Heart failure and pulmonary hypertension.
Heart failure and pulmonary hypertension.
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DOI：
10.1016/j.hfc.2009.11.007
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发表时间：
2010-04-01
影响因子：
3.4
通讯作者：
Semigran, Marc J
中科院分区：
文献类型：
--
作者：
Shin, Jordan T;Semigran, Marc J
当肺动脉高压（PH）和右心室功能障碍伴随心力衰竭时，对功能能力和预后的影响是不祥的。优先降低肺压和肺血管张力的新临床策略通过针对一氧化氮信号转导途径（如 PDE5 抑制）来改善功能表现和心力衰竭症状。需要进行更多研究来确定这些疗法是否会影响患者的长期治疗结果，并阐明这些疗法有效的具体机制。此外，最近发现 BMPR2 突变会导致家族性肺动脉高压，并且在继发性肺动脉高压中 BMPR2 表达降低，这强烈表明 BMP 信号传导与肺动脉高压的潜在病理生理学有关。 PH 和 BMP 信号传导血管生物学中新兴基础科学见解的转化将为一系列肺动脉高压疾病提供新的治疗策略。
When pulmonary hypertension (PH) and right ventricular dysfunction accompany heart failure, the impact on functional capacity and prognosis are ominous. Newer clinical strategies to preferentially lower pulmonary pressures and pulmonary vascular tone improve functional performance and symptoms of heart failure by targeting the nitric oxide signal transduction pathways, as with PDE5 inhibition. Additional studies are needed to determine if these therapies will impact long-term patient outcomes and elucidate the specific mechanisms whereby these treatments are effective. Furthermore, the recent finding that mutations in BMPR2 cause familial forms of pulmonary arterial hypertension and that BMPR2 expression is decreased in secondary forms of PH strongly implicate BMP signaling in the underlying pathophysiology of PH. Translation of emerging basic science insights in the vascular biology of PH and BMP signaling will provide novel therapeutic strategies for the spectrum of pulmonary hypertensive diseases.