Tom 12, Nr 3 (2017)
Kardiochirurgia
Opublikowany online: 2017-06-30
Wyświetlenia strony
752
Wyświetlenia/pobrania artykułu
11190
Nadciśnienie płucne w przebiegu chorób lewego serca — aktualne leczenie i kierunki rozwoju terapii
DOI: 10.5603/FC.2017.0061
Folia Cardiologica 2017;12(3):317-325.
Streszczenie
Przewlekła niewydolność serca jest schorzeniem nabierającym coraz większego znaczenia. Pomimo istotnych postępów
wyniki leczenia w tej grupie chorych są wciąż niezadowalające. Groźnym czynnikiem znacząco pogarszającym jakość
życia chorych z niewydolnością serca, zwiększającym ryzyko hospitalizacji i zgonu jest nadciśnienie płucne. Nadciśnienie
płucne związane z chorobami lewego serca (PH-LHD) wynika z zaburzeń funkcji skurczowej i rozkurczowej lewej
komory, które prowadzą do wzrostu ciśnienia napełniania lewej połowy serca. Zapoczątkowuje to wiele niekorzystnych
zmian patofizjologicznych i czynnościowych w krążeniu płucnym i w prawym sercu. Rozpoznanie i leczenie nadciśnienia
płucnego jest trudne. Na szczęście rozwój badań diagnostycznych, zharmonizowana terminologia i nowa klasyfikacja
PH-LHD pozwalają na lepszą diagnostykę i kwalifikację chorych do właściwej grupy. Kluczowe znaczenie w rozpoznaniu
nadciśnienia płucnego i odpowiedniej jego klasyfikacji ma cewnikowanie serca. Większość terapii celowanych w PH jest
przeznaczona dla osób z tętniczym nadciśnieniem płucnym, a zastosowanie tych leków w PH-LHD nie zostało dostatecznie zbadane w randomizowanych badaniach klinicznych lub wykazano wręcz szkodliwe ich działanie w tej grupie
chorych. Istnieje wyraźna potrzeba dalszych badań nad mechanizmami leżącymi u podstaw PH-LHD i nowych opcji
terapeutycznych, które pomogą stymulować rozwój nowych wytycznych leczenia tej grupy chorych.
Słowa kluczowe: niewydolność sercanadciśnienie płucne
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