Heart Failure Unit, IRCCS Policlinico San Donato, Piazza E. Malan 2, San Donato Milanese, Milano 20097, Italy.
Heart Fail Clin. 2018 Jul;14(3):297-309. doi: 10.1016/j.hfc.2018.02.006.
Pulmonary hypertension (PH) is a common hemodynamic evolution of heart failure (HF) with preserved or reduced ejection fraction, responsible for congestion, symptoms worsening, exercise limitation, and negative outcome. In HF of any origin, PH develops in response to a passive backward pressure transmission as result of increased left atrial pressure. Sustained pressure injury and chronic venous congestion can trigger pulmonary vasoconstriction and vascular remodeling, leading to irreversible pulmonary vascular disease, right ventricular hypertrophy, and failure. In this article, the key determinants of this "dangerous liaison" are analyzed with some digressions on related "leitmotiv" at the horizon.
肺动脉高压（PH）是射血分数保留或降低的心衰（HF）的一种常见血流动力学演变，可导致淤血、症状恶化、运动受限和不良结局。在任何病因的心衰中，PH 是由于左心房压力升高导致的被动后向压力传递增加而发展起来的。持续的压力损伤和慢性静脉淤血可引发肺血管收缩和血管重塑，导致不可逆转的肺血管疾病、右心室肥厚和衰竭。本文分析了这一“危险联姻”的关键决定因素，并对相关的“主导动机”进行了一些探讨。
