Tom 16, Nr 3 (2019)
Nadciśnienie płucne
Opublikowany online: 2019-09-24
Wyświetlenia strony
570
Wyświetlenia/pobrania artykułu
1423
Zakrzepowo-zatorowe nadciśnienie płucne — aktualny stan wiedzy
Choroby Serca i Naczyń 2019;16(3):151-157.
Streszczenie
Przewlekłe zakrzepowo-zatorowe nadciśnienie
płucne (CTEPH) stanowi 4. grupę nadciśnienia
płucnego według klasyfikacji World Health Organization.
Rozwija się zarówno u osób po przebytym
incydencie ostrej zatorowości płucnej (PE),
jak i u chorych, którzy nigdy nie przebyli jawnego
epizodu PE czy zakrzepicy żył głębokich.
Nieleczona choroba prowadzi do niewydolności
prawokomorowej i zgonu. Choć „złotym standardem”
leczenia CTEPH pozostaje endarterektomia
płucna (PEA), to ostatnie lata przyniosły znaczący
postęp w zakresie rozwoju alternatywnych metod
leczenia dla chorych niebędących kandydatami
do PEA. Niniejszy artykuł stanowi podsumowanie
aktualnego stanu wiedzy na temat patofizjologii
oraz leczenia tej jednostki chorobowej.
Słowa kluczowe: zakrzepowo-zatorowe nadciśnienie płucnezatorowość płucnaendarterektomia płucnaangioplastyka balonowa
Referencje
- Galiè N, Humbert M, Vachiery JL, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J. 2016; 37(1): 67–119.
- Riedel M, Stanek V, Widimsky J, et al. Longterm follow-up of patients with pulmonary thromboembolism. Late prognosis and evolution of hemodynamic and respiratory data. Chest. 1982; 81(2): 151–158.
- Ghofrani HA, D'Armini AM, Grimminger F, et al. CHEST-1 Study Group. Riociguat for the treatment of chronic thromboembolic pulmonary hypertension. N Engl J Med. 2013; 369(4): 319–329.
- Feinstein JA, Goldhaber SZ, Lock JE, et al. Balloon pulmonary angioplasty for treatment of chronic thromboembolic pulmonary hypertension. Circulation. 2001; 103(1): 10–13.
- Lang IM, Pesavento R, Bonderman D, et al. Risk factors and basic mechanisms of chronic thromboembolic pulmonary hypertension: a current understanding. Eur Respir J. 2013; 41(2): 462–468.
- Pepke-Zaba J, Jansa P, Kim NH, et al. Chronic thromboembolic pulmonary hypertension: role of medical therapy. Eur Respir J. 2013; 41(4): 985–990.
- Pengo V, Lensing AWA, Prins MH, et al. Thromboembolic Pulmonary Hypertension Study Group. Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med. 2004; 350(22): 2257–2264.
- Marshall PS, Kerr KM, Auger WR. Chronic thromboembolic pulmonary hypertension. Clin Chest Med. 2013; 34(4): 779–797.
- Hoeper MM, Barberà JA, Channick RN, et al. Diagnosis, assessment, and treatment of non-pulmonary arterial hypertension pulmonary hypertension. J Am Coll Cardiol. 2009; 54(1 Suppl): S85–S96.
- Hoeper MM, Mayer E, Simonneau G, et al. Chronic thromboembolic pulmonary hypertension. Circulation. 2006; 113(16): 2011–2020.
- Fedullo PF, Auger WR, Kerr KM, et al. Chronic thromboembolic pulmonary hypertension. N Engl J Med. 2001; 345(20): 1465–1472.
- Pesavento R, Filippi L, Pagnan A, et al. PROVE Investigators Group. Unexpectedly high recanalization rate in patients with pulmonary embolism treated with anticoagulants alone. Am J Respir Crit Care Med. 2014; 189(10): 1277–1279.
- Lang IM, Madani M. Update on chronic thromboembolic pulmonary hypertension. Circulation. 2014; 130(6): 508–518.
- Wolf M, Boyer-Neumann C, Parent F, et al. Thrombotic risk factors in pulmonary hypertension. Eur Respir J. 2000; 15(2): 395–399.
- Moser KM, Bloor CM. Pulmonary vascular lesions occurring in patients with chronic major vessel thromboembolic pulmonary hypertension. Chest. 1993; 103(3): 685–692.
- Tunariu N, Gibbs SJR, Win Z, et al. Ventilation-perfusion scintigraphy is more sensitive than multidetector CTPA in detecting chronic thromboembolic pulmonary disease as a treatable cause of pulmonary hypertension. J Nucl Med. 2007; 48(5): 680–684.
