ESC-Leitlinie 2015: Diagnostik und Therapie der pulmonalen Hypertonie

 

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Zusammenfassung

Die pulmonale Hypertonie (PH) ist gekennzeichnet durch den Anstieg des mittleren pulmonal arteriellen Drucks (PAPm) auf ≥ 25 mmHg in Ruhe und geht häufig mit einer erheblichen Einschränkung der Lebensqualität und Prognose einher. In den letzten Jahren konnten wesentliche Fortschritte in der Diagnostik und Therapie der PH erzielt werden, welche bei der Aktualisierung der gemeinsamen Leitlinien der European Society of Cardiology (ESC) und der European Respiratory Society (ERS) zur Diagnostik und Therapie der pulmonalen Hypertonie im Jahr 2015 berücksichtigt wurden [1]. Neu sind Änderungen der hämodynamischen Definitionen, der Empfehlungen zum diagnostischen Vorgehen bei Verdacht auf PH sowie zur Risikostratifizierung und Therapie der PAH. Schließlich beinhalten die neuen ESC / ERS-Leitlinien detaillierte Empfehlungen zum Management anderer PH-Formen wie der PH bei Linksherz- oder Lungenerkrankungen und der chronisch thromboembolischen pulmonalen Hypertonie und definieren Kriterien für spezialisierte Expertenzentren.

Abstract

Pulmonary hypertension (PH) is characterized by an increase in PAPmean > 25 mmHg associated with a reduced life expectancy. Recent advances in the management of these patients provided the basis for the updated recommendations of the 2015 joint guidelines of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS) on the diagnosis and treatment of pulmonary hypertension. The updated version includes important modifications with regards to hemodynamic definitions, clinical classification and diagnostic assessment of patients with PH. In addition, risk stratification and PH treatment were profoundly modified, introducing novel drugs and improved treatment strategies such as early combination therapy. Finally, the new ESC /ERS guidelines provide formal recommendations for the management of PH due to left heart or chronic lung disease and chronic thromboembolic pulmonary hypertension, and define criteria for specialized PH expert centers.

• Literatur

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