Treatment of exercise pulmonary hypertension improves pulmonary vascular distensibility.
Treatment of exercise pulmonary hypertension improves pulmonary vascular distensibility.
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DOI：
10.1177/2045894018787381
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发表时间：
2018-07
影响因子：
2.6
通讯作者：
Risbano MG
中科院分区：
文献类型：
--
作者：
Wallace WD;Nouraie M;Chan SY;Risbano MG
运动性肺动脉高压（ePH）是一种未被充分认识的运动限制形式。尽管静息肺动脉压正常，但ePH患者表现出早期肺血管改变，肺动脉顺应性（PAC）和血管扩张性（α）降低。最近的数据表明，靶向血管扩张剂治疗可以改善ePH的血流动力学，但这些药物是否会改变肺血管的扩张性尚不清楚。因此，我们试图评估血管扩张剂治疗是否能改善ePH早期肺血管疾病的标志物α。10例患者采用仰卧运动右心导管（exRHC），自行车测力仪达到运动高峰。诊断为ePH的患者使用肺血管扩张剂治疗。治疗后至少6个月进行重复症状限制性运动RHC。ePH患者有早期肺血管疾病的证据，因为基线PAC和α降低。经肺血管扩张剂治疗后，多项峰值运动血流动力学有统计学改善，包括总肺阻力和肺血管阻力降低，心输出量增加。重要的是，血管扩张剂治疗部分逆转了重复exRHC时α的致病性降低。肺血管扩张性α是早期肺血管疾病的标志，经肺血管扩张剂治疗后ePH改善。
Exercise pulmonary hypertension (ePH) is an underappreciated form of exertional limitation. Despite normal resting pulmonary artery pressures, patients with ePH demonstrate early pulmonary vascular changes with reduced pulmonary arterial compliance (PAC) and vascular distensibility (α). Recent data suggest that targeted vasodilator therapy may improve hemodynamics in ePH, but it is not well-known whether such medications alter pulmonary vascular distensibility. Thus, we sought to evaluate if vasodilator therapy improved α a marker of early pulmonary vascular disease in ePH. Ten patients performed supine exercise right heart catheterization (exRHC) with bicycle ergometer to peak exercise. Patients diagnosed with ePH were treated with pulmonary vasodilators. A repeat symptom-limited exercise RHC was performed at least six months after therapy. Patients with ePH had evidence of early pulmonary vascular disease, as baseline PAC and α were reduced. After pulmonary vasodilator therapy, a number of peak exercise hemodynamics statistically improved, including a decrease of total pulmonary resistance and pulmonary vascular resistance, while cardiac output increased. Importantly, vasodilator therapy partially reversed the pathogenic decreases of α at the time of repeat exRHC. Pulmonary vascular distensibility, α, a marker of early pulmonary vascular disease, improves in ePH after therapy with pulmonary vasodilators.
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DOI：
10.1136/heartjnl-2017-312865
发表时间：
2018-08
期刊：
Heart (British Cardiac Society)
影响因子：
--
作者：
Hutchings DC;Anderson SG;Caldwell JL;Trafford AW
通讯作者：
Trafford AW
影响因子：
9.6
作者：
Lau, Edmund M. T.;Chemla, Denis;Herve, Philippe
通讯作者：
Herve, Philippe
DOI：
10.1152/ajplung.00256.2014
发表时间：
2014-12-01
影响因子：
4.9
作者：
Dodson, R. Blair;Morgan, Matthew R.;Abman, Steven H.
通讯作者：
Abman, Steven H.
影响因子：
2.6
作者：
Jain, Pankaj;Rao, Sriram;Keogh, Anne
通讯作者：
Keogh, Anne
影响因子：
8.3
作者：
Gomez-Arroyo, Jose;Sandoval, Julio;Bogaard, Harm J
通讯作者：
Bogaard, Harm J