左心疾病相关肺动脉高压

Left heart disease-associated pulmonary arterial hypertension

左心疾病相关肺动脉高压(PAH)是肺循环压力升高最常见的原因,PAH是左心疾病发展到后期的常见并发症,可出现在任何左心系统疾病所引起的心力衰竭中。一旦出现PAH和右心功能不全,患者的临床症状和运动耐量将明显恶化,预后较差。然而,目前国内外关于左心力衰竭相关PAH的研究较少,其流行病学、病理生理机制、基础治疗及PAH靶向药物治疗方面尚缺乏有效的数据。文章将对左心疾病相关PAH的流行病学、临床评估、治疗、最新证据及预后评估方面的最新文献进行综述。

Pulmonary arterial hypertension （PAH） due to left heart disease （LHD）, i.e., group 2 PAH, is the most common reason for increased pressures in the pulmonary circuit. PAIl is a common complication of LHDs （PAH-LHD）, frequently occurring as a ＇symptom＇ of the underlying condition, and can complicate anyleft heart disorder. When present, PAH-LHD and right ventricular failure are associated with more severe symptoms, worse exercise tolerance, and outcomes. However, data about PAH-LHD are limited up to date. Here we discuss the recent researches on the epidemiology, clinical evaluation, treatment strategies, gaps in evidence and prognosis assessment for PAH-LHD.