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终末期心力衰竭合并可逆性肺动脉高压患者心脏移植指征的探讨

郑珊珊 刘盛

郑珊珊, 刘盛. 终末期心力衰竭合并可逆性肺动脉高压患者心脏移植指征的探讨[J]. 器官移植, 2021, 12(2): 239-243. doi: 10.3969/j.issn.1674-7445.2021.02.017
引用本文: 郑珊珊, 刘盛. 终末期心力衰竭合并可逆性肺动脉高压患者心脏移植指征的探讨[J]. 器官移植, 2021, 12(2): 239-243. doi: 10.3969/j.issn.1674-7445.2021.02.017
Zheng Shanshan, Liu Sheng. Discussion on heart transplantation indications in patients with end-stage heart failure complicated with reversible pulmonary artery hypertension[J]. ORGAN TRANSPLANTATION, 2021, 12(2): 239-243. doi: 10.3969/j.issn.1674-7445.2021.02.017
Citation: Zheng Shanshan, Liu Sheng. Discussion on heart transplantation indications in patients with end-stage heart failure complicated with reversible pulmonary artery hypertension[J]. ORGAN TRANSPLANTATION, 2021, 12(2): 239-243. doi: 10.3969/j.issn.1674-7445.2021.02.017

终末期心力衰竭合并可逆性肺动脉高压患者心脏移植指征的探讨

doi: 10.3969/j.issn.1674-7445.2021.02.017
基金项目: 

国家重点研发计划项目 2016YFC1300900

详细信息
    作者简介:

    郑珊珊,女,1995年生,博士研究生,研究方向为心脏移植,Email: zhengshanshan1122@163.com

    通讯作者:

    刘盛,男,1975年生,博士,主任医师,研究方向为心脏移植、慢性血栓栓塞性肺动脉高压、心脏瓣膜病等,Email: liusheng1999@msn.com

  • 中图分类号: R617, R563

Discussion on heart transplantation indications in patients with end-stage heart failure complicated with reversible pulmonary artery hypertension

More Information
  • 摘要: 心脏移植是挽救终末期心力衰竭患者生命并改善其生活质量的方法,但并非所有的终末期心力衰竭患者都适合心脏移植。肺动脉高压作为终末期心力衰竭的常见并发症,可能会增加心脏移植术后右心衰竭的发生率,其与心脏移植术后受者的早期和晚期死亡风险相关。在临床实践中,不同移植中心对终末期心力衰竭合并肺动脉高压患者心脏移植指征的评判标准不一。术前正确地评估手术指征是决定心脏移植能否成功的重要因素。本文综述了肺动脉高压的定义、病因及其对心脏移植的影响、诊断方法及其可逆性的判断,可逆性肺动脉高压的诊断性治疗及终末期心力衰竭合并可逆性肺动脉高压患者心脏移植指征。
  • [1] CRAWFORD TC, LEARY PJ, FRASER CD 3RD, et al. Impact of the new pulmonary hypertension definition on heart transplant outcomes: expanding the hemodynamic risk profile[J]. Chest, 2020, 157(1): 151-161. DOI: 10.1016/j.chest.2019.07.028.
    [2] GALIÈ N, HUMBERT M, VACHIERY JL, et al. 2015 ESC/ERS guidelines for the diagnosis and treatment of pulmonary hypertension[J]. Rev Esp Cardiol (Engl Ed), 2016, 69(2): 177. DOI: 10.1016/j.rec.2016.01.002.
    [3] MEHRA MR, KOBASHIGAWA J, STARLING R, et al. Listing criteria for heart transplantation: International Society for Heart and Lung Transplantation guidelines for the care of cardiac transplant candidates--2006[J]. J Heart Lung Transplant, 2006, 25(9): 1024-1042. DOI: 10.1016/j.healun.2006.06.008.
    [4] MEHRA MR, CANTER CE, HANNAN MM, et al. The 2016 International Society for Heart Lung Transplantation listing criteria for heart transplantation: a 10-year update[J]. J Heart Lung Transplant, 2016, 35(1): 1-23. DOI: 10.1016/j.healun.2015.10.023.
    [5] 中华医学会器官移植学分会. 中国心脏移植受者术前评估与准备技术规范(2019版)[J/CD]. 中华移植杂志(电子版), 2019, 13(1): 1-7. DOI: 10.3877/cma.j.issn.1674-3903.2019.01.001

