Protocolo diagnóstico y terapéutico del cor pulmonale
- Álvarez Vega, P.
- Cadenas Menéndez, S.
- Martín Moreiras, J.
- González Calle, D.
- Oterino Manzanas, A.
- Sánchez Fernández, P.L.
ISSN: 0304-5412
Año de publicación: 2017
Serie: 12
Número: 45
Páginas: 2722-2728
Tipo: Artículo
Otras publicaciones en: Medicine: Programa de Formación Médica Continuada Acreditado
Resumen
Resumen El cor pulmonale es el término que se utiliza para definir la insuficiencia ventricular derecha derivada de la presencia de hipertensión pulmonar y, más concretamente, a la hipertensión pulmonar que se produce como consecuencia de las enfermedades respiratorias crónicas o las enfermedades vasculares pulmonares. La diferenciación etiológica anterior resulta primordial a la hora de establecer un tratamiento adecuado, ya que en el primer caso el enfoque terapéutico se debe dirigir al tratamiento óptimo de la enfermedad pulmonar, mientras que en el segundo caso la base del tratamiento es la reducción de la poscarga del ventrículo derecho mediante fármacos vasodilatadores pulmonares y/o técnicas quirúrgicas como la septostomía atrial con balón y el trasplante pulmonar.
Referencias bibliográficas
- Sheehan F, Redington A. The right ventricle: anatomy, physiology and clinical imaging. Heart. 2008;94:1510-5.
- Van Wolferen SA, Marcus JT, Boonstra A, Marques KMJ, Bronzwaer JGF, Spreeuwenberg MD. Prognostic value of right ventricular mass, volume, and function in idiopathic pulmonary arterial hypertension. Eur Heart J. 2007;28:1250-57.
- Swift AJ, Rajaram S, Campbell MJ, Hurdman J, Thomas S, Capener D. Prognostic value of cardiovascular magnetic resonance imaging measurements corrected for age and sex in idiopathic pulmonary arterial hypertension. Circ Cardiovasc Imaging. 2014;7:100-6.
- Magder S. The left heart can only be as good as the right heart: determinants of function and dysfunction of the right ventricle. Crit Care Resusc. 2007;9:344-51.
- Segovia J, Bermejo J, Alfonso F, Heras M. (2010). Corazón derecho y circulación pulmonar: ¿una circulación menor? Rev Esp Cardiol. 2010; 63(01):77-80.
- Wrobel JP, Thompson BR, Williams TJ. Mechanisms of pulmonary hypertension in chronic obstructive pulmonary disease: a pathophysiologic review. J Heart Lung Transplant. 2012;31:557-64.
- Weitzenblum E, Sautegeau A, Ehrhart M, Mammosser M, Hirth C, Roegel E. Long term course of pulmonary arterial pressure in chronic obstructive pulmonary disease. Am Rev Respir Dis. 1984;130:993-8.
- Andersen KH, Iversen M, Kjaergaard J, Mortensen J, Nielsen-Kudsk JE, Bendstrup E. Prevalence, predictors, and survival in pulmonary hypertension related to end-stage chronic obstructive pulmonary disease. J HeartLung Transplant. 2012;31:373-80.
- Burrows B, Kettel LJ, Niden AH, Rabinowitz M, Diener CF. Patterns of cardiovascular dysfunction in chronic obstructive lung disease. N Engl J Med. 1972;286:912-8.
- Oswald-Mammosser M, Weitzenblum E, Quoix E, Moser G, Chaouat A, Charpentier C. Prognostic factors in COPD patients receiving long term oxygen therapy. Importance of pulmonary artery pressure. Chest. 1995;107:1193-8.
- Chaouat A, Bugnet AS, Kadaoui N, Schott R, Enache I, Ducoloné A. Severe pulmonary hypertension and chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2005;172(2):189-94.
- Behr J, Ryu JH. Pulmonary hypertension in interstitial lung disease. Eur Respir J. 2008;31:1357-67.
- Minai OA, Santacruz JF, Alster JM, Budev MM, McCarthy K. Impact of pulmonary hemodynamics on 6 min walk test in idiopathic pulmonary fibrosis. Respir Med. 2012;106:1613-21.
- Nathan SD, Shlobin OA, Ahmad S, Koch J, Barnett SD, Ad N. Serial development of pulmonary hypertension in patients with idiopathic pulmonary fibrosis. Respiration. 2008;76:288-94.
- Shorr AF, Wainright JL, Cors CS, Lettieri CJ, Nathan SD. Pulmonary hypertension in patients with pulmonary fibrosis awaiting lung transplant. Eur Respir J. 2007;30:715-21.
- Corte TJ, Wort SJ, Wells AU. Pulmonary hypertension in idiopathic pulmonary fibrosis: a review. Sarcoidosis Vasc Diffuse Lung Dis. 2009;26: 7-19.
- Cottin V, Le Pavec J, Prévot G, Mal H, Humbert M, Simonneau G. Pulmonary hypertension in patients with combined pulmo-nary fibrosis and emphysema syndrome. Eur Respir J. 2010;35: 105-11.
- Seeger W, Adir Y, Barberá JA, Champion H, Coghlan JG, Cottin V. Pulmonary hypertension in chronic lung diseases. J Am Coll Cardiol. 2013;62(25):D109-D116.
- Shamsuzzaman AS, Gersh BJ, Sommers VV. Obstructive sleep apnea complications and cardiovascular disease. JAMA. 2003;290:1906-14.
- Sandoval J, Gaspar J, Pulido T, Bautista E, Martínez Guerra ML, Zeballos M. Graded balloon dilation atrial septostomy in severe primary pulmonary hypertension. A therapeutic alternative for patients nonresponsive to vasodilator treatment. J Am Coll Cardiol. 1998;32:297-304.
- Kurzyna M, Dabrowski M, Bielecki D, Fijalkowska A, Pruszczyk P, Opolski G. Atrial septostomy in treatment of end stage right heart failure in Patients with pulmonary hypertension. Chest. 2007;131:977-83.
- Zamanian RT, Haddad F, Doyle RL, Weinacker AB. Management strategies for patients with pulmonary hypertension in the intensive care unit. Crit Care Med. 2007;35:2037-50.
- Price LC, Wort SJ, Finney SJ, Marino PS, Brett SJ. Pulmonary vascular and right ventricular dysfunction in adult critical care: current and emerging options for management: a systematic literature review. Crit Care. 2010;14:R169.
- 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;184:1114-24.
- Keogh A, Benza RL, Corris P, Dartevelle P, Frost A, Kim NH. Interventional and surgical modalities of treatment in pulmonary arterial hypertension. J Am Coll Cardiol. 2009;54(Suppl):S67–S77.
- Sitbon O, Humbert M, Nunes H, Parent F, García G, Herve P. Long term intravenous epoprostenol infusion in primary pul-monary hypertension: prognostic factors and survival. J Am Coll Cardiol. 2002;40: 780-8.
- McLaughlin VV, Shillington A, Rich S. Survival in primary pulmonary hypertension: the impact of epoprostenol therapy. Circulation. 2002;106: 1477-82.
- Roman A, Borro JM, Ussetti P, Vaquero JM, Solé A, De Pablo A. Selección de pacientes candidatos a trasplante pulmonar. Archivos de bronconeumología. 2011;47:303-9.