- Madani MM, Auger WR, Pretorius V, et al. Pulmonary endarterectomy: recent changes in a single institution's experience of more than 2,700 patients. Ann Thorac Surg. 2012; 94(1): 97–103; discussion 103.
- Fedullo P, Kerr KM, Kim NH, et al. Chronic thromboembolic pulmonary hypertension. Am J Respir Crit Care Med. 2011; 183(12): 1605–1613.
- Auger WR, Fedullo PF. Chronic thromboembolic pulmonary hypertension. Semin Respir Crit Care Med. 2009; 30(4): 471–483.
- Delcroix M, Lang I, Pepke-Zaba J, et al. Surgical management and outcome of patients with chronic thromboembolic pulmonary hypertension: results from an international prospective registry. J Thorac Cardiovasc Surg. 2011; 141(3): 702–710.
- Freed DH, Thomson BM, Berman M, et al. Survival after pulmonary thromboendarterectomy: effect of residual pulmonary hypertension. J Thorac Cardiovasc Surg. 2011; 141(2): 383–387.
- Jamieson SW, Kapelanski DP, Sakakibara N, et al. Pulmonary endarterectomy: experience and lessons learned in 1,500 cases. Ann Thorac Surg. 2003; 76(5): 1457–62; discussion 1462.
- Cannon JE, Su Li, Kiely DG, et al. Dynamic Risk Stratification of Patient Long-Term Outcome After Pulmonary Endarterectomy: Results From the United Kingdom National Cohort. Circulation. 2016; 133(18): 1761–1771.
- Hoeper MM. Pharmacological therapy for patients with chronic thromboembolic pulmonary hypertension. Eur Respir Rev. 2015; 24(136): 272–282.
- Ghofrani HA, Schermuly RT, Rose F, et al. Sildenafil for long-term treatment of nonoperable chronic thromboembolic pulmonary hypertension. Am J Respir Crit Care Med. 2003; 167(8): 1139–1141.
- Reichenberger F, Voswinckel R, Enke B, et al. Long-term treatment with sildenafil in chronic thromboembolic pulmonary hypertension. Eur Respir J. 2007; 30(5): 922–927.
- Bonderman D, Nowotny R, Skoro-Sajer N, et al. Bosentan therapy for inoperable chronic thromboembolic pulmonary hypertension. Chest. 2005; 128(4): 2599–2603.
- Hughes RJ, Jais X, Bonderman D, et al. The efficacy of bosentan in inoperable chronic thromboembolic pulmonary hypertension: a 1-year follow-up study. Eur Respir J. 2006; 28(1): 138–143.
- Cabrol S, Souza R, Jais X, et al. Intravenous epoprostenol in inoperable chronic thromboembolic pulmonary hypertension. J Heart Lung Transplant. 2007; 26(4): 357–362.
- Vizza CD, Badagliacca R, Sciomer S, et al. Mid-term efficacy of beraprost, an oral prostacyclin analog, in the treatment of distal CTEPH: a case control study. Cardiology. 2006; 106(3): 168–173.
- Kerr KM, Rubin LJ. Epoprostenol therapy as a bridge to pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension. Chest. 2003; 123(2): 319–320.
- Nagaya N, Sasaki N, Ando M, et al. Prostacyclin therapy before pulmonary thromboendarterectomy in patients with chronic thromboembolic pulmonary hypertension. Chest. 2003; 123(2): 338–343.
- Simonneau G, D'Armini AM, Ghofrani HA, et al. Riociguat for the treatment of chronic thromboembolic pulmonary hypertension: a long-term extension study (CHEST-2). Eur Respir J. 2015; 45(5): 1293–1302.
- Voorburg JA, Cats VM, Buis B, et al. Balloon angioplasty in the treatment of pulmonary hypertension caused by pulmonary embolism. Chest. 1988; 94(6): 1249–1253.
- Darocha S, Kurzyna M, Pietura R, et al. Balloon pulmonary angioplasty for inoperable chronic thromboembolic pulmonary hypertension. Kardiol Pol. 2013; 71(12): 1331.
- Ogawa A, Matsubara H. Balloon Pulmonary Angioplasty: A Treatment Option for Inoperable Patients with Chronic Thromboembolic Pulmonary Hypertension. Front Cardiovasc Med. 2015; 2: 4.
- Darocha S, Pietura R, Pietrasik A, et al. Improvement in Quality of Life and Hemodynamics in Chronic Thromboembolic Pulmonary Hypertension Treated With Balloon Pulmonary Angioplasty. Circ J. 2017; 81(4): 552–557.
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