Pathobiology of pulmonary arterial hypertension and right ventricular failure.

Pathobiology of pulmonary arterial hypertension and right ventricular failure.
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DOI:
10.1183/09031936.00046612
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发表时间:
2012-12
期刊:
The European respiratory journal
影响因子:
--
通讯作者:
Nicolls MR
Nicolls MR
中科院分区:
其他
文献类型:
--
作者:
Voelkel NF;Gomez-Arroyo J;Abbate A;Bogaard HJ;Nicolls MR

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肺动脉高压(PAH)不再是一种罕见疾病。目前正在使用三种不同类型的药物治疗PAH,越来越多的患者正在接受单药或联合治疗。在过去的25年里,对PAH的病理生物学有了新的认识。经典的压力,流量,剪切应力,右心室壁应力和阻抗的力学概念已经补充了细胞损伤和修复以及复杂的多细胞系统的相互作用的新概念。当我们设计新的医学疗法以改变这些致命疾病患者的预后时,整合这些概念将变得至关重要。本综述旨在总结主要来自人类研究的PAH和右心室衰竭的最新病理生物学概念,这些概念反映了对这一复杂肺血管疾病组的理解所取得的进展。
Pulmonary arterial hypertension (PAH) is no longer an orphan disease. There are three different classes of drugs for the treatment of PAH that are currently being used and an increasing number of patients are being treated with a single drug or combination therapy. During the last 25 yrs, new insights into the pathobiology of PAH have been gained. The classical mechanical concepts of pressure, flow, shear stress, right ventricle wall stress and impedance have been complemented with the new concepts of cell injury and repair and interactions of complex multicellular systems. Integrating these concepts will become critical as we design new medical therapies in order to change the prognosis of patients with these fatal diseases. This review intends to summarise recent pathobiological concepts of PAH and right ventricle failure mainly derived from human studies, which reflect the progress made in the understanding of this complex group of pulmonary vascular diseases.
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