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慢性血栓栓塞性肺动脉高压：诊断评估

Chronic thromboembolic pulmonary hypertension: the diagnostic assessment.

作者信息

Simeone Beatrice, Maggio Enrico, Schirone Leonardo, Rocco Erica, Sarto Gianmarco, Spadafora Luigi, Bernardi Marco, Ambrosio Luca D', Forte Maurizio, Vecchio Daniele, Valenti Valentina, Sciarretta Sebastiano, Vizza Carmine Dario

机构信息

Department of Cardiology, ICOT Istituto Marco Pasquali, Latina, Italy.

Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy.

出版信息

Front Cardiovasc Med. 2024 Sep 6;11:1439402. doi: 10.3389/fcvm.2024.1439402. eCollection 2024.

DOI:10.3389/fcvm.2024.1439402
PMID:39309600
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11412851/
Abstract

Chronic Thromboembolic Pulmonary Hypertension (CTEPH) presents a significant diagnostic challenge due to its complex and often nonspecific clinical manifestations. This review outlines a comprehensive approach to the diagnostic assessment of CTEPH, emphasizing the importance of a high index of suspicion in patients with unexplained dyspnea or persistent symptoms post-acute pulmonary embolism. We discuss the pivotal role of multimodal imaging, including echocardiography, ventilation/perfusion scans, CT pulmonary angiography, and magnetic resonance imaging, in the identification and confirmation of CTEPH. Furthermore, the review highlights the essential function of right heart catheterization in validating the hemodynamic parameters indicative of CTEPH, establishing its definitive diagnosis. Advances in diagnostic technologies and the integration of a multidisciplinary approach are critical for the timely and accurate diagnosis of CTEPH, facilitating early therapeutic intervention and improving patient outcomes. This manuscript aims to equip clinicians with the knowledge and tools necessary for the efficient diagnostic workflow of CTEPH, promoting awareness and understanding of this potentially treatable cause of pulmonary hypertension.

摘要

慢性血栓栓塞性肺动脉高压（CTEPH）因其复杂且往往不具特异性的临床表现而带来重大的诊断挑战。本综述概述了CTEPH诊断评估的综合方法，强调对不明原因呼吸困难或急性肺栓塞后持续症状患者保持高度怀疑指数的重要性。我们讨论了多模态成像，包括超声心动图、通气/灌注扫描、CT肺动脉造影和磁共振成像，在CTEPH识别和确诊中的关键作用。此外，本综述强调了右心导管检查在验证指示CTEPH的血流动力学参数、确立其明确诊断方面的重要功能。诊断技术的进步和多学科方法的整合对于CTEPH的及时准确诊断至关重要，有助于早期治疗干预并改善患者预后。本文旨在为临床医生提供CTEPH高效诊断流程所需的知识和工具，提高对这种潜在可治疗的肺动脉高压病因的认识和理解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea4b/11412851/0d47a745f387/fcvm-11-1439402-g008.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea4b/11412851/0d47a745f387/fcvm-11-1439402-g008.jpg
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Highlights from the International Chronic Thromboembolic Pulmonary Hypertension Congress 2021.2021 年国际慢性血栓栓塞性肺动脉高压大会亮点。
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