Revisión de Tema: Hipertensión Pulmonar. Una Aproximación Clínica y Terapéutica de un Problema Multicausal y Complejo
Resumen
La hipertensión pulmonar (HP) se define como una presión arterial pulmonar media (mPAP) de 20 mm Hg o más en reposo (1), confirmado por cateterismo del lado derecho del corazón. Si bien existen muchas causas para la HP, casi siempre se asocia con el deterioro de los síntomas y el aumento de la mortalidad, independientemente de la enfermedad subyacente.2La hipertensión pulmonar afecta aproximadamente al 1% de la población mundial, hasta el 10% de los mayores de 65 años y al menos al 50% de los pacientes con insuficiencia cardíaca (IC) (2). Por lo tanto, los clinicos pueden esperar encontrarse con HP en su práctica clínica. Este artículo proporciona una descripción general del diagnóstico y tratamiento de la HP.
Descargas
Citas
Simonneau G, Montani D, Celermajer DS, et al. Haemodynamic definitions and updated clinical classification of pulmonary hypertension. Eur Respir J. 2019;53(1):1801913.
Hoeper MM, Humbert M, Souza R, et al. A global view of pulmonary hypertension. Lancet Respir Med. 2016;4(4):306-322.
Galiè N, Humbert M, Vachiery J-L, et al. 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension: the Joint Task Force for the Diagnosis and Treatment of Pulmonary
Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS); Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation. (ISHLT) [published correction appears in Eur Respir J. 2015;46(6):1855-1856]. Eur Respir J. 2015;46(4):903-975.
Rose-Jones LJ, McLaughlin VV. Pulmonary hypertension: types and treatments. Curr Cardiol Rev. 2015;11(1):73-79.
Vachiéry J-L, Tedford RJ, Rosenkranz S, et al. Pulmonary hypertension due to left heart disease. Eur Respir J. 2019;53(1): 1801897.
Nathan SD, Barbera JA, Gaine SP, et al. Pulmonary hypertension in chronic lung disease and hypoxia. Eur Respir J. 2019; 53(1):1801914.
Kim NH, Delcroix M, Jais X, et al. Chronic thromboembolic pulmonary hypertension. Eur Respir J. 2019;53(1):1801915.
Boucly A, Weatherald J, Savale L, et al. Risk assessment, prognosis and guideline implementation in pulmonary arterial hypertension. Eur Respir J. 2017;50(2):1700889.
Hoeper MM, Kramer T, Pan Z, et al. Mortality in pulmonary arterial hypertension: prediction by the 2015 European pulmonary hypertension guidelines risk stratification model. Eur Respir J. 2017;50(2):1700740.
Kylhammar D, Kjellström B, Hjalmarsson C, et al. A comprehensive risk stratification at early follow-up determines prognosis in pulmonary arterial hypertension. Eur Heart J. 2018;39(47):4175-4181.
Benza RL, Gomberg-Maitland M, Elliott CG, et al. Predicting survival in patients with pulmonary arterial hypertension: the REVEAL risk score calculator 2.0 and comparison with ESC/ERS-based risk
assessment strategies. Chest. 2019;156(2):323-337.
Galiè N, Channick RN, Frantz RP, et al. Risk stratification and medical therapy of pulmonary arterial hypertension. Eur Respir J. 2019;53(1):1801889.
Farber HW, Gibbs S. Under pressure: pulmonary hypertension associated with left heart disease. Eur Respir Rev. 2015;24(138): 665-673.
Hirashiki A, Kondo T, Murohara T. The roles of classic and current prognostic factors in pulmonary hypertension due to left heart disease [editorial]. Circ J. 2016;80(1):72-73.
Rose L, Prins KW, Archer SL, et al. Survival in pulmonary hypertension due to chronic lung disease: influence of low diffusion capacity of the lungs for carbon monoxide. J Heart Lung Transplant. 2019;38(2):145-155.
Westerhof BE, Saouti N, van der Laarse WJ, Westerhof N, Vonk Noordegraaf A. Treatment strategies for the right heart in pulmonary hypertension. Cardiovasc Res. 2017;113(12): 1465-1473.
Adusumalli S, Mazurek JA. Pulmonary hypertension due to left ventricular cardiomyopathy: is it the result or cause of disease progression? Curr Heart Fail Rep. 2017;14(6):507-513.
Hoeper MM, Granton J. Intensive care unit management of patients with severe pulmonary hypertension and right heart failure. Am J Respir Crit Care Med. 2011;184(10):1114-1124.
Vonk Noordegraaf A, Chin KM, Haddad F, et al. Pathophysiology of the right ventricle and of the pulmonary circulation in pulmonary hypertension: an update. Eur Respir J. 2019;53(1):1801900.
Frost A, Badesch D, Gibbs JSR, et al. Diagnosis of pulmonary hypertension. Eur Respir J. 2019;53(1):1801904.
