Lu Ming, Wang Baoguo, Rong Chunyan, Wang Yin, Zhang Weihua
Jilin University, Changchun, China.
Front Med (Lausanne). 2025 May 2;12:1579112. doi: 10.3389/fmed.2025.1579112. eCollection 2025.
With a high frequency and a poor prognosis, combined pre-and post-capillary pulmonary hypertension (Cpc-PH) is a significant subtype of pulmonary hypertension linked to left-sided heart disease (PH-LHD). The complicated pathophysiology of Cpc-PH is primarily characterized by elevated pulmonary venous pressure leading to an increase in retrocapillary pressure, which is followed by elevated pulmonary artery pressure and a marked rise in pulmonary vascular resistance (PVR). There is currently no well-defined treatment plan for Cpc-PH, and there are numerous obstacles to overcome. In patients with Cpc-PH, the effectiveness of targeted medications for pulmonary hypertension is limited and debatable. Recent research has revealed that the prevalence and progression of Cpc-PH may be influenced by genetic factors, metabolic syndrome, oxidative stress, and fibrosis. To help doctors better manage and treat patients with Cpc-PH, this review provides a detailed description of the disease's epidemiology, pathogenesis, diagnostic techniques, current treatment status, and potential therapeutic targets.
毛细血管前和毛细血管后合并性肺动脉高压(Cpc-PH)是一种与左心疾病相关的肺动脉高压(PH-LHD)的重要亚型,其发病率高且预后较差。Cpc-PH复杂的病理生理学主要特征是肺静脉压升高导致毛细血管后压力增加,随后肺动脉压升高和肺血管阻力(PVR)显著升高。目前尚无明确的Cpc-PH治疗方案,且有许多障碍需要克服。在Cpc-PH患者中,肺动脉高压靶向药物的有效性有限且存在争议。最近的研究表明,Cpc-PH的患病率和进展可能受遗传因素、代谢综合征、氧化应激和纤维化的影响。为帮助医生更好地管理和治疗Cpc-PH患者,本综述详细描述了该疾病的流行病学、发病机制、诊断技术、当前治疗状况和潜在治疗靶点。