Cardiopulmonary Department, Ignacio Chavez National Heart Institute, Mexico City Mexico.
Curr Opin Cardiol. 2019 Jan;34(1):98-103. doi: 10.1097/HCO.0000000000000583.
The purpose of this review is to demonstrate advances in the medical treatment of pulmonary arterial hypertension (PAH). Reviewed will be the evidence that favors the use of risk assessment in the treatment of PAH. Optimization of combination therapy depending on the risk or worsening will be reviewed. Finally, recent advances in new treatment strategies will be mentioned.
The use of therapies in sequence or in combination for the treatment of PAH has been shown to decrease morbidity and mortality. Tailoring these treatment strategies to a risk of worsening has been shown to decrease mortality and time to clinical worsening because of PAH. In addition, there have been several advances in the development of other medications separate from the three known pathogenic pathways in PAH.
In the last 15 years, 12 specific therapies have been approved for PAH. These therapies target three separate pathogenic pathways [the endothelin (ET), nitric oxide (NO) and prostacyclin (PGI2)]. As a result, treatment guidelines have tailored the treatment of PAH with these medications either as single drug therapy or in combination. Recently, other treatment pathways have been explored as new strategies for the treatment of PAH.
本文旨在展示肺动脉高压（PAH）治疗方面的医学进展。本文将阐述支持在 PAH 治疗中使用风险评估的证据。将讨论根据风险或病情恶化优化联合治疗的问题。最后，将提到新治疗策略的最新进展。
已有研究表明，序贯或联合应用治疗 PAH 的疗法可降低发病率和死亡率。将这些治疗策略调整为病情恶化风险，可降低死亡率和因 PAH 导致的临床恶化时间。此外，在肺动脉高压的三个已知致病途径之外，其他药物的开发也取得了一些进展。
在过去的 15 年中，已有 12 种特定的疗法被批准用于 PAH。这些疗法针对三个独立的致病途径[内皮素（ET）、一氧化氮（NO）和前列环素（PGI2）]。因此，治疗指南针对这些药物的治疗，无论是单一药物治疗还是联合治疗，都根据 PAH 进行了调整。最近，人们还探索了其他治疗途径，作为治疗 PAH 的新策略。
