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Возможности инвазивной диагностики при легочной гипертензии
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Аннотация
Инвазивная диагностика легочной гипертензии (ЛГ) является динамично развивающейся отраслью практической медицины. Технические подходы к изучению ЛГ совершенствуются параллельно с выявлением новых форм заболевания, а получаемые при инвазивной диагностике данные являются основой классификации ЛГ. Будучи «золотым стандартом» выявления ЛГ и анализа эффективности терапии, инвазивная диагностика позволяет внедрять в клиническую практику все новые и новые высокочувствительные неинвазивные методы инструментального и лабораторного обследования. Это становится особенно актуальным в последнее время, когда исследуются и затем рекомендуются к применению целые группы качественно новых медикаментозных препаратов для лечения ЛГ.
Ключевые слова: легочная гипертензия, катетеризация правых отделов сердца, острые фармакологические пробы.
Ключевые слова: легочная гипертензия, катетеризация правых отделов сердца, острые фармакологические пробы.
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The invasive diagnostic of pulmonary hypertension (PH) is dynamically developing branch of applied medicine. Technical approaches to studying PH are improved in parallel with revealing of new forms disease. Received at invasive diagnostic data are basis of classification PH. Invasive diagnostic to introduce new high-sensitivity noninvasive diagnostic methods to clinical practice. But it remains «the gold standard» revealing PH and the analysis of therapy efficiency. It’s very actual for research of new drugs for treatment of PH.
Keywords: pulmonary hypertension, catheterization of right ventricular, acute pharmacological tests
Полный текст
Список литературы
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3. Г.Е. Ройтберг, А.В. Стурынский. Внутренние болезни. Сердечно- сосудистая система. М., 2003.
4. Kovacs G, Berghold A, Scheidl S, Olschewski H. Pulmonary arterial pressure during rest and exercise in healthy control subjects: a systematic review. Eur Respir J 2009 Mar 26.
5. Galie N, Torbicki A, Barst R et al. Guidelines on diagnosis and treatment of pulmonary arterial hypertension. The Task Force on Diagnosis and Treatment of Pulmonary Arterial Hypertension of the European Society of Cardiology. Eur Heart J 2004; 25: 2243–78.
6. Rubin LJ. Diagnosis and management of pulmonary arterial hypertension: ACCP evidence-based clinical practice guidelines. Chest 2004; 126: 7S–10S.
7. D?Alonzo GE, Barst RJ, Ayeres SM et al. Survival in patients with primary pulmonary hypertension: results from a national prospective registry. Ann Intern Med 1991; 115: 343–9.
8. Sandoval J, Bauerle O, Palomar A et al. Survival in primary pulmonary hypertension: validation of a prognostic equation. Circulation 1994; 89: 1733–44.
9. Appelbaum L, Yigla M, Bendayan D et al. Primary pulmonary hypertension in Israel: a national survey. Chest 2001; 119: 1801–6. Rajasekhar D, Balakrishnan KG, Venkitachalam CG et al. Primary pulmonary hypertension: natural history and prognostic factors. Indian Heart J 1994; 46: 165–70.
10. McLaughlin VV, Shillington A, Rich S. Survival in primary pulmonary hypertension: the impact of epoprostenol therapy.Circulation 2002; 106: 1477–82.
11. Sitbon O, Humbert M, Jais X et al. Long-term response to calcium channel blockers in idiopathic pulmonary arterial hypertension. Circulation 2005; 111: 3105–11.
12. Morales-Blanhir J, Santos S, de Jover L et al. Clinical value of vasodilator test with inhaled nitric oxide for predicting long-term response to oral vasodilators in pulmonary hypertension. Respir Med 2004; 98: 225–34.
13. Rubin LJ, Groves BM, Reeves JT et al. Prostacyclin-induced acute pulmonary vasodilation in primary pulmonary hypertension. Circulation 1982; 66: 334–8.
14. Schrader BJ, Inbar S, Kaufmann L et al. Comparison of the effects of adenosine and nifedipine in pulmonary hypertension. J Am Coll Cardiol. 1992; 19: 1060–4.
15. Pepke-Zaba J, Higenbottam TW, Dinh’Xuan AT et al. Inhaled nitric oxide as a cause of selective pulmonary vasodilatation in pulmonary hypertension. Lancet 1991; 338: 1173–4.
16. Badesch DB, Abman SH, Simonneau G et al. Medical therapy for pulmonary arterial hypertension: updated ACCP evidence-based clinical practice guidelines. Chest 2007; 131: 1917–28.
17. Hemnes AR, Forfia PR, Champion HC. Assessment of pulmonary vasculature and right heart by invasive haemodynamics and echocardiography. Int J Clin Pract, 2009; 63 (Suppl. 162): 4–19.
18. Doyle RL, McCrory D, Channick RN et al. Gerald Simonneau and John Conte. Surgical Treatments/Interventions for Pulmonary Arterial Hypertension. Chest 2004; 126; 63S–71S.
19. Hoeper MM, Lee SH, Voswinckel R et al. Complications of right heart catheterization procedures in patients with pulmonary hypertension in experienced centers. J Am Coll Cardiol 2006; 48: 2546–52.
20. Ю.Н.Беленков, И.Е.Чазова. Первичная легочная гипертензия. М.: Нолидж, 1999.
