左心室辅助装置支持下患者的肺动脉高压管理

Salem Mahmoud, Al-Saffar Farah, Hall Shelley

Center for Advanced Heart and Lung Diseases, Baylor University Medical Center, Dallas, TX 75246, USA.

Heart and Vascular Institute, University of Pittsburgh Medical Center, Harrisburg, PA 17101, USA.

Rev Cardiovasc Med. 2022 Sep 13;23(9):308. doi: 10.31083/j.rcm2309308. eCollection 2022 Sep.

Left ventricular assist devices (LVADs) are increasingly utilized for patients with end-stage heart failure (HF). Pulmonary hypertension (PH) is highly prevalent in this patient population mainly due to prolonged left ventricular (LV) failure and chronically elevated filling pressures. The effect of LVADs on pulmonary circulation and right ventricular (RV) function has recently become an area of great attention in literature. PH can lead to post-LVAD right ventricular failure (RVF) that confers a high risk of morbidity and mortality. Multiple pulmonary vasodilators, that are primarily used for the treatment of pulmonary arterial hypertension (PAH), have been studied for the treatment of PH after LVAD implantation, and some of them have shown promising results. This review aims to investigate the treatment options for PH in patients on LVADs, as well as to give an overview about the pathophysiology of PH and RVF in these patients.

左心室辅助装置（LVADs）越来越多地用于终末期心力衰竭（HF）患者。肺动脉高压（PH）在这一患者群体中非常普遍，主要是由于长期左心室（LV）衰竭和持续升高的充盈压。LVADs对肺循环和右心室（RV）功能的影响最近已成为文献中备受关注的领域。PH可导致LVAD植入术后右心室衰竭（RVF），这会带来高发病率和死亡率风险。多种主要用于治疗肺动脉高压（PAH）的肺血管扩张剂已被研究用于LVAD植入后PH的治疗，其中一些已显示出有前景的结果。本综述旨在探讨LVAD患者PH的治疗选择，并概述这些患者PH和RVF的病理生理学。