Clinical guidelines for the diagnosis and treatment of pulmonary hypertension

• Published in: Terapevtic̆eskii arhiv Vol. 86; no. 9; pp. 4 - 23
• Main Authors: Chazova, I E, Avdeev, S N, Tsareva, N A, Volkov, A V, Martyniuk, T V, Nakonechnikov, S N
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) "Consilium Medicum" Publishing house 01-01-2014
• Subjects: Algorithms; Anticoagulants - therapeutic use; Cardiac Surgical Procedures - methods; Cardiovascular Agents - classification; Cardiovascular Agents - therapeutic use; clinical guidelines; Disease Management; Disease Progression; Humans; Hypertension, Pulmonary - classification; Hypertension, Pulmonary - diagnosis; Hypertension, Pulmonary - physiopathology; Hypertension, Pulmonary - therapy; Lung Transplantation - methods; Practice Guidelines as Topic; Prognosis; Prostaglandins - therapeutic use; Pulmonary Circulation - drug effects; pulmonary hypertension; Pulmonary Wedge Pressure; Randomized Controlled Trials as Topic; Symptom Assessment - methods; Vascular Resistance
• ISSN: 0040-3660; 2309-5342

Pulmonary hypertension (PH) is a group of diseases characterized by progressive increases in pulmonary vascular resistance and pulmonary artery pressure, which results in right ventricular heart failure and sudden death. Based on the current version of the guidelines for PH diagnosis and treatment, adopted by the experts of the European Society of Cardiology and the European Respiratory Society in 2009, and on the data of Russian and foreign clinical trials, the Russian experts elaborated clinical guidelines for PH in 2013. The latter consider the current classifications of PH, the specific features of its pathogenesis, and its diagnostic algorithm. The section dealing with drugs for maintenance therapy discusses data on the use of oral anticoagulants, diuretics, cardiac glycosides, and oxygen therapy. PH-specific therapy includes calcium antagonists, prostanoids, endothelin receptor antagonists, and phosphodiesterase type 5 inhibitors. Surgical procedures for PH involve atrial septostomy, thromboendartectomy, and lung or heart-lung transplantation. A treatment algorithm is proposed for PH patients. The current medicinal approaches using specific therapy agents and their combinations offer new promises for the effective treatment of patients with PH and improve its prognosis.