Cardiovascular Subphenotypes in ARDS: Diagnostic and Therapeutic Implications and Overlap with Other ARDS Subphenotypes.
Cardiovascular Subphenotypes in ARDS: Diagnostic and Therapeutic Implications and Overlap with Other ARDS Subphenotypes.
复制标题
DOI：
10.3390/jcm12113695
复制
发表时间：
2023-05-26
影响因子：
3.9
通讯作者：
Parekh, Dhruv
中科院分区：
文献类型：
--
作者：
Chotalia, Minesh;Patel, Jaimin M.;Bangash, Mansoor N.;Parekh, Dhruv
关键词：
急性呼吸窘迫综合征(ARDS)是一种高度异质性的临床症状。休克是ARDS预后不良的标志，其病理生理学的异质性可能是其有效治疗的障碍。虽然右心功能不全是常见的病因，但对其诊断尚无统一的定义，而左心功能则被忽视。有必要确定ARDS中具有相似病理生物学特征的同质亚群，然后可以进行靶向治疗。ARDS患者的血流动力学聚类分析确定了两种日益严重的右室损伤亚型，以及另一种高动力左心功能亚型。在这篇综述中，我们讨论了ARDS的心血管系统表型如何与血流动力学病理生理学相一致，如何帮助最佳地定义右心功能障碍，以及如何确定ARDS休克的定制治疗靶点。此外，炎症、临床和放射学数据的聚类分析描述了ARDS的其他亚型。我们详细描述了这些和心血管表型之间的潜在重叠。
Acute respiratory distress syndrome (ARDS) is a highly heterogeneous clinical condition. Shock is a poor prognostic sign in ARDS, and heterogeneity in its pathophysiology may be a barrier to its effective treatment. Although right ventricular dysfunction is commonly implicated, there is no consensus definition for its diagnosis, and left ventricular function is neglected. There is a need to identify the homogenous subgroups within ARDS, that have a similar pathobiology, which can then be treated with targeted therapies. Haemodynamic clustering analyses in patients with ARDS have identified two subphenotypes of increasingly severe right ventricular injury, and a further subphenotype of hyperdynamic left ventricular function. In this review, we discuss how phenotyping the cardiovascular system in ARDS may align with haemodynamic pathophysiology, can aid in optimally defining right ventricular dysfunction and can identify tailored therapeutic targets for shock in ARDS. Additionally, clustering analyses of inflammatory, clinical and radiographic data describe other subphenotypes in ARDS. We detail the potential overlap between these and the cardiovascular phenotypes.
登录
查看更多内容
影响因子：
3.9
作者：
Hua Z;Xin D;Xiaoting W;Dawei L
通讯作者：
Dawei L
DOI：
10.1186/s13054-020-03385-5
发表时间：
2020-11-30
期刊：
Critical care (London, England)
影响因子：
--
作者：
D'Alto M;Marra AM;Severino S;Salzano A;Romeo E;De Rosa R;Stagnaro FM;Pagnano G;Verde R;Murino P;Farro A;Ciccarelli G;Vargas M;Fiorentino G;Servillo G;Gentile I;Corcione A;Cittadini A;Naeije R;Golino P
通讯作者：
Golino P
影响因子：
76.2
作者：
Calfee, Carolyn S.;Delucchi, Kevin;Parsons, Polly E.;Thompson, B. Taylor;Ware, Lorraine B.;Matthay, Michael A.
通讯作者：
Matthay, Michael A.
DOI：
10.1164/rccm.201603-0645oc
发表时间：
2017-02-01
影响因子：
24.7
作者：
Famous, Katie R.;Delucchi, Kevin;Calfee, Carolyn S.
通讯作者：
Calfee, Carolyn S.
影响因子：
76.2
作者：
Constantin, Jean-Michel;Jabaudon, Matthieu;Futier, Emmanuel
通讯作者：
Futier, Emmanuel