Current status of long-term prognosis among all subtypes of pulmonary hypertension in Japan
Current status of long-term prognosis among all subtypes of pulmonary hypertension in Japan
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DOI：
10.1016/j.ijcard.2019.11.139
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发表时间：
2020-02-01
影响因子：
3.5
通讯作者：
Shimokawa, Hiroaki
中科院分区：
文献类型：
--
作者：
Kozu, Katsuya;Sugimura, Koichiro;Shimokawa, Hiroaki
背景：在目前日本治疗肺动脉高压(PH)的时代，由于医疗保险制度，联合疗法已被频繁使用。此外，肺血管球囊成形术(BPA)被广泛用于治疗慢性血栓栓塞性PH(CTEPH)。方法：为了阐明新时代下所有五种PH亚型的长期预后和预后因素，我们调查了日本肺循环学会2012年11月至2016年4月在多中心登记的PH的治疗现状。结果：在日本20个PH中心连续登记的1253例患者中，我们分析了997例经右心插管平均肺动脉压<25 mm Hg的患者。肺动脉高压(PAH)患者的5年无移植存活率。PH由左心疾病引起，PH由肺部疾病引起。CTEPH、69.3、63.7、92.0和55.3%。值得注意的是，32%的PAH患者接受双重联合治疗，42%的患者接受三联治疗，66%的CTEPH患者接受双酚A治疗。虽然三联疗法治疗的PAH患者的血流动力学指标较其他药物治疗差，但三联疗法预后最好。结论：在日本目前的PH治疗时代，本研究中PAH的5年无移植生存率为74%，CTEPH的5年无移植生存率为92%，这可能与PAH的积极联合药物治疗和更高的CTEPH的有效率有关。(C)2019爱思唯尔B.V.保留所有权利。
Background: In the current era of treatment of pulmonary hypertension (PH) in Japan, combination therapy has been frequently used thanks to the medical insurance system. Additionally, pulmonary balloon angioplasty (BPA) is widely performed for chronic thromboembolic PH (CTEPH).Methods: To elucidate the long-term prognosis and the prognostic factors among all five subtypes of PH in this new era, we examined the current status of management of PH from November 2012 to April 2016 in the multicenter registry by the Japanese Pulmonary Circulation Society.Results: Among 1253 consecutive patients registered from 20 PH centers in Japan, we analyzed 997 patients with mean pulmonary arterial pressure >= 25 mmHg by right heart catheterization. Transplant-free survival at 5 years in pulmonary arterial hypertension (PAH). PH due to left-heart disease, PH due to lung diseases. CTEPH, and miscellaneous PH were 74.0, 69.3, 63.7, 92.0, and 55.3%, respectively. Of note, 32% of PAH patients were treated with double combination therapy and 42% of those with triple combination therapy, and 66% of CTEPH patients with BPA. Although PAH patients with triple combination therapy had worse hemodynamic parameters than those with other medications, triple combination therapy showed the best prognosis. BPA in (MPH improved survival even when adjusted for the key background factors.Conclusions: In the current era of PH treatment in Japan, the five-year transplant-free survival rate in this study was 74% for PAH and 92% for CTEPH, in which active combination medical therapy for PAH and higher performance rate of BPA for CTEPH may be involved. (C) 2019 Elsevier B.V. All rights reserved.