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ACVIM 共识声明指南:犬肺动脉高压的诊断、分类、治疗和监测。

ACVIM consensus statement guidelines for the diagnosis, classification, treatment, and monitoring of pulmonary hypertension in dogs.

机构信息

Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri.

Department of Medicine and Epidemiology, School of Veterinary Medicine, University of California, Davis, Davis, California.

出版信息

J Vet Intern Med. 2020 Mar;34(2):549-573. doi: 10.1111/jvim.15725. Epub 2020 Feb 17.

Abstract

Pulmonary hypertension (PH), defined by increased pressure within the pulmonary vasculature, is a hemodynamic and pathophysiologic state present in a wide variety of cardiovascular, respiratory, and systemic diseases. The purpose of this consensus statement is to provide a multidisciplinary approach to guidelines for the diagnosis, classification, treatment, and monitoring of PH in dogs. Comprehensive evaluation including consideration of signalment, clinical signs, echocardiographic parameters, and results of other diagnostic tests supports the diagnosis of PH and allows identification of associated underlying conditions. Dogs with PH can be classified into the following 6 groups: group 1, pulmonary arterial hypertension; group 2, left heart disease; group 3, respiratory disease/hypoxia; group 4, pulmonary emboli/pulmonary thrombi/pulmonary thromboemboli; group 5, parasitic disease (Dirofilaria and Angiostrongylus); and group 6, disorders that are multifactorial or with unclear mechanisms. The approach to treatment of PH focuses on strategies to decrease the risk of progression, complications, or both, recommendations to target underlying diseases or factors contributing to PH, and PH-specific treatments. Dogs with PH should be monitored for improvement, static condition, or progression, and any identified underlying disorder should be addressed and monitored simultaneously.

摘要

肺动脉高压(PH)定义为肺血管内压力升高,是多种心血管、呼吸和系统性疾病中的一种血流动力学和病理生理状态。本共识旨在为犬 PH 的诊断、分类、治疗和监测提供多学科指南方法。全面评估包括考虑品种、临床症状、超声心动图参数和其他诊断测试的结果,支持 PH 的诊断,并确定相关的潜在疾病。PH 犬可分为以下 6 组:第 1 组,肺动脉高压;第 2 组,左心疾病;第 3 组,呼吸疾病/缺氧;第 4 组,肺栓塞/肺血栓/肺血栓栓塞;第 5 组,寄生虫病(心丝虫和血管圆线虫);第 6 组,多因素或机制不明的疾病。PH 治疗方法侧重于降低进展、并发症或两者风险的策略,针对潜在疾病或导致 PH 的因素的建议,以及 PH 特异性治疗。应监测 PH 犬的改善、稳定状况或进展情况,并同时解决和监测任何确定的潜在疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e569/7097566/35584e78ffe4/JVIM-34-549-g001.jpg

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