Boxhammer Elke, Berezin Alexander E, Paar Vera, Bacher Nina, Topf Albert, Pavlov Sergii, Hoppe Uta C, Lichtenauer Michael
Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University of Salzburg, 5020 Salzburg, Austria.
Internal Medicine Department, State Medical University of Zaporozhye, 69035 Zaporozhye, Ukraine.
J Pers Med. 2022 Apr 8;12(4):603. doi: 10.3390/jpm12040603.
Patients with severe aortic valve stenosis and concomitant pulmonary hypertension show a significantly reduced survival prognosis. Right heart catheterization as a preoperative diagnostic tool to determine pulmonary hypertension has been largely abandoned in recent years in favor of echocardiographic criteria. Clinically, determination of echocardiographically estimated systolic pulmonary artery pressure falls far short of invasive right heart catheterization data in terms of accuracy. The aim of the present systematic review was to highlight noninvasive possibilities for the detection of pulmonary hypertension in patients with severe aortic valve stenosis, with a special focus on cardiovascular biomarkers. A total of 525 publications regarding echocardiography, cardiovascular imaging and biomarkers related to severe aortic valve stenosis and pulmonary hypertension were analyzed in a systematic database analysis using PubMed Central. Finally, 39 publications were included in the following review. It was shown that the current scientific data situation, especially regarding cardiovascular biomarkers as non-invasive diagnostic tools for the determination of pulmonary hypertension in severe aortic valve stenosis patients, is poor. Thus, there is a great scientific potential to combine different biomarkers (biomarker scores) in a non-invasive way to determine the presence or absence of PH.
重度主动脉瓣狭窄合并肺动脉高压的患者生存预后显著降低。近年来，作为术前诊断肺动脉高压的工具，右心导管检查已基本被放弃，转而采用超声心动图标准。临床上，超声心动图估算的收缩期肺动脉压在准确性方面远不及有创右心导管检查数据。本系统评价的目的是强调在重度主动脉瓣狭窄患者中检测肺动脉高压的非侵入性方法，特别关注心血管生物标志物。使用美国国立医学图书馆的生物医学期刊数据库（PubMed Central）对525篇关于超声心动图、心血管成像以及与重度主动脉瓣狭窄和肺动脉高压相关的生物标志物的出版物进行了系统的数据库分析。最后，39篇出版物被纳入以下综述。结果表明，目前的科学数据状况不佳，尤其是关于心血管生物标志物作为重度主动脉瓣狭窄患者肺动脉高压非侵入性诊断工具方面。因此，以非侵入性方式组合不同生物标志物（生物标志物评分）来确定是否存在肺动脉高压具有巨大的科学潜力。
