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[肺动脉高压的血流动力学定义:关于第六届世界肺动脉高压研讨会提议变更的评论]

[Hemodynamic Definition of Pulmonary Hypertension: Commentary on the Proposed Change by the 6th World Symposium on Pulmonary Hypertension].

作者信息

Rosenkranz Stephan, Diller Gerhard-Paul, Dumitrescu Daniel, Ewert Ralf, Ghofrani H Ardeschir, Grünig Ekkehard, Halank Michael, Held Matthias, Kaemmerer Harald, Klose Hans, Kovacs Gabor, Konstantinides Stavros, Lang Irene M, Lange Tobias J, Leuchte Hanno, Mayer Eckhard, Olschewski Andrea, Olschewski Horst, Olsson Karen M, Opitz Christian, Schermuly Ralph T, Seeger Werner, Wilkens Heinrike, Hoeper Marius M

机构信息

Klinik III für Innere Medizin und Cologne Cardiovascular Research Center (CCRC), Herzzentrum der Universität zu Köln.

Department für Kardiologie und Angiologie, Klinik für angeborene (EMAH) und erworbene Herzfehler, Universitätsklinikum Münster.

出版信息

Dtsch Med Wochenschr. 2019 Sep;144(19):1367-1372. doi: 10.1055/a-0918-3772. Epub 2019 Jul 5.

Abstract

The ESC/ERS guidelines (published at the end of 2015) and other international recommendations defined pulmonary hypertension (PH) by an invasively measured mean pulmonary arterial pressure (mPAP) ≥ 25 mmHg at rest. At the 6 World Symposium on Pulmonary Hypertension in Nice a modification of this hemodynamic definition in the sense of lowering the threshold to > 20 mmHg was proposed. A pulmonary vascular resistance (PVR) ≥ 3 Wood units (WU) is additionally required for the diagnosis of pre-capillary PH. This modification must be critically reviewed with regard to the underlying rationale and possible consequences. Therefore, a detailed explanation is required. In particular, it must be made clear that this change currently has no influence on the evidence-based and approval-compliant prescription of drugs for the targeted therapy of pulmonary arterial hypertension (PAH).

摘要

欧洲心脏病学会/欧洲呼吸学会指南(于2015年底发布)及其他国际推荐将肺动脉高压(PH)定义为静息时经有创测量的平均肺动脉压(mPAP)≥25 mmHg。在尼斯召开的第6届世界肺动脉高压研讨会上,有人提议对这一血流动力学定义进行修改,即将阈值降至>20 mmHg。毛细血管前性PH的诊断还额外要求肺血管阻力(PVR)≥3伍德单位(WU)。必须从潜在原理和可能后果方面对这一修改进行严格审视。因此,需要给出详细解释。尤其必须明确的是,目前这一变化对肺动脉高压(PAH)靶向治疗的循证且符合批准要求的药物处方并无影响。

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