左心疾病所致肺动脉高压：更新。
Pulmonary Hypertension Due to Left Heart Disease: an Update.
机构信息
Division of Cardiology, University of California San Francisco, 505 Parnassus Avenue, Box 0124, San Francisco, CA, 94143, USA.
Inova Heart and Vascular Institute, Falls Church, VA, USA.
出版信息
Curr Cardiol Rep. 2019 May 27;21(7):62. doi: 10.1007/s11886-019-1149-1.
PURPOSE OF REVIEW
Pulmonary hypertension (PH) frequently complicates heart failure and portends a worse prognosis. This review will summarize and discuss recent updates in the classification and management of patients with PH due to left heart disease.
RECENT FINDINGS
Careful hemodynamic assessment is critical to the classification of patients with PH and heart failure. Two hemodynamic subgroups of PH in heart failure patients have been described: isolated post-capillary pulmonary hypertension and combined post- and precapillary pulmonary hypertension. The cornerstone in management of PH due to left heart disease is the treatment of the underlying left heart pathology; however, ongoing trials have been designed to test pulmonary vasodilators in this cohort. PH-specific therapies have not demonstrated a benefit in patients with pulmonary hypertension due to left heart disease. Understanding the distinct pathobiology of each hemodynamic subgroup may lead to the development of useful biomarkers and effective targeted therapies.
目的综述
肺动脉高压（PH）常并发心力衰竭，并预示预后更差。本综述将总结和讨论左心疾病所致 PH 患者分类和管理的最新进展。
最新发现
对 PH 和心力衰竭患者进行仔细的血流动力学评估对其分类至关重要。已描述心力衰竭患者 PH 的两个血流动力学亚组：单纯毛细血管后 PH 和混合毛细血管后和前 PH。左心疾病所致 PH 管理的基石是治疗潜在的左心病变；然而，已设计了多项试验来检测该队列中的肺血管扩张剂。PH 特异性治疗并未显示出对左心疾病所致肺动脉高压患者的获益。了解每个血流动力学亚组的独特病理生理学可能会导致有用的生物标志物和有效的靶向治疗的发展。
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