Skowasch Dirk, Klose Hans, Ewert Ralf, Wilkens Heinrike, Richter Manuel, Rosenkranz Stephan, Setzer Gesine, Grünig Ekkehard, Halank Michael
Heart Center Bonn, Department of Medicine II, University Hospital Bonn, Bonn, Germany.
II. Medical Clinic and Polyclinic, Department of Pulmonology, Center for Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
ERJ Open Res. 2024 Jan 29;10(1). doi: 10.1183/23120541.00668-2023. eCollection 2024 Jan.
Idiopathic pulmonary arterial hypertension (IPAH) is often diagnosed in elderly patients with many comorbidities. Whereas a clear treatment strategy and risk assessment is recommended for patients with rare classical IPAH, monotherapy with phosphodiesterase type 5 inhibitors or endothelin receptor antagonists followed by regular follow-up and individualised therapy should be used for patients with many cardiopulmonary comorbidities. Here, we focus on these patients with IPAH and comorbidities, present a review of the literature with a focus on recently published work and summarise factors that may help to provide guidance for individualised treatment approaches in such patients.
特发性肺动脉高压(IPAH)常在患有多种合并症的老年患者中被诊断出来。对于罕见的典型IPAH患者,推荐采用明确的治疗策略和风险评估,而对于患有多种心肺合并症的患者,则应使用5型磷酸二酯酶抑制剂或内皮素受体拮抗剂进行单药治疗,随后进行定期随访和个体化治疗。在此,我们聚焦于这些患有IPAH和合并症的患者,对文献进行综述,重点关注近期发表的研究,并总结可能有助于为此类患者的个体化治疗方法提供指导的因素。