Department of Paediatric Cardiology and Congenital Heart Disease, German Heart Centre Munich, Technical University of Munich, Germany.
Department of Paediatric Cardiology, University Hospital for Paediatric and Adolescent Medicine, Ulm, Germany.
Int J Cardiol. 2018 Dec 1;272S:79-88. doi: 10.1016/j.ijcard.2018.08.078. Epub 2018 Aug 25.
In the summer of 2016, delegates from the German Respiratory Society (DGP), the German Society of Cardiology (DGK) and the German Society of Pediatric Cardiology (DGPK) met in Cologne, Germany, to define consensus-based practice recommendations for the management of patients with pulmonary hypertension (PH). These recommendations were built on the 2015 European Pulmonary Hypertension guidelines, aiming at their practical implementation, considering country-specific issues, and including new evidence, where available. To this end, a number of working groups was initiated, one of which was specifically dedicated to PH in adults associated with congenital heart disease (CHD). As such patients are often complex and require special attention, and the general PAH treatment algorithm in the ESC/ERS guidelines appears too unspecific for CHD, the working group proposes an analogous algorithm for the management of PH-CHD which takes the special features of this patient group into consideration, and includes general measures, supportive therapy, targeted PAH drug therapy as well as interventional and surgical procedures. The detailed results and recommendations of the working group on PH in adults with CHD, which were last updated in the spring of 2018, are summarized in this article.
2016 年夏天,德国呼吸学会(DGP)、德国心脏病学会(DGK)和德国儿科心脏病学会(DGPK)的代表在德国科隆开会,为肺动脉高压(PH)患者的管理制定了基于共识的实践建议。这些建议是建立在 2015 年欧洲肺动脉高压指南的基础上,旨在实际实施,考虑到具体国情,并纳入了现有新证据。为此,成立了多个工作组,其中一个专门针对与先天性心脏病(CHD)相关的成人 PH。由于这些患者通常较为复杂,需要特别关注,而 ESC/ERS 指南中的一般 PAH 治疗算法对 CHD 来说过于不具体,因此工作组提出了一种类似的 PH-CHD 管理算法,该算法考虑到了该患者群体的特殊特征,包括一般措施、支持性治疗、靶向 PAH 药物治疗以及介入和手术程序。该工作组关于成人 CHD 合并 PH 的详细结果和建议于 2018 年春季最后更新,本文对此进行了总结。