是预后的主要决定因素。因此，右心已成为治疗高血压性肺血管疾病的新型疗法的潜在有吸引力的靶标。
