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Pulmonale Hypertonie

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Herzerkrankungen und Interventions-möglichkeiten

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Zusammenfassung

Die pulmonale Zirkulation unterliegt in vieler Hinsicht Anforderungen, die an kein anderes Gefäßbett gestellt werden. Die Regulation des Gefäßtonus ist daher in vielfältiger Weise komplex reguliert. Die pulmonale Zirkulation hat die Aufgabe, das Blut mit Sauerstoff zu versorgen und den pH-Wert des Blutes über die Abatmung von Kohlendioxid aufrechtzuerhalten, die Perfusion an die Ventilation anzupassen, den Gesamtwiderstand im System entsprechend den Möglichkeiten des rechten Ventrikels niedrig zu halten. Sie dient dariiber hinaus als Filter vor dem arteriellen Blutgefäßsystem und hat aufgrund ihrer riesigen Endotheloberfläche große Bedeutung für alle endothelial regulierten Stoffwechselvorgänge. Die Aufgaben der pulmonalen Zirkulation und die Sicherung der Vitalität des Lungenparenchyms bedingen eine zweite Zirkulation, die bronchiale Zirkulation. Die Interaktion dieser beiden Zirkulationen kann ebenfalls pathophysiologist Bedeutung gewinnen. Eine pulmonale Hypertonie entsteht dann, wenn die Gesamtquerschnittsfläche der Lungenstrombahn strukturell oder funktionell reduziert ist, wenn der Ausflußdruck erhöht ist oder wenn eine sehr beträchtliche Steigerung des pulmonalen Blutflusses eintritt.

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Literatur

  1. Abenhaim L, Higenbottam T, Rich S (1994) International primary pulmonary hypertension study. Br Heart J 71: 303

    Article  PubMed  CAS  Google Scholar 

  2. Anderson TJ, Larsen ET, Wyse DG et al. (1991) Primary pulmonary hypertension for 30 years. Am J Cardiol 68: 284–285

    Article  PubMed  CAS  Google Scholar 

  3. Aromatorio GJ, Uretsky BF, Reddy PS (1985) Hypotension and sinus arrest with nifedipine in pulmonary hypertension. Chest 87: 265–267

    Article  PubMed  CAS  Google Scholar 

  4. Barrat-Boyes BG, Wood EH (1958) Cardiac output and related measurements and pressure values in the right heart and associated vessels, together with an analysis of the hemodynamic response to the inhalation of high oxygen mixtures in healthy subjects. J Lab Clin Med 51: 172

    Google Scholar 

  5. Barst RJ, Flaster ER, Menon A et al. (1992) Evidence for the association of unexplained pul-monary hypertension in children with the major hystocompatibility complex. Circulation 85: 249–258

    PubMed  CAS  Google Scholar 

  6. Barst RJ, Rubin LJ, McGoon MD et al. (1994) Survival in primary pulmonary hypertension with long-term continuous intravenous prostacyclin. Ann Intern Med 121: 409–415

    PubMed  CAS  Google Scholar 

  7. Barst RJ, Rubin LJ, Long WA et al. (1996) A comparison of continuous intravenous epo- prostenol (prostacyclin) with conventional therapy for primary pulmonary hypertension. N Engl J Med 334: 296–301

    Article  PubMed  CAS  Google Scholar 

  8. Cacoub P, Dorent R, Maistre G et al. (1993) Endothelin–1 in primary pulmonary hypertension and the Eisenmenger syndrome. J Am Coll Cardiol 71: 448–450

    CAS  Google Scholar 

  9. Celermajer DS, Dollery C, Burch M, Deanfield JE (1994) Role of endothelium in the main-tenance of low pulmonary vascular tone in normal children. Circulation 8: 2041–2044

    Google Scholar 

  10. Christman BW, McPherson C, Newman JH et al. (1992) An imbalance between the excretion of thromboxane and prostacyclin metabolits in pulmonary hypertension. N Engl J Med 327: 70–75

    Article  PubMed  CAS  Google Scholar 

  11. Cremona G, Higenbottam T (1995) Role of prostacyclin in the treatment of primary pulmonary hypertension. Am J Cardiol 75: 67A–71A

