Intersection of Pulmonary Hypertension and Right Ventricular Dysfunction in Patients on Left Ventricular Assist Device Support Is There a Role for Pulmonary Vasodilators?

被引：31

作者：

Sparrow, Christopher T. ^{[1
]}

LaRue, Shane J. ^{[1
]}

Schilling, Joel D. ^{[1
,2
]}

机构：

[1] Washington Univ, Sch Med, Div Cardiol, Dept Med, St Louis, MO 63110 USA

[2] Washington Univ, Sch Med, Dept Pathol & Immunol, St Louis, MO 63110 USA

来源：

CIRCULATION-HEART FAILURE | 2018年 / 11卷 / 01期

关键词：

heart failure; heart-assist devices; humans; hypertension; pulmonary; quality of life; CHRONIC HEART-FAILURE; LUNG TRANSPLANTATION GUIDELINES; PRESERVED EJECTION FRACTION; ETA-RECEPTOR BLOCKADE; ARTERY PRESSURE; PHOSPHODIESTERASE-5; INHIBITION; INTERNATIONAL SOCIETY; DOUBLE-BLIND; EXERCISE CAPACITY; CLINICAL-OUTCOMES;

D O I：

10.1161/CIRCHEARTFAILURE.117.004255

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Left ventricular assist devices (LVADs) improve survival and quality of life in patients with advanced heart failure. Despite these benefits, combined post- and precapillary pulmonary hypertension can be particularly problematic in patients on LVAD support, often exacerbating right ventricular (RV) dysfunction. Both persistently elevated pulmonary vascular resistance and RV dysfunction are associated with adverse outcomes, including death after LVAD. These observations have led to significant interest in the use of pulmonary vasodilators to treat pulmonary hypertension and preserve RV function among LVAD-supported patients. Although pulmonary vasodilators are commonly used for the treatment of pulmonary hypertension and RV dysfunction in LVADs, the benefits of this practice remain unclear. The purpose of this review is to highlight the current challenges in managing pulmonary vascular disease and RV dysfunction in patients with heart failure on LVAD support.

引用

页数：10

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