肺动脉高压介入治疗研究进展
高强,徐巍,王定宇,李悦
摘要(Abstract):
<正>据统计,肺高血压发病率约占全球人口的1%,在65岁以上的人群中比例高达10%~([1])。肺高血压诊断标准为海平面状态下、静息时、右心导管测量平均肺动脉压(mean pulmonary arterypressure,mPAP)≥25mm Hg(1mm Hg=0.133k Pa)~([2])。肺动脉高压(pulmonary arteryhypertension,PAH)是肺高血压临床分类第1组,诊断标准为右心导管测量mPAP≥25mm Hg、肺小动脉楔压≤15mm Hg,且肺血管阻力>3 Wood单位~([2-3])。PAH发病过程呈进展性。右心衰竭(right heart failure,
关键词(KeyWords): 肺动脉高压;介入治疗;右心衰竭
基金项目(Foundation):
作者(Author): 高强,徐巍,王定宇,李悦
参考文献(References):
- [1]Hoeper MM,Humbert M,Souza R,et al.A global view of pulmonary hypertension Lancet RespirMed,2016,4(4):306-322.
- [2]Galie N,Humbert M,Vachiery JL,et al.2015 ESCGERS Guidelines for the diagnosis and treatment of pulmonary hypertension:The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension ofthe 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 Respir J,2015,46(4):903-975.
- [3]Humbert M,Sitbon O,Simonneau G.Treatment of pulmonary arterial hypertension.N Engl J Med,2004,65(10):1337-1354.
- [4]Galie N,Corris PA,Frost A,et al.Updated treatment algorithm of pulmonary arterial hypertension.J Am Coll Cardiol,2013,62(25 Suppl):D60-D72.
- [5]Humbert M,Sitbon O,Chaouat A,et al.Survival in patients with idiopathic,familial,and anorexigen-associated pulmonary arterial hypertension in the modern management era.Circulation,2010,122(2):156-163.
- [6]Leopold JA.Catheter-based therapies for patients with medicationrefractory pulmonary arterial hypertension.Circ Cardiovasc Interv,2015,8(11):e003332.
- [7]Bhamra-Ariza P,Keogh AM,Muller D.Percutaneous interventional therapies for the treatment of patients with severe pulmonary hypertension.J Am Coll Cardiol,2014,63(7):611-618.
- [8]Lang I,Meyer BC,Ogo T,et al.Balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension.Eur Respir Rev,2017,26(143):160119.
- [9]Rozkovec A,Montanes P,Oakley CM.Factors that influence the outcome of primary pulmonary hypertension.Br Heart J,1986,55(5):449-458.
- [10]Hopkins WE,Ochoa LL,Richardson GW,et al.Comparison of the hemodynamics and survival of adults with severe primary pulmonary hypertension or Eisenmenger syndrome.J Heart Lung Transplant,1996,15(1 Pt 1):100-105.
- [11]Weimar T,Watanabe Y,Kazui T,et al.Impact of differential rightto-left shunting on systemic perfusion in pulmonary arterial hypertension.Catheter Cardiovase Inter,,2013,81(5):888-895.
- [12]Sandoval J,Gaspar J,Pulido T,et al.Graded balloon dilation atrial septostomy in severe primary pulmonary hypertension.A therapeutic alternative for patients nonresponsive to vasodilator treatment.J Am Coll Cardiol,1998,32(2):297-304.
- [13]Sandoval J,Gaspar J,Pena H,et al.Effect of atrial septostomy on the survival of patients with severe pulmonary arterial hypertension.Eur Respir J,2011,38(6):1343-1348.
- [14]Troost E,Delcroix M,Gewillig M,et al.A modified technique of stent fenestration of the interatrial sqrtum improves patients with pulmonary hypertension.Catheter Cardiovasc Inter,,2009,73(2):173-179.
- [15]Rajeshkumar R,Pavithran S,Sivakumar K,et al.Atrial septostomy with a predefined diameter using a novel occlutech atrial flow regulator improves symptoms and cardiac index in patients with severe pulmonary arterial hypertension.Catheter Cardiovasc Interv,2017,90(7):1145-1153.
- [16]Guerrero M,Cajigas H,Awdish R,et al.First-in-man experience with cryoplasty during graded balloon atrial septostomy to reduce spontaneous closure in a patient with severe pulmonary arterial hypertension.Eurointervention,2014,9(10):1235-1236.
- [17]Baglini R.Atrial septostomy in patients with end-stage pulmonary hypertension.No more needles but wires,energy and close anatomical definition.J Interv Cardiol,2013,26(1):62-68.
