Department of Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Curr Opin Pulm Med. 2019 Sep;25(5):405-409. doi: 10.1097/MCP.0000000000000608.
The last decade's progress has been made in the pharmacological treatment of pulmonary arterial hypertension (PAH). The role of nutrition in relation to quality of life in this group of patients is not investigated yet. In addition to avoiding salt and high-fluid intake based on left heart failure diet, there is no evidence-based diet recommendation for PAH.
It was recently demonstrated that patients with PAH suffer from malnutrition resulting in iron and vitamin D deficiency and glucose/insulin resistance. Recent experimental studies suggest that besides reduced malabsorption of important nutrients, the microbiome of the gut is also less diverse in PAH. In this review, we summarize the current knowledge on malnutrition and dietary intake in PAH. We discuss the possible underlying mechanisms and discuss novel therapeutic interventions validated in patients with left heart failure.
Large-scaled studies on dietary interventions are needed in PAH.
过去十年在肺动脉高压（PAH）的药物治疗方面取得了进展。然而，目前尚未研究营养与这组患者生活质量之间的关系。除了根据左心衰竭饮食避免盐和高液体摄入外，目前尚无针对 PAH 的基于证据的饮食建议。
最近的研究表明，PAH 患者存在营养不良，导致铁和维生素 D 缺乏以及葡萄糖/胰岛素抵抗。最近的实验研究表明，除了重要营养素吸收减少外，PAH 患者的肠道微生物组也不够多样化。在这篇综述中，我们总结了 PAH 中营养不良和饮食摄入的现有知识。我们讨论了可能的潜在机制，并讨论了在左心衰竭患者中得到验证的新的治疗干预措施。
PAH 需要进行大规模的饮食干预研究。
