Traitement de l'hypertension artérielle pulmonaire
作者： D. Montani , X. Jaïs , V. Ioos , O. Sitbon , G. Simonneau
DOI: 10.1016/J.REVMED.2004.05.007
关键词: Transplantation 、 Heart septum 、 Medicine 、 Gynecology 、 Prostaglandins I 、 Internal medicine 、 Gastroenterology
摘要: Resume Propos. – L'hypertension arterielle pulmonaire (HTAP) associe vasoconstriction, thrombose et surtout un intense remodelage des arteres pulmonaires de petit calibre a l'origine d'une obstruction fixee entrainant une elevation persistante resistances arterielles pulmonaires. Le traitement conventionnel repose sur mesures simples (limitation efforts) traitements non specifiques (anticoagulant, diuretique, oxygenotherapie). Actualites points forts. Les vasodilatateurs purs comme les antagonistes calciques entrainent peu ou pas d'effets chez la grande majorite patients, probablement parce que lesions d'arteriopathie fixees predominent vasoconstriction. La prostacycline intraveineuse (epoprostenol) recepteurs l'endotheline-1 (bosentan) possedent proprietes vasodilatatrices effet le vasculaire. L'epoprostenol transforme pronostic cette maladie constitue reference formes severes d'HTAP. bosentan interessant en premiere ligne patients classe fonctionnelle III NYHA. developpement nouveaux (antagonistes selectifs A l'endotheline, derives prostacycline, inhibiteurs phosphodiesterases type 5) ouvert nouvelles perspectives dans prise charge l'HTAP. Leur benefice reste evaluer leur place respective ces est encore definir. Nous tenterons ici presenter differentes alternatives therapeutiques disponibles l'HTAP proposer algorithme pour malades. Perspectives projets. L'amelioration future dependra partie progres comprehension physiopathologie maladie.
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elsevier.com参考文章(70)
Julio Sandoval, Jorge Gaspar, Tomás Pulido, Edgar Bautista, Maria Luisa Martínez-Guerra, Marco Zeballos, Andrés Palomar, Arturo Gómez, Graded balloon dilation atrial septostomy in severe primary pulmonary hypertension: A therapeutic alternative for patients nonresponsive to vasodilator treatment Journal of the American College of Cardiology. ,vol. 32, pp. 297- 304 ,(1998) , 10.1016/S0735-1097(98)00238-1
Kirk B Lane, Rajiv D Machado, Michael W Pauciulo, Jennifer R Thomson, John A Phillips, James E Loyd, William C Nichols, Richard C Trembath, None, Heterozygous germline mutations in BMPR2 , encoding a TGF-β receptor, cause familial primary pulmonary hypertension Nature Genetics. ,vol. 26, pp. 81- 84 ,(2000) , 10.1038/79226
GERALD SIMONNEAU, ROBYN J. BARST, NAZZARENO GALIE, ROBERT NAEIJE, STUART RICH, ROBERT C. BOURGE, ANNE KEOGH, RONALD OUDIZ, ADAANI FROST, SHELMER D. BLACKBURN, JAMES W. CROW, LEWIS J. RUBIN, Continuous subcutaneous infusion of treprostinil, a prostacyclin analogue, in patients with pulmonary arterial hypertension: a double-blind, randomized, placebo-controlled trial. American Journal of Respiratory and Critical Care Medicine. ,vol. 165, pp. 800- 804 ,(2002) , 10.1164/AJRCCM.165.6.2106079
Richard N Channick, Gérald Simonneau, Olivier Sitbon, Ivan M Robbins, Adaani Frost, Victor F Tapson, David B Badesch, Sébastien Roux, Maurizio Rainisio, Frédéric Bodin, Lewis J Rubin, Effects of the dual endothelin-receptor antagonist bosentan in patients with pulmonary hypertension: a randomised placebo-controlled study. The Lancet. ,vol. 358, pp. 1119- 1123 ,(2001) , 10.1016/S0140-6736(01)06250-X
Marc Humbert, Hilario Nunes, Olivier Sitbon, Florence Parent, Philippe Hervé, Gérald Simonneau, Risk factors for pulmonary arterial hypertension. Clinics in Chest Medicine. ,vol. 22, pp. 459- 475 ,(2001) , 10.1016/S0272-5231(05)70284-7
Lucie H. Clapp, Paul Finney, Sally Turcato, Sandy Tran, Lewis J. Rubin, Andrew Tinker, Differential Effects of Stable Prostacyclin Analogs on Smooth Muscle Proliferation and Cyclic AMP Generation in Human Pulmonary Artery American Journal of Respiratory Cell and Molecular Biology. ,vol. 26, pp. 194- 201 ,(2002) , 10.1165/AJRCMB.26.2.4695
Lewis J. Rubin, Treatment of Primary Pulmonary Hypertension with Continuous Intravenous Prostacyclin (Epoprostenol) Annals of Internal Medicine. ,vol. 112, pp. 485- 491 ,(1990) , 10.7326/0003-4819-112-7-485
Tim Higenbottam, Frank Wells, Derek Wheeldon, John Wallwork, LONG-TERM TREATMENT OF PRIMARY PULMONARY HYPERTENSION WITH CONTINUOUS INTRAVENOUS EPOPROSTENOL (PROSTACYCLIN) The Lancet. ,vol. 323, pp. 1046- 1047 ,(1984) , 10.1016/S0140-6736(84)91452-1
Marius M. Hoeper, Michael Schwarze, Stefan Ehlerding, Angelika Adler-Schuermeyer, Edda Spiekerkoetter, Jost Niedermeyer, Michael Hamm, Helmut Fabel, Long-Term Treatment of Primary Pulmonary Hypertension with Aerosolized Iloprost, a Prostacyclin Analogue The New England Journal of Medicine. ,vol. 342, pp. 1866- 1870 ,(2000) , 10.1056/NEJM200006223422503
Vallerie V. McLaughlin, Alicia Shillington, Stuart Rich, Survival in Primary Pulmonary Hypertension Circulation. ,vol. 106, pp. 1477- 1482 ,(2002) , 10.1161/01.CIR.0000029100.82385.58