International Corner: Multidisciplinary Research

Advances in Pulmonary Hypertension

¹ 

关键词: Psychosocial Issues;    Nursing;    Social Work;    Qualityof Life;    nitric oxide;    endothelial dysfunction;    patient-reported outcomes;    CAMPHOR;    Education;    CME;    CEU;    Classification;   

DOI  :  

学科分类：医学（综合）

来源: Pulmonary Hypertension Association

【 摘 要 】

The natural history of patients with primary pulmonary hypertension is a sobering 34% survival at 5 years.4 Though a regression equation has been derived to give prognostic information based on baseline hemodynamic variables (right atrial pressure, mean pulmonary artery pressure, and cardiac index), new medical therapeutics including calcium channel blockers,5 anticoagulation,5,6 prostacyclins,7-11 and anti-endothelins12 can alter prognosis significantly. Despite the lack of a predictive model, some guidelines are available.13-16 All patients who are NYHA class III and IV with refractory right ventricular failure on presentation should be referred for transplantation.17 Further, those who continue to have progressive right ventricular failure while on maximal medical therapy should also be referred at that time.18 Recent evidence from a prospective observational study19 demonstrates that patients on intravenous epoprostenol therapy and at first follow-up NYHA functional class has not improved to class I or II should be listed because their mortality at 3 years was 38% and 100% for NYHA class III and IV, respectively. Patients with NYHA class I and II limitation will likely have better survival on state-of-the-art medical therapy and referral should be deferred. However, patient characteristics with respect to blood type, size, and panel reactive antibodies should also be taken into account as these factors can significantly prolong time on the waiting list.

【 授权许可】

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