Pulmonale Hypertonie: Diagnostik, Klassifikation und Therapie

Lücke, Eva; Schmeißer, Alexander; Schreiber, Jens

doi:10.1055/a-0668-4642

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…Pulmonary hypertension (PH) is a pathological disorder with multiple clinical manifestations that lead to cardiovascular and respiratory diseases in most patients ( Biener et al, 2023 ). It is characterized by a mean pulmonary arterial pressure of at least 25 mmHg ( Lucke et al, 2019 ). PH can be primary or secondary to several other diseases.…”

Section: Introductionmentioning

confidence: 99%

Whole-genome microRNA sequencing analysis in patients with pulmonary hypertension

Chen,

Zhong,

et al. 2023

Front. Genet.

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Pulmonary hypertension (PH) is a pathological disorder with multiple clinical manifestations that lead to cardiovascular and respiratory diseases in most patients. Recent studies have revealed that microRNAs (miRNAs) play important roles as upstream signaling molecules in several diseases, including PH. However, miRNAs that can be used as diagnostic or prognostic biomarkers for PH have not been identified. Thus, in this study, peripheral blood samples obtained from patients with PH and healthy individuals were subjected to genome-wide miRNA sequencing and transcriptome analysis. We screened 136 differentially expressed miRNAs in patients with PH and verified that four differentially expressed miRNAs, namely, hsa-miR-1304-3p, hsa-miR-490-3p, hsa-miR-11400, and hsa-miR-31-5p, could be used as clinical diagnostic biomarkers for pulmonary arterial hypertension. Our findings provide a basis for further in-depth investigations of the specific mechanisms of miRNAs in PH.

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Section: Introductionmentioning

confidence: 99%

Whole-genome microRNA sequencing analysis in patients with pulmonary hypertension

Chen,

Zhong,

et al. 2023

Front. Genet.

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“…Bezüglich detaillierter Darstellungen der Grundlagen zur pulmonalen Hypertonie (PH) möchten wir auf den Artikel von Lücke et al in dieser Ausgabe verweisen [1]. Erforderlich für das anästhesiologische perioperative Management der Patienten mit PH sind insbesondere Kenntnisse der ▪ Ursachen, ▪ Pathophysiologie, ▪ vorausgehenden Behandlung, ▪ perioperativen Optionen des Monitorings als auch ▪ therapeutischer Interventionsmöglichkeiten.…”

Section: Introductionunclassified

Pulmonale Hypertonie: anästhesiologisches Management

Hötzel¹,

Loop²

2019

Anästhesiol Intensivmed Notfallmed Schmerzther

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ZusammenfassungDas perioperative Management von Patienten mit pulmonaler Hypertonie erfordert von den behandelnden Anästhesisten fundierte Kenntnisse über die zugrunde liegenden Ursachen, die Pathophysiologie, den Einfluss anästhesiologischer und chirurgischer Maßnahmen wie z. B. die mechanische Beatmung sowie intraoperative Behandlungsoptionen. In der präoperativen Vorbereitung gilt es, alle vorliegenden Befunde zu evaluieren, die Belastbarkeit des Patienten zu erheben und die bestehende Dauermedikation zu kennen. Die Basis für einen sicheren intraoperativen Verlauf stellt die Vermeidung einer pulmonalarteriellen Druckerhöhung und Rechtsherzdysfunktion dar. Hierbei gilt es Hypoxie, Hyperkapnie, Azidose, Hypothermie, Stress und eine koronare Hypoperfusion zu verhindern. Bei einem Anstieg des pulmonalarteriellen Drucks können sowohl inhalative, selektive pulmonale Vasodilatatoren, wie Stickstoffmonoxid oder Prostazykline, als auch intravenös Phosphodiesterase-3-Inhibitoren und Phosphodiesterase-5-Inhibitoren eingesetzt werden. Bei einer rechtsventrikulären Dysfunktion oder Dekompensation sollte mittels inotroper Substanzen und Inodilatoren die Herzfunktion unterstützt werden. Abhängig vom Ausmaß der Operation und dem Schweregrad der pulmonalen Hypertonie erfordert die postoperative Betreuung vor allem Expertise und Strukturen, die ein kontinuierliches Monitoring zulassen.

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“…PAH is a common disease characterized by increased PAP and PVR, and prolonged PAH could lead to systolic dysfunction of the right ventricle, right ventricle hypertrophy, and right ventricle dilation, thus causing right heart failure(Lücke et al, 2019). Congenital heart disease (CHD) and CTD are two main causes of PAH.…”

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confidence: 99%

Evaluation of pulmonary arterial pressure in patients with connective tissue disease‐associated pulmonary arterial hypertension by myocardial perfusion imaging

Wang

Jiao

Wang

et al. 2021

Noninvasive Electrocardiol

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Background Pulmonary arterial hypertension (PAH) is a complex and severe complication of connective tissue disease (CTD). We aimed to evaluate the application value of myocardial perfusion imaging (MPI) in evaluating CTD‐associated PAH (CTD‐PAH). Methods We retrospectively included 88 patients who were diagnosed with CTD between January 2018 and December 2020 at our hospital. Fifty‐eight patients had PAH and were included into the CTD‐PAH group. Thirty patients without PAH were included in the control group. All patients received routine physical examination, biochemical tests and cardiac function evaluation, right heart catheterization (RHC), and 99mTc‐MIBI MPI. PAH patients were divided into the mild, moderate, and severe PAH group according to their mean pulmonary artery pressures by RHC. Pearson correlation analysis was used to calculate the correlation between the right ventricle target/background (T/B) and right ventricle stroke volume (RV‐SV), total pulmonary resistance (TPR), pulmonary vascular resistance (PVR), mean pulmonary arterial pressure (mPAP), 6‐minute walk distance (6‐MWD), and N‐terminal B‐type natriuretic peptide (NT‐proBNP). The ROC curves of T/B and pulmonary artery pressure classification were plotted and the sensitivity and specificity of T/B in diagnosing PAH of different severities were analyzed. Results The analysis of correlation revealed that T/B correlated negatively with 6‐MWD and positively with NT‐proBNP and exhibited good positive correlation with mPAP, TPR, and PVR by RHC and negative correlation with RV‐SV. T/B was of the most diagnostic value for severe PAH, and its correlation with severe PAH was stronger than that with mild PAH and moderate PAH. Conclusions Target/background is a noninvasive method that can simultaneously evaluate pulmonary arterial pressure and myocardial perfusion of CTD‐CHD patients and is particularly of relatively high value for severe PAH patients.

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Pulmonale Hypertonie: Diagnostik, Klassifikation und Therapie

Cited by 3 publications

References 19 publications

Whole-genome microRNA sequencing analysis in patients with pulmonary hypertension

Whole-genome microRNA sequencing analysis in patients with pulmonary hypertension

Pulmonale Hypertonie: anästhesiologisches Management

Evaluation of pulmonary arterial pressure in patients with connective tissue disease‐associated pulmonary arterial hypertension by myocardial perfusion imaging

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