Uncertainties in the diagnosis and treatment of pulmonary arterial hypertension
Uncertainties in the diagnosis and treatment of pulmonary arterial hypertension
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DOI：
10.1161/circulationaha.106.674002
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发表时间：
2008-09-09
期刊：
影响因子：
37.8
通讯作者：
Rich, Stuart
中科院分区：
文献类型：
--
作者：
Ghofrani, Hossein A.;Wilkins, Martin W.;Rich, Stuart
肺动脉高压患者新疗法的出现提高了医学界对肺血管疾病的认识和兴趣。然而，肺动脉高压患者的诊断和治疗存在许多不确定性，尤其是与特发性肺动脉高压和与基础疾病相关的肺动脉高压患者的治疗相关。这篇综述强调了围绕肺动脉高压的定义和诊断、血流动力学变量的解释以及对慢性治疗的临床反应的解释等有争议的问题。此外，我们提出了适用于进行肺动脉高压新治疗试验的指南，旨在为目前正在开发的新治疗方法的有效性和安全性提供更大的信心。
The availability of new treatments for patients with pulmonary arterial hypertension has increased awareness and interest in the medical community for pulmonary vascular diseases in general. Many uncertainties exist, however, regarding the diagnosis and treatment of patients with pulmonary arterial hypertension that are particularly pertinent for the management of patients with idiopathic pulmonary arterial hypertension and pulmonary hypertension associated with underlying diseases. This review highlights controversial issues around the definition and diagnosis of pulmonary hypertension, the interpretation of hemodynamic variables, and the interpretation of clinical responsiveness to chronic therapies. In addition, we propose guidelines applicable to the conduct of new therapeutic trials in pulmonary arterial hypertension, which aim to provide greater confidence in the efficacy and safety of new treatments currently under development.