Pulmonell hypertension vanligt vid vänstersidig hjärtsjukdom - Kunskapsläget är dåligt – fler kliniska studier behövs
(2017) In Läkartidningen 114.- Abstract
Pulmonary hypertension (PH) is a serious complication to left heart disease (LHD), affecting a majority of the patients during the course of the disease. Initially, PH-LHD is caused by passive congestion of the pulmonary vessels due to increased left atrial pressures, a condition that is currently denoted as isolated post-capillary PH (Icp-PH). In the majority of patients the increased atrial pressure is a result of elevated left ventricular filling pressures. Furthermore, chronically elevated filling pressures may yield endothelial damage, resulting in structural and functional alterations in the pre-capillary bed with further elevation in pulmonary pressures as well as elevated vascular resistance, defined as combined precapillary and... (More)
Pulmonary hypertension (PH) is a serious complication to left heart disease (LHD), affecting a majority of the patients during the course of the disease. Initially, PH-LHD is caused by passive congestion of the pulmonary vessels due to increased left atrial pressures, a condition that is currently denoted as isolated post-capillary PH (Icp-PH). In the majority of patients the increased atrial pressure is a result of elevated left ventricular filling pressures. Furthermore, chronically elevated filling pressures may yield endothelial damage, resulting in structural and functional alterations in the pre-capillary bed with further elevation in pulmonary pressures as well as elevated vascular resistance, defined as combined precapillary and postcapillary PH (Cpc-PH). With previous definitions of PH-LHD it has been difficult to differentiate between the subgroups, so a new classification was presented in the 2015 PH guidelines. Despite PH-LHD being common and serious, specific therapies are lacking for the pulmonary component. Instead, treatments focus on optimizing the underlying cause of PH-LHD and involve medical as well as surgical therapies. In the present review we presents, based on the new guidelines, current knowledge on pathophysiological and pathobiological mechanisms, epidemiology, investigation and treatment of PH-LHD.
(Less)- Abstract (Swedish)
- Pulmonell hypertension är en vanlig komplikation till vänstersidig hjärtsjukdom och medför såväl försämrad livskvalitet som försämrad prognos.Den pulmonella hypertensionen beror initialt på passiv stockning av blod i lungkretsloppet men kan kompliceras av såväl pulmonell vasokonstriktion som vaskulär remodulering.2015 års europeiska riktlinjer innefattar en ny definition av pulmonell hypertension sekundär till vänstersidig hjärtsjukdom, vilken tagits fram för att möjliggöra adekvat subgruppering av tillståndet.Specifik medicinsk behandling för de prekapillära förändringarna i lungcirkulationen saknas. Terapin syftar i stället till att optimera bakomliggande hjärtsjukdom.
- author
- Lundgren, Jakob LU and Rådegran, Göran LU
- organization
- publishing date
- 2017-12-01
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Läkartidningen
- volume
- 114
- publisher
- Swedish Medical Association
- external identifiers
-
- pmid:29292958
- scopus:85043362786
- ISSN
- 0023-7205
- language
- Swedish
- LU publication?
- yes
- id
- f23e97dd-88af-4bfd-b10b-5b171bcf60c2
- date added to LUP
- 2018-03-23 13:03:40
- date last changed
- 2024-03-01 16:07:57
@article{f23e97dd-88af-4bfd-b10b-5b171bcf60c2,
abstract = {{<p>Pulmonary hypertension (PH) is a serious complication to left heart disease (LHD), affecting a majority of the patients during the course of the disease. Initially, PH-LHD is caused by passive congestion of the pulmonary vessels due to increased left atrial pressures, a condition that is currently denoted as isolated post-capillary PH (Icp-PH). In the majority of patients the increased atrial pressure is a result of elevated left ventricular filling pressures. Furthermore, chronically elevated filling pressures may yield endothelial damage, resulting in structural and functional alterations in the pre-capillary bed with further elevation in pulmonary pressures as well as elevated vascular resistance, defined as combined precapillary and postcapillary PH (Cpc-PH). With previous definitions of PH-LHD it has been difficult to differentiate between the subgroups, so a new classification was presented in the 2015 PH guidelines. Despite PH-LHD being common and serious, specific therapies are lacking for the pulmonary component. Instead, treatments focus on optimizing the underlying cause of PH-LHD and involve medical as well as surgical therapies. In the present review we presents, based on the new guidelines, current knowledge on pathophysiological and pathobiological mechanisms, epidemiology, investigation and treatment of PH-LHD.</p>}},
author = {{Lundgren, Jakob and Rådegran, Göran}},
issn = {{0023-7205}},
language = {{swe}},
month = {{12}},
publisher = {{Swedish Medical Association}},
series = {{Läkartidningen}},
title = {{Pulmonell hypertension vanligt vid vänstersidig hjärtsjukdom - Kunskapsläget är dåligt – fler kliniska studier behövs}},
volume = {{114}},
year = {{2017}},
}