Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, Texas, USA.
Pulmonary and Critical Care, Mount Sinai Medical Center, Miami, Florida, USA.
Cardiovasc Hematol Disord Drug Targets. 2023;23(4):215-225. doi: 10.2174/011871529X258234230921112507.
Pulmonary hypertension (PH) associated with left heart disease (LHD) is a complex cardiopulmonary condition where a variable degree of pulmonary congestion, arterial vasoconstriction and vascular remodeling can lead to PH and right heart strain. Right heart dysfunction has a significant prognostic impact on these patients. Therefore, preserving right ventricular (RV) function is an important treatment goal. However, the treatment of PH in patients with left heart disease has produced conflicting evidence. The transition from pure LHD to LHD with PH is a continuum and clinically challenging. The heart failure with preserved ejection fraction (HFpEF) patient population is heterogeneous when it comes to PH and RV function. Appropriate clinical and hemodynamic phenotyping of patients with HFpEF and concomitant PH is paramount to making the appropriate treatment decision. This manuscript will summarize the current evidence for the use of pulmonary arterial vasodilators in patients with HFpEF.
左心疾病相关肺动脉高压（PH）是一种复杂的心肺病症，其中一定程度的肺充血、动脉血管收缩和血管重构可导致 PH 和右心劳损。右心功能障碍对这些患者的预后有重大影响。因此，保留右心室（RV）功能是一个重要的治疗目标。然而，左心疾病患者的 PH 治疗产生了相互矛盾的证据。从单纯左心疾病到左心疾病伴 PH 的转变是一个连续的过程，具有临床挑战性。射血分数保留的心力衰竭（HFpEF）患者人群在 PH 和 RV 功能方面存在异质性。对 HFpEF 合并 PH 患者进行适当的临床和血液动力学表型分析对于做出适当的治疗决策至关重要。本文将总结目前在 HFpEF 患者中使用肺动脉血管扩张剂的证据。
Zotero 插件