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慢性阻塞性肺疾病(COPD)中的心血管合并症——临床实践的当前考量

Cardiovascular Comorbidities in Chronic Obstructive Pulmonary Disease (COPD)-Current Considerations for Clinical Practice.

作者信息

Trinkmann Frederik, Saur Joachim, Borggrefe Martin, Akin Ibrahim

机构信息

1st Department of Medicine (Cardiology, Angiology, Pulmonary and Intensive Care), University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany.

DZHK (German Center for Cardiovascular Research), partner site Mannheim, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany.

出版信息

J Clin Med. 2019 Jan 10;8(1):69. doi: 10.3390/jcm8010069.

Abstract

In patients with chronic obstructive pulmonary disease (COPD), cardiovascular comorbidities are highly prevalent and associated with considerable morbidity and mortality. This coincidence is increasingly seen in context of a "cardiopulmonary continuum" rather than being simply attributed to shared risk factors such as cigarette smoking. Overlapping symptoms such as dyspnea or chest pain lead to a worse prognosis due to missed concomitant diagnoses. Moreover, medication is often withheld as a result of unfounded concerns about side effects. Despite the frequent coincidence, current guidelines are still mostly restricted to the management of the individual disease. Future diagnostic and therapeutic strategies should therefore be guided by an integrative perspective as well as a refined phenotyping of disease entities.

摘要

在慢性阻塞性肺疾病(COPD)患者中,心血管合并症非常普遍,且与相当高的发病率和死亡率相关。这种并存情况越来越多地在“心肺连续体”的背景下被观察到,而不是简单地归因于诸如吸烟等共同的风险因素。诸如呼吸困难或胸痛等重叠症状会因漏诊合并症而导致更差的预后。此外,由于对副作用毫无根据的担忧,药物治疗常常被搁置。尽管这种并存情况很常见,但目前的指南大多仍局限于单一疾病的管理。因此,未来的诊断和治疗策略应以综合观点以及对疾病实体更精细的表型分析为指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cbb/6352261/e3dbf12c01f4/jcm-08-00069-g001.jpg

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