Eur Heart J：左心疾病引起肺动脉高压患者肺血管疾病的病理生理学意义

2022-07-12 MedSci原创 MedSci原创

LHD中的肺血管疾病与病理生理特征相关，其特征为运动引起的肺充血、动脉低氧血症、RV-PA解耦、心室相互依赖以及氧输送受损、有氧能力受损。需要进一步的研究来确定新的治疗PH-LHD的方法。

肺动脉高压(PH)和肺血管疾病(PVD)是常见的，并与左心疾病(LHD)的不良结局相关。近日，心血管领域权威杂志Eur Heart J上发表了一篇研究文章，该研究试图通过LHD的PH谱来归纳总结PVD的病理生理特征。

在这项前瞻性研究中，PH-LHD(平均肺动脉压(PA)>20mmHg，肺动脉楔压(PAWP)≥15mmHg)患者和无PH或LHD的对照组同时进行有创血流动力学运动检测，同时进行超声心动图、呼气和血气分析和肺超声检查。根据肺血管阻力(PVR<3.0或≥3.0WU)将PH-lhd患者分为单纯的毛细血管后PH(IpcPH)和联合的毛细血管后及前PH(CpcPH)。

与对照组(n=69)和IpcPH-LHD(n=55)相比，CpcPH-LHD(n=40)患者在休息时左房功能较差，右心室(RV)功能障碍较严重。

运动时，CpcPH-LHD患者的PAWP与IpcPH-LHD相似，但伴有更严重的RV-PA解耦联，更大的心室相互作用，更严重的心输出量、氧输送和峰值氧消耗障碍。尽管PVR较高，但与IpcPH-LHD和对照组相比，CpcPH参与者发生了更严重的肺充血，这与较低的动脉O2张力、肺泡通气减少、肺O2扩散减少和更大的通气-灌注错配相关。

由此可见，LHD中的肺血管疾病与病理生理特征相关，其特征为运动引起的肺充血、动脉低氧血症、RV-PA解耦、心室相互依赖以及氧输送受损、有氧能力受损。需要进一步的研究来确定新的治疗PH-LHD的方法。

原始出处：

Kazunori Omote.et al.Pulmonary vascular disease in pulmonary hypertension due to left heart disease: pathophysiologic implications.European Heart Journal.2022.https://academic.oup.com/eurheartj/advance-article-abstract/doi/10.1093/eurheartj/ehac184/6633254?redirectedFrom=fulltext

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2023-01-18 chenzhuanggui

#生理学#

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2023-05-03 jklm09

#动脉高压#

40 0
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2022-07-19 许安

#病理生理#

46 0
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2023-05-08 zhao4616

#病理生理学#

36 0
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2023-06-01 lingaifan

#肺血管疾病#

37 0
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2023-05-03 naiwu77

#肺动脉高压患者#

39 0
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2022-07-11 zhaojie88

#ART#

29 0
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2022-07-11 andy2090

#血管疾病#

0 0
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2022-07-11 slcumt

#HEART#

44 0

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