    Branch of Organ Transplantation of Chinese Medical Association. Technical specifications for preoperative evaluation and preparation for heart transplant recipients in China (2019 edition)[J/CD]. Chin J Transplant (Electr Edit), 2019, 13(1): 1-7. DOI: 10.3877/cma.j.issn.1674-3903.2019.01.001.
    [6] 陈军, 魏翔. 合并肺动脉高压的心脏移植[J]. 临床外科杂志, 2018, 26(12): 896-899. DOI: 10.3969/j.issn.1005-6483.2018.12.002.

    CHEN J, WEI X. Heart transplantation with pulmonary hypertension[J]. J Clin Surg, 2018, 26(12): 896-899. DOI: 10.3969/j.issn.1005-6483.2018.12.002.
    [7] MARTENS P, BELIËN H, DUPONT M, et al. The reverse remodeling response to sacubitril/valsartan therapy in heart failure with reduced ejection fraction[J]. Cardiovasc Ther, 2018, 36(4): e12435. DOI: 10.1111/1755-5922.12435.
    [8] STRONG C, RAPOSO L, CASTRO M, et al. Haemodynamic effects and potential clinical implications of inhaled nitric oxide during right heart catheterization in heart transplant candidates[J]. ESC Heart Fail, 2020, 7(2): 673-681. DOI: 10.1002/ehf2.12639.
    [9] DELGADO JF, CONDE E, SÁNCHEZ V, et al. Pulmonary vascular remodeling in pulmonary hypertension due to chronic heart failure[J]. Eur J Heart Fail, 2005, 7(6): 1011-1016. DOI: 10.1016/j.ejheart.2004.10.021.
    [10] KONSTAM MA, KIERNAN MS, BERNSTEIN D, et al. Evaluation and management of right-sided heart failure: a scientific statement from the American Heart Association[J]. Circulation, 2018, 137(20): e578-e622. DOI: 10.1161/CIR.0000000000000560.
    [11] SCARDULLA F, BELLAVIA D, VITULO P, et al. Biomechanical determinants of right ventricular failure in pulmonary hypertension[J]. ASAIO J, 2018, 64(4): 557-564. DOI: 10.1097/MAT.0000000000000683.
    [12] 陈伟, 姜桢. 可逆性肺高压在行原位心脏移植术中的危险性分析[J]. 复旦学报(医学版), 2006, 33(5): 635-638. DOI: 10.3969/j.issn.1672-8467.2006.05.015.

