Pulmonary hypertension associated with left heart disease: Updated Recommendations of the Cologne Consensus Conference 2018

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:272

Article

Rosenkranz, Stephan^1,2  Lang, Irene M.³  Blindt, Ruediger⁴  Bonderman, Diana³  Bruch, Leonhard⁵  Diller, Gerhard P.⁶  Felgendreher, Ralf⁷  Gerges, Christian³  Hohenforst-Schmidt, Wolfgang⁸  Holt, Stephan⁹  Jung, Christian¹⁰  Kindermann, Ingrid¹¹  Kramer, Tilmann^1,2  Kuebler, Wolfgang M.^12,13,14  Mitrovic, Veselin¹⁵  Riedel, Andreas¹⁶  Rieth, Andreas¹⁵  Schmeisser, Alexander¹⁷  Wachter, Rolf¹⁸  Weil, Joachim¹⁹  Opitz, Christian F.²⁰ 

[1] Univ Cologne, Herzzentrum, Innere Med Klin 3, Cologne, Germany

[2] Univ Cologne, Herzzentrum, Cologne Cardiovasc Res Ctr CCRC, Cologne, Germany

[3] Med Univ Wien, Abt Kardiol, Klin Innere Med 2, Vienna, Austria

[4] Rotes Kreuz Krankenhaus Bremen, Kardio Bremen, Bremen, Germany

[5] Unfallkrankenhaus Berlin, Klin Innere Med & Kardiol, Berlin, Germany

[6] Univ Klinikum Munster, Dept Kardiol & Angiol, Klin Angeborene EMAH & Erworbene Herzfehler, Munster, Germany

[7] Klinikum Lippe, Med Klin 2, Detmold, Germany

[8] Klinikum Furth, Klin Herz & Lungenerkrankungen, Furth, Germany

[9] Krankenhaus Bethanien, Klin Pneumol, Solingen, Germany

[10] Heinrich Heine Univ Dusseldorf, Herzzentrum, Klin Kardiol Pneumol & Angiol, Dusseldorf, Germany

[11] Univ Klinikum Saarlandes, Innere Med Klin 3, Homburg, Germany

[12] Charite, CC2, Inst Physiol, Berlin, Germany

[13] Univ Toronto, Dept Surg, Keenan Res Ctr Biomed Sci, Toronto, ON, Canada

[14] Univ Toronto, Dept Physiol, Keenan Res Ctr Biomed Sci, Toronto, ON, Canada

[15] Kerckhoff Klin, Abt Kardiol, Bad Nauheim, Germany

[16] Evangel Fachkrankenhaus Atemwegserkrankungen, Neustadt, Germany

[17] Univ Klinikum Magdeburg, Klin Kardiol Pneumol & Angiol, Magdeburg, Germany

[18] Georg August Univ Gottingen, Univ Med, Klin Kardiol & Pneumol, Gottingen, Germany

[19] Sana Klin Lubeck, CardioMed Herzzentrum, Lubeck, Germany

[20] DRK Kliniken Berlin, Schwerpunkt Kardiol, Innere Med Klin, Berlin, Germany

关键词: Pulmonary hypertension;    Left heart disease;    Heart failure;    Isolated post-capillary pulmonary hypertension (IpcPH);    Combined post- and pre-capillary pulmonary hypertension (CpcPH);   

DOI  :  10.1016/j.ijcard.2018.08.080

来源: Elsevier

【 摘 要 】

In the summer of 2016, delegates from the German Society of Cardiology (DGK), the German Respiratory Society (DGP), and the German Society of Pediatric Cardiology (DGPK) met in Cologne, Germany, to define consensus-based practice recommendations for the management of patients with pulmonary hypertension (PH). These recommendations were built on the 2015 European Pulmonary Hypertension guidelines, aiming at their practical implementation, considering country-specific issues, and including newevidence, where available. To this end, a number of working groups was initiated, one of which was specifically dedicated to PH associated with left heart disease. In this context, the European Guidelines point out that the drugs currently approved to treat patients with PAH (prostanoids, endothelin receptor antagonists, phosphodiesterase type 5 inhibitors, sGC stimulators) have not sufficiently been investigated in other forms of PH. However, despite the lack of respective efficacy data, an uncritical use of targeted PAH drugs in patients with PH associated with left heart disease is currently observed at an increasing rate. This development is a matter of concern. On the other hand, PH is a frequent problem that is highly relevant for morbidity and mortality in patients with left heart disease. In that sense, the distinction between isolated post-capillary pulmonary hypertension (IpcPH) and combined post-and pre-capillary pulmonary hypertension (CpcPH) and their proper definition may be of particular relevance. The detailed results and recommendations of the working group on PH associated with left heart disease, which were last updated in the spring of 2018, are summarized in this article. (c) 2018 Published by Elsevier B.V.

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