- [18]Potts WJ,Smith S,Gibson S.Anastomosis of the aorta to a pulmonary artery;certain types in congenital heart disease.J Am Med Assoc,1946,132(11):627-631.
- [19]Esch JJ,Shah PB,Cockrill BA,etal. Transcatheter Potts shunt creation in patients with severe pulmonary arterial hypertension:initial clinical experience.J Heart Lung Transplant,2013,32(4):381-387.
- [20]Baruteau AE,Belli E,Boudjemline Y,et al.Palliative Pottsshunt for the treatment of children with drug-refractory pulmonary arterial hypertension:updated data from the first 24 patients.Eur J Cardiothorac Surg,2015,47(3):e105-e110.
- [21]Guo K,Langleben D,Afilalo J,et al.Anatomical considerations for the development of a new transcatheter aortopulmonary shunt device in patients with severe pulmonary arterial hypertension.Pulm Circ,2013,3(3):639-646.
- [22]Sayadpour Zanjani K.Radiofrequency perforation may increase the safety of transcatheter Potts shunt creation.J Heart Lung Transplant,2013,32(9):938.
- [23]Kim NH.Group 4 Pulmonary hypertension:chronic thromboembolic pulmonary hypertension:epidemiology,pathophysiology,and treatment.Cardiol Clin,2016,34(3):435-441.
- [24]Rarnka S,Mohananey D,Agarwal N,et al.Chronic thromboembolic pulmonary hypertension-management strategies and outcomes.J Cardiothorac Vase Anesth,2020,34(9):2513-2523.
- [25]Kataoka M,Inami T,Hayashida K,et al.Percutaneous transluminal pulmonary angicplasty fer the treatment of chronic thromboembolic pulmonary hypertensian.Circ Cardiovasc Intery,2012,5(6):756-762.
- [26]Sugimura K,Fukumoto Y,Satoh K,et al.Percutaneous transluminal pulmonary angioplasty markedly improves pulmonary hemodynamics and long-term prognosis in patients with chronic thromboembolic pulmonary hypertension.Circ J,2012,76(2):485-488.
- [27]Rubin LJ.Pulmonary artery denervation for pulmonary artery hypertension.JACC Cardiovasc Interv,2015,8(15):2024-2025.
- [28]Laks MM,Juratsch CE,Garner D,et al.Acute pulmonary artery hypertension produced by distention of the main pulmonary artery in the conscious dog.Chest,1975,68(6):807-813.
- [29]Chen SL,Zhang YJ,Zhou L,et al.Percutaneous pulmonary artery denervation completely abolishes experimental pulmonary arterial hypertension in vivo.Eurointervention,2013,9(2):269-276.
- [30]Zhou L,Zhang J,Jiang XM,et al.Pulmonary artery denervation attenuates pulmonary arterial remodeling in dogs with pulmonary arterial hypertension induced by dehydrogenized monocrotaline.JACC Cardiovasc Interv,2015,8(15):2013-2023.
- [31]Liu C,Jiang XM,Zhang J,et al.Pulmonary artery denervation improves pulmonary arterial hypertension induced right ventricular dysfunction by modulating the local renin-angiotensin-aldosterone system.BMC Cardiovasc Disord,2016,16(1):192.
- [32]Huang Y,Liu YW,Pan HZ,et al.Transthoracic pulmonary artery denervation for pulmonary arterial hypertension.Arterioscler Thromb Vase Biol,2019,39(4):704-718.
- [33]Rothman A,Jonas M,Castel D,et al.Pulmonary artery denervation using catheter-based ultrasonic energy.Eurolntervention,2019,15(8):722-730.
- [34]Chen SL,Zhang FF,Xu J,et al.Pulmonary artery denervation to treat pulmonary arterial hypertension:the single-center,prospective,first-in-man PADN-1 study(first-in-man pulmonaip artery denervation for treatment of pulmonary artery hypertension).J Am Coll Cardiol,2013,62(12):1092-1100.
- [35]Chen SL,Zhang H,Xie DJ,et al.Hemodynamic,functional,and clinical responses to pulmonary artery denervation in patients with pulmonary arterial hypertension of different causes:phase II results from the Pulmonary Artery Denervation-1 study.Circ Cardiovasc Interv,2015,8(11):e002837.
- [36]Zhang H,Zhang J,Chen M,et al.Pulmonary artery denervation significantly increases 6-min walk distance for patients with combined pre-and post-capillary pulmonary hypertension associated with left heart failure:The PADN-5Study.JACC Cardiovasc Interv,2019,12(3):274-284.