    CHEN W, JIANG Z. Retrospective study on risk factors of reversible pulmonary hypertension in heart transplantation recipients[J]. Fudan Univ J Med Sci, 2006, 33(5): 635-638. DOI: 10.3969/j.issn.1672-8467.2006.05.015.
    [13] RIVINIUS R, HELMSCHROTT M, RUHPARWAR A, et al. Elevated pre-transplant pulmonary vascular resistance is associated with early post-transplant atrial fibrillation and mortality[J]. ESC Heart Fail, 2020, 7(1): 176-187. DOI: 10.1002/ehf2.12549.
    [14] BOUCLY A, WEATHERALD J, SAVALE L, et al. Risk assessment, prognosis and guideline implementation in pulmonary arterial hypertension[J]. Eur Respir J, 2017, 50(2): 1700889. DOI: 10.1183/13993003.00889-2017.
    [15] KRISHNAMURTHY Y, COOPER LB, LU D, et al. Trends and outcomes of patients with adult congenital heart disease and pulmonary hypertension listed for orthotopic heart transplantation in the United States[J]. J Heart Lung Transplant, 2016, 35(5): 619-624. DOI: 10.1016/j.healun.2015.12.017.
    [16] CANTERO-PÉREZ EM, SAYAGO I, SOBRINO-MÁRQUEZ JM, et al. Impact of preoperative pulmonary hypertension on survival in patients undergoing elective heart transplant[J]. Transplant Proc, 2020, 52(2): 580-583. DOI: 10.1016/j.transproceed.2019.11.034.
    [17] TRUBY LK, DEROO S, SPELLMAN J, et al. Management of primary graft failure after heart transplantation: preoperative risks, perioperative events, and postoperative decisions[J]. Clin Transplant, 2019, 33(6): e13557. DOI: 10.1111/ctr.13557.
    [18] BUTLER J, STANKEWICZ MA, WU J, et al. Pre-transplant reversible pulmonary hypertension predicts higher risk for mortality after cardiac transplantation[J]. J Heart Lung Transplant, 2005, 24(2): 170-177. DOI: 10.1016/j.healun.2003.09.045.
    [19] SCHUMER EM, GALLO M, ROGERS MP, et al. The development of pulmonary hypertension results in decreased post-transplant survival[J]. ASAIO J, 2018, 64(4): 508-514. DOI: 10.1097/MAT.0000000000000682.
    [20] KURZYNA M, ARASZKIEWICZ A, BŁASZCZAK P, et al. Summary of recommendations for the haemodynamic and angiographic assessment of the pulmonary circulation. joint statement of the Polish Cardiac Society's Working Group on Pulmonary Circulation and Association of Cardiovascular Interventions[J]. Kardiol Pol, 2015, 73(1): 63-68. DOI: 10.5603/KP.2015.0011.
    [21] 肖丹, 张毅, 徐大春, 等. 左心功能不全继发的肺动脉高压[J]. 现代生物医学进展, 2013, 13(34): 6781-6785.

    XIAO D, ZHANG Y, XU DC, et al. Pulmonary hypertension secondary to left heart dysfunction: a review[J]. Prog Mod Biomed, 2013, 13(34): 6781-6785.
    [22] SELIM AM, WADHWANI L, BURDORF A, et al. Left ventricular assist devices in pulmonary hypertension group 2 with significantly elevated pulmonary vascular resistance: a bridge to cure[J]. Heart Lung Circ, 2019, 28(6): 946-952. DOI: 10.1016/j.hlc.2018.04.299.
    [23] MOAYEDIFAR R, ZUCKERMANN A, ALIABADI-ZUCKERMANN A, et al. Long-term heart transplant outcomes after lowering fixed pulmonary hypertension using left ventricular assist devices[J]. Eur J Cardiothorac Surg, 2018, 54(6): 1116-1121. DOI: 10.1093/ejcts/ezy214.
    [24] ANDO M, TAKAYAMA H, KURLANSKY PA, et al. Effect of pulmonary hypertension on transplant outcomes in patients with ventricular assist devices[J]. Ann Thorac Surg, 2020, 110(1): 158-164. DOI: 10.1016/j.athoracsur.2019.09.095.
    [25] KETTNER J, DORAZILOVÁ Z, NETUKA I, et al. Is severe pulmonary hypertension a contraindication for orthotopic heart transplantation? not any more[J]. Physiol Res, 2011, 60(5): 769-775. DOI: 10.33549/physiolres.932158.
    [26] SULTAN S, TSENG S, STANZIOLA AA, et al. Pulmonary hypertension: the role of lung transplantation[J]. Heart Fail Clin, 2018, 14(3): 327-331. DOI: 10.1016/j.hfc.2018.02.007.
    [27] AMMIRATI E, OLIVA F, CANNATA A, et al. Current indications for heart transplantation and left ventricular assist device: a practical point of view[J]. Eur J Intern Med, 2014, 25(5): 422-429. DOI: 10.1016/j.ejim.2014.02.006.
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出版历程
  • 收稿日期:  2020-11-30
  • 网络出版日期:  2021-03-19
  • 刊出日期:  2021-03-15

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