Reddy YNV, Carter RE, Obokata M, Redfield MM, Borlaug BA. A simple, evidence-based approach to help guide diagnosis of heart failure with preserved ejection fraction. Circulation. 2018; 138(9):861-870.
Cordina RL, Playford D, Lang I, Celermajer DS. State-of-the-art review: echocardiography in pulmonary hypertension. Heart Lung Circ. 2019;28(9):1351-1364.
Opotowsky AR, Ojeda J, Rogers F, et al. A simple echocardiographic prediction rule for hemodynamics in pulmonary hypertension. Circ Cardiovasc Imaging. 2012;5(6):765-775.
Agrawal V, Byrd BF III, Brittain EL. Echocardiographic evaluation of diastolic function in the setting of pulmonary hypertension. Pulm Circ. 2019;9(1):2045894019826043.
Grapsa J, Pereira Nunes MC, Tan TC, et al. Echocardiographic and hemodynamic predictors of survival in precapillary pulmonary hypertension: seven-year follow-up. Circ Cardiovasc Imaging. 2015;8(6):e002107.
Mazurek JA, Vaidya A, Mathai SC, Roberts JD, Forfia PR. Follow-up tricuspid annular plane systolic excursion predicts survival in pulmonary arterial hypertension. Pulm Circ. 2017; 7(2):361-371.
Hoeper MM, Benza RL, Corris P, et al. Intensive care, right ventricular support and lung transplantation in patients with pulmonary hypertension. Eur Respir J. 2019;53(1):1801906.
Humbert M, Ghofrani H-A. The molecular targets of approved treatments for pulmonary arterial hypertension. Thorax. 2016; 71(1):73-83.
Galié N, Manes A, Branzi A. The endothelin system in pulmonary arterial hypertension. Cardiovasc Res. 2004;61(2):227-237.
Klinger JR, Elliott CG, Levine DJ, et al. Therapy for pulmonary arterial hypertension in adults: update of the CHEST guideline and expert panel report. Chest. 2019;155(3):565-586.
Raza F, Vaidya A, Lacharite-Roberge A-S, et al. Initial clinical and hemodynamic results of a regional pulmonary thromboendarterectomy program. J Cardiovasc Surg (Torino). 2018;59(3): 428-437.
Elwing JM, Vaidya A, Auger WR. Chronic thromboembolic pulmonary hypertension: an update. Clin Chest Med. 2018;39(3): 605-620.
Ghofrani H-A, Simonneau G, D’Armini AM, et al; MERIT Study Investigators. Macitentan for the treatment of inoperable chronic thromboembolic pulmonary hypertension (MERIT-1): results from the multicentre, phase 2, randomised, double-blind, placebo-controlled study. Lancet Respir Med. 2017;5(10):785-794.
Howard LS, Ghofrani HA, D’Armini AM, et al. Long-term safety, tolerability and efficacy of macitentan in patients with inoperable chronic thromboembolic pulmonary hypertension: the MERIT-1 study and its open-label extension MERIT-2 [abstract]. Am J Respir Crit Care Med. 2020;201:A6068.
Silva Herrera , G. A. (2023). La Influencia de las Redes Sociales en el Sistema Judicial. Estudios Y Perspectivas Revista Científica Y Académica , 2(1), 1-26. https://doi.org/10.61384/r.c.a.v2i1.7
García Pérez , M., & Rodríguez López, C. (2022). Factores Asociados a la Obesidad y su Impacto en la Salud: un Estudio de Factores Dietéticos, de Actividad Física y Sociodemográficos. Revista Científica De Salud Y Desarrollo Humano, 3(2), 01-15. https://doi.org/10.61368/r.s.d.h.v3i2.31
Ruíz Ledesma, E. F., Córdova Pérez., C., & Montiel Sánchez, A. S. (2023). Errores comunes en estudiantes universitarios al trabajar con la integral definida. Emergentes - Revista Científica, 3(2), 21-31. https://doi.org/10.60112/erc.v3i2.29
Rivera, M., & Pérez, C. (2023). Factores Asociados a la Obesidad y su Impacto en la Salud: Un Estudio de Factores Dietéticos, de Actividad Física y Sociodemográficos. Sapiencia Revista Científica Y Académica , 3(2), 145-160. https://doi.org/10.61598/s.r.c.a.v3i2.59
European Commission. (2023). Ethical Guidelines on the Use of Artificial Intelligence (AI) and Data in Teaching and Learning for Educators. Available online: https://op.europa.eu/en/publication-detail/-/publication/d81a0d54-5348-11ed-92ed-01aa75ed71a1/language-en (accessed on 18 November 2023)
Derechos de autor 2024 Juan Sebastián Theran León, María Paula Meléndez Pedraza , Jeisson Andrés Niño Pedraza , Neider Juliano Medina Medina , Miguel Angel Duran Patiño, Jessica Andrea Echeverría López, Stephany Yulieth Vergara Vega , Juan Anthony Orozco Rivero, Edinson Rafael Zapata Campo
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.