21. Domingo E, Aguilar R, Lopez-Meseguer M et al. New Concepts in the Invasive and Non Invasive Evaluation of Remodelling of the Right Ventricle and Pulmonary Vasculature in Pulmonary Arterial Hypertension. The Open Respirat Med J 2009; 3: 31–7.
22. Javed U, Balasubramanian V, Wessel RJ et al. Correlation of right ventricular tissue doppler imaging with invasive hemodynamics in pulmonary hypertension. Chest 2009; Nov. Abstract.
2. Hoeper MM, Maier R, Tongers J, et al. Determination of cardiac output by the Fick method, thermodilution, and acetylene rebreathing in pulmonary hypertension. Am J Respir Crit Care Med 1999; 160: 535–41.
3. Г.Е. Ройтберг, А.В. Стурынский. Внутренние болезни. Сердечно- сосудистая система. М., 2003.
4. Kovacs G, Berghold A, Scheidl S, Olschewski H. Pulmonary arterial pressure during rest and exercise in healthy control subjects: a systematic review. Eur Respir J 2009 Mar 26.
5. Galie N, Torbicki A, Barst R et al. Guidelines on diagnosis and treatment of pulmonary arterial hypertension. The Task Force on Diagnosis and Treatment of Pulmonary Arterial Hypertension of the European Society of Cardiology. Eur Heart J 2004; 25: 2243–78.
6. Rubin LJ. Diagnosis and management of pulmonary arterial hypertension: ACCP evidence-based clinical practice guidelines. Chest 2004; 126: 7S–10S.
7. D?Alonzo GE, Barst RJ, Ayeres SM et al. Survival in patients with primary pulmonary hypertension: results from a national prospective registry. Ann Intern Med 1991; 115: 343–9.
8. Sandoval J, Bauerle O, Palomar A et al. Survival in primary pulmonary hypertension: validation of a prognostic equation. Circulation 1994; 89: 1733–44.
9. Appelbaum L, Yigla M, Bendayan D et al. Primary pulmonary hypertension in Israel: a national survey. Chest 2001; 119: 1801–6. Rajasekhar D, Balakrishnan KG, Venkitachalam CG et al. Primary pulmonary hypertension: natural history and prognostic factors. Indian Heart J 1994; 46: 165–70.
10. McLaughlin VV, Shillington A, Rich S. Survival in primary pulmonary hypertension: the impact of epoprostenol therapy.Circulation 2002; 106: 1477–82.
11. Sitbon O, Humbert M, Jais X et al. Long-term response to calcium channel blockers in idiopathic pulmonary arterial hypertension. Circulation 2005; 111: 3105–11.
12. Morales-Blanhir J, Santos S, de Jover L et al. Clinical value of vasodilator test with inhaled nitric oxide for predicting long-term response to oral vasodilators in pulmonary hypertension. Respir Med 2004; 98: 225–34.
13. Rubin LJ, Groves BM, Reeves JT et al. Prostacyclin-induced acute pulmonary vasodilation in primary pulmonary hypertension. Circulation 1982; 66: 334–8.
14. Schrader BJ, Inbar S, Kaufmann L et al. Comparison of the effects of adenosine and nifedipine in pulmonary hypertension. J Am Coll Cardiol. 1992; 19: 1060–4.
15. Pepke-Zaba J, Higenbottam TW, Dinh’Xuan AT et al. Inhaled nitric oxide as a cause of selective pulmonary vasodilatation in pulmonary hypertension. Lancet 1991; 338: 1173–4.
16. Badesch DB, Abman SH, Simonneau G et al. Medical therapy for pulmonary arterial hypertension: updated ACCP evidence-based clinical practice guidelines. Chest 2007; 131: 1917–28.
17. Hemnes AR, Forfia PR, Champion HC. Assessment of pulmonary vasculature and right heart by invasive haemodynamics and echocardiography. Int J Clin Pract, 2009; 63 (Suppl. 162): 4–19.
18. Doyle RL, McCrory D, Channick RN et al. Gerald Simonneau and John Conte. Surgical Treatments/Interventions for Pulmonary Arterial Hypertension. Chest 2004; 126; 63S–71S.
19. Hoeper MM, Lee SH, Voswinckel R et al. Complications of right heart catheterization procedures in patients with pulmonary hypertension in experienced centers. J Am Coll Cardiol 2006; 48: 2546–52.
20. Ю.Н.Беленков, И.Е.Чазова. Первичная легочная гипертензия. М.: Нолидж, 1999.
21. Domingo E, Aguilar R, Lopez-Meseguer M et al. New Concepts in the Invasive and Non Invasive Evaluation of Remodelling of the Right Ventricle and Pulmonary Vasculature in Pulmonary Arterial Hypertension. The Open Respirat Med J 2009; 3: 31–7.
22. Javed U, Balasubramanian V, Wessel RJ et al. Correlation of right ventricular tissue doppler imaging with invasive hemodynamics in pulmonary hypertension. Chest 2009; Nov. Abstract.
Авторы
Н.М.Данилов, И.Е.Чазова
ФГУ РКНПК Минзравсоцразвития
ФГУ РКНПК Минзравсоцразвития
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N.M.Danilov, I.E.Chazova
FSI Russian cardiology scientific and production complex, Moscow
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