    Article  PubMed  CAS  Google Scholar 

  12. D’Alonzo GE, Barst RJ, Ayres SM et al. (1991) Survival in patients with primary pulmonary hypertension. Ann Intern Med 115: 343–349

    PubMed  Google Scholar 

  13. Dinh-Xuan A (1993) Disorders of Endothelium-dependent relaxation in pulmonary disease. Circulation [Suppl]V/87: V81–87

    Google Scholar 

  14. DiSalvo TG, Mathier M, Semigran MJ, Dec GW (1995) Preserved right ventricular ejection fraction predicts exercise capacity and survival in advanced heart failure. J Am Coll Cardiol 25 (5): 1143–1153

    Article  PubMed  Google Scholar 

  15. Domenighetti GM, Saglini VG (1992) Hypertension secondary to COPD and lung fibrosis. Chest 102 [3]: 708–714

    Article  PubMed  CAS  Google Scholar 

  16. Farber HW, Karlinsky JB, Faling LJ (1983) Fatal outcome following nifedipine for pulmonary hypertension. Chest 83: 708–709

    Article  PubMed  CAS  Google Scholar 

  17. Fuster V, Steele PM, Edwards WD et al. (1984) Primary pulmonary hypertension: natural history and the importance of thrombosis. Circulation 70: 580–587

    Article  PubMed  CAS  Google Scholar 

  18. Galie N, Ussia G, Pasarelli P et al. (1995) Role of pharmacologic tests in the treatment of primary pulmonary hypertension. Am Cardiol 75: 55A–62A

    Article  CAS  Google Scholar 

  19. Haque W, Boehmer J, Clemson BS et al. (1996) Hemodynamic effects of supplemental oxygen administration in congestive heart failure. J Am Coll Cardiol 27: 353–357

    Article  PubMed  CAS  Google Scholar 

  20. Hausknecht MJ, Sims RE, Nihill MR, Cashion WR (1990) Successful palliation of primary pulmonary hypertension by atrial septostomy. Am J Cardiol 65: 1045–1046

    Article  PubMed  CAS  Google Scholar 

  21. Heath D, Edwards JE (1958) The pathology of hypertensive pulmonary vascular disease. A description of six grades of structural changes in the pulmonary arteries with special references to congenital cardiac septal defects. Circulation 18: 533

    Google Scholar 

  22. Higenbottam T, Wheeldon D, Wells F, Wallwork J (1984) Long-term treatment of primary pulmonary hypertension with continuous intravenous epoprostenol (prostacyclin). Lancet 1: 1046–1047

    Article  PubMed  CAS  Google Scholar 

  23. Higenbottam TW, Spiegelhalter D, Scott JP et al. (1993) Prostacyclin (epoprostenol) and heart-lung transplantation as treatments for severe pulmonary hypertension. Br Heart J 70: 366–370

    Article  PubMed  CAS  Google Scholar 

  24. Janicki JS, Weber KT, Likoff MJ et al. (1985) The pressure-flow response of the pulmonary circulation in patients with heart failure and pulmonary vascular disease. Circulation 72: 1270–1278

    Article  PubMed  CAS  Google Scholar 

  25. Kerstein D, Levy PS, Hsu DT et al. (1995) Blade balloon atrial septostomy in patients with severe primary pulmonary hypertension. Circulation 91: 2028–2035

    PubMed  CAS  Google Scholar 

  26. Krol RC, Evans AT, Albright DP, Reilly JM (1984) Primary pulmonary hypertension, nifedipi-ne and hypoxemia. Ann Intern Med 100: 163

    PubMed  CAS  Google Scholar 

  27. Loyd JE, Primm RK, Newman JH (1984) Familial primary pulmonary hypertension: clinical patterns. Am Rev Respir Dis 129: 194–197

    PubMed  CAS  Google Scholar 

  28. McGregor M, Sniderman A (1985) On pulmonary vascular resistance: the need for more precise definition. Am J Cardiol 55: 217–221

