Abstract:
Pulmonary hypertension (PH) is a common disease affecting up to 1% of the population and at least 50% of patients diagnosed with heart failure (HF) (Hoeper et al. in Lancet Respir Med 4(4):306-322, 2016). It is estimated that PH is present in 15% to 60% of patients with valvular heart disease (VHD) which can result from an increase in pulmonary blood flow and subsequently in pulmonary venous congestion and pulmonary vascular resistance (PVR). It is important to identify the severity of PH in patients with VHD to appropriately risk stratify and manage these patients (Magne et al. in JACC Cardiovasc Imaging 8(1):83-99, 2015). In this review, we examine the diagnostic criteria for PH and its pathophysiology. We also focus on the growing evidence supporting the presence of PH secondary to VHD and describe the contemporary surgical and medical therapeutic interventions in this patient population (Fig. 1).
摘要:
肺动脉高压(PH)是一种常见疾病,影响多达1%的人群和至少50%的被诊断为心力衰竭(HF)的患者(Hoeper等人。柳叶刀RespirMed4(4):306-322,2016)。据估计,15%至60%的瓣膜性心脏病(VHD)患者存在PH,这可能是由于肺血流量增加以及随后的肺静脉充血和肺血管阻力(PVR)所致。重要的是要确定患有VHD的患者中PH的严重程度,以适当地对这些患者进行风险分层和管理(Magne等人。JACC心血管成像8(1):83-99,2015)。在这次审查中,我们研究了PH的诊断标准及其病理生理学。我们还关注越来越多的证据支持VHD继发PH的存在,并描述了该患者人群中的当代外科和医学治疗干预措施(图。1).