Laboratory of Cardiovascular Diseases, Guangdong Medical University, Zhanjiang, Guangdong 524001, P.R. China.
Department of Cardiovascular Internal Medicine, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong 524001, P.R. China.
Int J Mol Med. 2020 Sep;46(3):913-924. doi: 10.3892/ijmm.2020.4650. Epub 2020 Jun 18.
Left heart disease is the main cause of clinical pulmonary arterial hypertension (PAH). Common types of left heart disease that result in PAH include heart failure, left ventricular systolic dysfunction, left ventricular diastolic dysfunction and valvular disease. It is currently believed that mechanical pressure caused by high pulmonary venous pressure is the main cause of myocardial infarction (MI) in individuals with ischemic cardiomyopathy and left ventricular systolic dysfunction. In the presence of decreased cardiac function, vascular remodeling of pulmonary vessels in response to long‑term stimulation by high pressure in turn leads to exacerbation of PAH. However, the underlying pathological mechanisms remain unclear. Elucidating the association between the development of MI and PAH may lead to a better understanding of potential risk factors and better disease treatment. In this article, the pathophysiological effects of multiple systems in individuals with MI and PAH were reviewed in order to provide a general perspective on various potential interactions between cardiomyocytes and pulmonary vascular cells.
左心疾病是临床肺动脉高压(PAH)的主要病因。导致 PAH 的常见左心疾病包括心力衰竭、左心室收缩功能障碍、左心室舒张功能障碍和瓣膜疾病。目前认为,缺血性心肌病和左心室收缩功能障碍患者中,由高肺静脉压引起的机械压力是导致心肌梗死(MI)的主要原因。在心脏功能下降的情况下,肺部血管对高压的长期刺激引起的血管重塑反过来又导致 PAH 加重。然而,其潜在的病理机制尚不清楚。阐明 MI 和 PAH 发展之间的关联可能有助于更好地了解潜在的危险因素和改善疾病治疗。本文综述了 MI 和 PAH 患者多个系统的病理生理学效应,以期为心肌细胞和肺血管细胞之间各种潜在相互作用提供一个总体视角。