    Article  PubMed  CAS  Google Scholar 

  29. Melmon KL, Braunwald E (1963) Familial pulmonary hypertension. N Engl J Med 269: 770

    Article  PubMed  CAS  Google Scholar 

  30. Mikhail GW, Gibbs JS, Richardson M et a. (1995) The superiority of nebulized prostacyclin in the treatment of patients with primary and secondary pulmonary hypertension. Circulation 92 [Suppl]: 1–242

    Google Scholar 

  31. Moncada S, Gryglewski R, Bunting S, Vane RJ (1976) An enzyme isolated from arteries trans-forms prostaglandin endoperoxides to an unstable substance that inhibits platelet aggregation. Nature 263: 663–665

    Article  PubMed  CAS  Google Scholar 

  32. Monckeberg JG (1907) Ueber die genuine Arteriosklerose der Lungenarterie. Dtsch Med Wochenschr 33: 1243

    Article  Google Scholar 

  33. Miinster W, Romaniuk P, Wierny L, Stofilein F (1986) Interventionsradiologie des Herzens und der herznahen Gefafie. Angiologisches Symposium. In: Oeser H (Hrsg) Buchreihe von Schering, Berlin, Bd 75

    Google Scholar 

  34. Naeije R, Lipski A, Abramowicz M et al. (1994) Nature of pulmonary hypertension in con-gestive heart failure. Effects of cardiac transplantation. Am J Respir Crit Car Med 149: 881–887

    Google Scholar 

  35. Nihill MR, McNamara DG, Vick RL (1976) The effects of increased blood viscosity on pul-monary vascular resistance. Am Heart J 92: 65–72

    Article  PubMed  CAS  Google Scholar 

  36. Nihill MR, O’Laughlin MP, Mullins CE (1991) Effects of atrial septostomy on patients with terminal cor pulmonale due to pulmonary vascular disease. Cathet Cardiovasc Diagn 24: 166–172

    Article  PubMed  CAS  Google Scholar 

  37. Olschewski H, Walmrath D, Schermuly R et al. (1996) Aerosolized Prostacyclin and Iloprost in severe pulmonary hypertension. Ann Intern Med 124: 820–824

    PubMed  CAS  Google Scholar 

  38. Palevsky Hi, Schloo BL, Pietra GG (1989) Primary pulmonary hypertension. Vascular structure, morphometry and responsiveness to vasodilator agents. Circulaton 80: 1207–1221

    Google Scholar 

  39. Palevsky HJ, Long W, Crow J, Fishman AP (1990) Prostacyclin and acetylcholine as screening agents for acute pulmonary vasodilator responsiveness in primary pulmonary hypertension. Circulation 82: 2018–2026

    Article  PubMed  CAS  Google Scholar 

  40. Pietra GG, Edwards WD, Kay JM (1989) Histopathology of primary pulmonary hypertension. A qualitative and quantitative study of pulmonary blood vessels from 58 patients in the National Heart, Lung and Blood Institute primary pulmonary hypertension registry. Circu-lation 80: 1198–1206

    Google Scholar 

  41. Porstmann W, Wierny L, Warnke H (1967) Der Verschlufi des Ductus arteriosus persistens ohne Thorakotomie. Thoraxchirurgie 15 [2]

    Google Scholar 

  42. Porter TR, Taylor DO, Cycan A et al. (1993) Endothelium-dependent pulmonary artery res-ponses in chronic heart failure: influence of pulmonary hypertension. J Am Coll Cardiol 22: 1418–1424

    Article  PubMed  CAS  Google Scholar 

  43. Raffy O, Azarian R, Brenot F et al. (1996) Clinical significance of the pulmonary vasodilator response during short-term infusion of prostacyclin in primary pulmonary hypertension. Circulaton 93: 484–488

    CAS  Google Scholar 

  44. Rich S, Brundage BH (1987) High-dose calcium channel-blocking therapy for primary pul-monary hypertension: evidence for long-term reduction in pulmonary arterial pressure and regression of right ventricular hypertrophy. Circulation 76: 135–141

    Article  PubMed  CAS  Google Scholar 

  45. Rich S, Lam W (1983) Atrial septostomy as palliative therapy for refractory primary pulmonary hypertension. Am J Cardiol 51: 1560–1561

