Effects of Fasudil on Patients with Pulmonary Hypertension Associated with Left Ventricular Heart Failure with Preserved Ejection Fraction: A Prospective Intervention Study.
Effects of Fasudil on Patients with Pulmonary Hypertension Associated with Left Ventricular Heart Failure with Preserved Ejection Fraction: A Prospective Intervention Study.
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法舒地尔对射血分数保留的肺动脉高压合并左室心力衰竭患者的影响：一项前瞻性干预研究
DOI：
10.1155/2018/3148259
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发表时间：
2018
影响因子：
2.2
通讯作者：
Shen J
中科院分区：
文献类型：
--
作者：
Zhang X;Zhang X;Wang S;Luo J;Zhao Z;Zheng C;Shen J
左心室心力衰竭伴保留射血分数（PH-HFpEF）引起的肺动脉高压是一个日益严重的医学问题。本研究旨在评价法舒地尔对老年PH-HFpEF患者的临床疗效，找出可能成为法舒地尔治疗对象的PH-HFpEF亚型。纳入58例PH-HFpEF老年患者。患者通过右心导管诊断为被动肺动脉高压（PPH）或反应性肺动脉高压（RPH），均接受Rho激酶抑制剂法舒地尔治疗2周。终点包括治疗2周后SpO2、NT-pro BNP、心功能分类和超声心动图测量的变化。RPH组病程长于PPH组（p < 0.05）。RPH组心输出量明显低于PPH组（p < 0.01）。RPH组经肺压力梯度（TPG）、肺血管阻力（PVR）及肺动脉收缩压（PASP）、平均肺动脉压（mPAP）均高于PPH组（p < 0.01），符合RPH特征。法舒地尔治疗后，RPH组PASP显著降低（p < 0.01）， E/E′降低，E/A升高（p < 0.05），表明肺血流动力学和心脏舒张功能得到改善，而PPH组无明显变化。两组患者NT-pro BNP及6 MWD均有改善（p < 0.05）。RPH组总有效率为74.29%，高于PPH组的47.83% （p < 0.05）。Rho激酶抑制剂法舒地尔可以改善PH-HFpEF患者的肺和左心室血流动力学。RPH组总有效率较高。法舒地尔可能是治疗PH-HFpEF患者RPH的一种有前景的靶向药物。该试验注册号为ChiCTR-INR-16009511。
Pulmonary hypertension due to left ventricular heart failure with preserved ejection fraction (PH-HFpEF) is an increasingly medical problem. The aim of the study was to evaluate the clinical efficacy of fasudil on PH-HFpEF elderly patients and to figure out the subtype of PH-HFpEF which may be the therapeutic object of fasudil. 58 PH-HFpEF elderly patients were enrolled. Patients were diagnosed with passive pulmonary hypertension (PPH) or reactive pulmonary hypertension (RPH) by right heart catheterization and all receiving Rho kinase inhibitor fasudil for 2 weeks. The endpoint includes changes in SpO2, NT-pro BNP, cardiac functional classification, and echocardiography measurements after 2 weeks treatment. The course of disease in the RPH group was longer than the PPH group (p < 0.05). Cardiac output was found to be worse in the RPH group than the PPH group (p < 0.01). Besides, the RPH group demonstrated a greater transpulmonary pressure gradient (TPG) and pulmonary vascular resistance (PVR) than the PPH group (p < 0.01 for both) as well as pulmonary arterial systolic pressure (PASP) and mean pulmonary arterial pressure (mPAP) (p < 0.01 for both), which fits the feature of RPH. After treatment of fasudil, in RPH group, PASP significantly decreased (p < 0.01) with decreased E/E′ and increased E/A (p < 0.05 for both), indicating that pulmonary haemodynamics and cardiac diastolic function were ameliorated, but the measurements in the PPH group had no significant changes. NT-pro BNP and 6 MWD of both groups were improved (p < 0.05). The total effective rate of the RPH group was 74.29%, which was higher than 47.83% of the PPH group (p < 0.05). The Rho kinase inhibitor fasudil can improve pulmonary and left ventricular haemodynamics in patients with PH-HFpEF. The total effective rate was higher in the RPH group. Fasudil may be a promising targeted drug for the RPH in PH-HFpEF patients. This trial is registered with ChiCTR-INR-16009511.
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影响因子：
7.4
作者：
Dong, Ming;Yan, Bryan P.;Liao, James K.;Lam, Yat-Yin;Yip, Gabriel W. K.;Yu, Cheuk-Man
通讯作者：
Yu, Cheuk-Man
影响因子：
37.8
作者：
Tedford RJ;Hassoun PM;Mathai SC;Girgis RE;Russell SD;Thiemann DR;Cingolani OH;Mudd JO;Borlaug BA;Redfield MM;Lederer DJ;Kass DA
通讯作者：
Kass DA
DOI：
10.1164/rccm.201701-0150ws
发表时间：
2017-06-15
影响因子：
24.7
作者：
Newman, John H.;Rich, Stuart;Xiao, Lei
通讯作者：
Xiao, Lei
影响因子：
9.7
作者：
Aronson, Doron;Eitan, Amnon;Burger, Andrew J.
通讯作者：
Burger, Andrew J.
影响因子：
24
作者：
Lam, Carolyn S. P.;Roger, Veronique L.;Rodeheffer, Richard J.;Borlaug, Barry A.;Enders, Felicity T.;Redfield, Margaret M.
通讯作者：
Redfield, Margaret M.