    Article  PubMed  CAS  Google Scholar 

  46. Rich S, Pietra GG, Kieras K et al. (1986) Primary pulmonary hypertension: radiographic and scintigraphic patterns of histologic subtypes. Ann Intern Med 105: 499–502

    PubMed  CAS  Google Scholar 

  47. Rich S, Dantzker DR, Ayres SM et al. (1987) Primary pulmonary hypertension. A national prospective study. Ann Intern Med 107: 216–223

    Google Scholar 

  48. Rich S, Kaufmann E, Levy PS (1992) The effect of high doses of calcium-channel blockers on survival in primary pulmonary hypertension. N Engl J Med 327: 76–81

    Article  PubMed  CAS  Google Scholar 

  49. Romberg E (1891) Ueber Sklerose der Lungenarterie: Aus der medicinischen Klinik zu Leipzig. Dtsch Arch Klin Med 48: 197

    Google Scholar 

  50. Rozkovec A, Montanes P, Oakley CM (1986) Factors that influence the outcome of primary pulmonary hypertension. Br Heart J 55: 449–458

    Article  PubMed  CAS  Google Scholar 

  51. Rozkovec A, Stradling JR, Shepherd G et al. (1988) Prediction of favourable responses to long term vasodilator treatment of pulmonary hypertension by short term administration of epoprostenol (prostacyclin) or nifedipine. Br Heart J 59: 696–705

    Article  PubMed  CAS  Google Scholar 

  52. Rubin LJ, Mendoza J, Hood M et al. (1990) Treatment of primary pulmonary hypertension with continuous intravenous prostacyclin (epoprostenol). Results of randomized trial. Ann Intern Med 112: 485–491

    Google Scholar 

  53. Sandoval J, Bauerle O, Palomar A et al. (1994) Survival in primary pulmonary hypertension. Validation of a prognostic equation. Circulation 89: 1733–1744

    Google Scholar 

  54. Tarpi SP, Celli BR (1995) Long-term oxygen therapy. New Engl J Med 333 (11): 710–714

    Article  Google Scholar 

  55. Tsutamoto T, Wada A, Maeda Y et al. (1994) Relation between Endothelin–1 spillover in the lungs and pulmonary vascular resistance in patients with chronic heart failure. J Am Coll Cardiol 23: 1427–1433

    Article  PubMed  CAS  Google Scholar 

  56. Tubbs RR, Lewin RD, Shirey EK et al. (1979) Fibrinolysis in familial pulmonary hypertension. Am J Clin Pathol 71: 384–387

    PubMed  CAS  Google Scholar 

  57. Walmrath D, Schneider T, Schermuly R, Olschewski H, Grimminger F, Seeger W (1996) Direct comparison of inhaled nitric oxide and aerosolized prostacyclin in acute respiratory distress syndrome. Am J Respir Crit Care Med 153: 991–996

    PubMed  CAS  Google Scholar 

  58. Wuertemberger G, Zielinsky J, Sliwinsky P (1990) Survival in chronic obstructive pul-monary disease after diagnosis of pulmonary hypertension related to long-term oxygen therapy. Lung [Suppl]: 762–769

    Google Scholar 

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Authors
  1. F. X. Kleber
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Editors and Affiliations

  1. Müllner Hauptstraße 48, A-5020, Salzburg, Österreich

    Felix Unger FESC, FACC (Vorstand der Herzchirurgie Salzburg, Direktor) (Vorstand der Herzchirurgie Salzburg, Direktor)

  2. European Heart Institute, Europäischen Akademie der Wissenschaften und Künste, Waagplatz 3, A-5020, Salzburg, Österreich

    Felix Unger FESC, FACC (Vorstand der Herzchirurgie Salzburg, Direktor) (Vorstand der Herzchirurgie Salzburg, Direktor)

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© 1998 Springer-Verlag Berlin Heidelberg

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Kleber, F.X. (1998). Pulmonale Hypertonie. In: Unger, F. (eds) Herzerkrankungen und Interventions-möglichkeiten. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-80404-5_22

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  • DOI: https://doi.org/10.1007/978-3-642-80404-5_22

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-80405-2

  • Online ISBN: 978-3-642-80404-5

  • eBook Packages: Springer Book Archive

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