肺心病左室舒张功能障碍发病机制的研究进展
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摘要
近年来肺心病的发病率逐年上升,以往认为肺心病对心脏的影响主要以右心功能障碍为主,不影响左心功能,左心功能障碍主要为原发左心病变所致,但近年来不少文献指出由慢阻肺长期发展引起的肺心病在早期即可合并左心功能障碍,主要以左室舒张功能障碍为主。本文主要从五个不同方面阐述由慢阻肺长期发展引起的肺心病患者左室舒张功能障碍的原因,结合相关文献做一综述。
In recent years, the incidence of pulmonary heart disease has increased year by year. In the past, the influence of pulmonary heart disease on the heart was mainly due to right heart dysfunction, which did not affect left heart function. Left heart dysfunction was mainly caused by primary left heart disease, but in recent years, many literatures indicate that pulmonary heart disease caused by long-term development of chronic obstructive pulmonary disease can be combined with left ventricular dysfunction in the early stage, mainly with left ventricular diastolic dysfunction. This article mainly describes the causes of left ventricular diastolic dysfunction in patients with pulmonary heart disease caused by long-term development of chronic obstructive pulmonary disease from five different aspects, and summarizes the related literature.
In recent years, the incidence of pulmonary heart disease has increased year by year. In the past, the influence of pulmonary heart disease on the heart was mainly due to right heart dysfunction, which did not affect left heart function. Left heart dysfunction was mainly caused by primary left heart disease, but in recent years, many literatures indicate that pulmonary heart disease caused by long-term development of chronic obstructive pulmonary disease can be combined with left ventricular dysfunction in the early stage, mainly with left ventricular diastolic dysfunction. This article mainly describes the causes of left ventricular diastolic dysfunction in patients with pulmonary heart disease caused by long-term development of chronic obstructive pulmonary disease from five different aspects, and summarizes the related literature.
引文
[1]Zangiabadi A,De Pasquale CG,Sajkov D.Pulmonary hypertension and right heart dysfunction in chronic lung disease[J].Biomed Res Int,2014(24):739674.
[2]Stone IS,Barnes NC,Petersen SE.Chronic obstructive pulmonary disease:a modifiable risk factor for cardiovascular dis-ease?[J].Heart(British Cardiac Society),2012,98(14):1055-1062.
[3]葛均波,徐永健.内科学[M].第8版.北京:人民卫生出版社,2013.
[4]Xu W,Yao J,Chen L.Anxiety in Patients with Chronic Cor Pulmonale and Its Effect on Exercise Capacity[J].Iranian Journalof Public Health,2016,45(8):1004-1011.
[5]Nojiri T,Yamamoto K,Maeda H,et al.Effects of inhaled tiotropium on left ventricular diastolic function in chronic ob-structive pulmonary disease patients after pulmonary resection[J].Ann Thorac Cardiovasc Surg,2012,18(3):206-211.
[6]Lopez-Sanchez M,Munoz-Esquerre M,Huertas D,et al.High Prevalence of Left Ventricle Diastolic Dysfunction in SevereCOPD Associated with A Low Exercise Capacity:A Cross-Sectional Study[J].PLoS One,2013,8(6):e68034.
[7]Caram LM,Ferrari R,Naves CR,et al.Association between left ventricular diastolic dysfunction and severity of chronic obstruc-tive pulmonary disease[J].Clinics(Sao Paulo),2013,68(6):772-776.
[8]Jeong EM,Dudley SC Jr.Diastolic dysfunction[J].Circ J,2015,79(3):470-477.
[9]Nicoara A,Jones-Haywood M.Diastolic heart failure:diagnosis and therapy[J].Curr Opin Anaesthesiol,2016,29(1):61-67.
[10]Aljaroudi W,Alraies MC,Halley C,et al.Impact of progression of diastolic dysfunction on mortality in patients with normalejection fraction[J].Circulation,2012,125(6):782-788.
[11]Gurudevan SV,Malouf PJ,Auger WR,et al.Abnormal left ventricular diastolic filling in chronic thromboembolic pul-monary hypertension:true diastolic dysfunction or left ventricularunderfilling?[J].Journal of the American College of Cardiology,2007,49(12):1334-1339.
[12]Rosenkranz S,Gibbs JS,Wachter R,et al.Left ventricular heart failure and pulmonary hypertension[J].European HeartJournal,2016,37(12):942-954.
[13]Voelkel NF,Bogaard HJ,Gomez-Arroyo J.The need to recognize the pulmonary circulation and the right ventricle as anintegrated functional unit:facts and hypotheses(2013 GroverConference series)[J].Pulmonary Circulation,2015,5(1):81-89.
[14]Khan NA,Daga MK,Ahmad I,et al.Evaluation of BODE index and its relationship with systemic inflammation mediated byproinflammatory biomarkers in patients with COPD[J].Journal ofInflammation Research,2016(9):187-198.
[15]Paulus WJ,Tschope C.A novel paradigm for heart failure with preserved ejection fraction:comorbidities drive myocardialdysfunction and remodeling through coronary microvascular en-dothelial inflammation[J].Journal of the American College ofCardiology,2013,62(4):263-271.
[16]Majewska-Pulsakowska M,Wytrychowski K,Rozek-Piechura K.The Role of Inspiratory Muscle Training in theProcess of Rehabilitation of Patients with Chronic ObstructivePulmonary Disease[J].Adv Exp Med Biol,2016,885(1):47-51.
[17]Florea VG,Cohn JN.The autonomic nervous system andheart failure[J].Circulation Research,2014,114(11):1815-1826.
[18]Wang C,Xu J,Yang L,et al.Prevalence and risk factors ofchronic obstructive pulmonary disease in China(the ChinaPulmonary Health[CPH] study):a national cross-sectional study[J].Lancet,2018,391(10131):1706-1717.
[19]Murray LA,Dunmore R,Camelo A,et al.Acute cigarette smoke exposure activates apoptotic and inflammatory programsbut a second stimulus is required to induce epithelial to mes-enchymal transition in COPD epithelium[J].Respiratory Re-search,2017,18(1):82.
[20]Lubin JH,Couper D,Lutsey PL,et al.Risk of Cardiovascular Disease from Cumulative Cigarette Use and the Impact ofSmoking Intensity[J].Epidemiology(Cambridge, Mass.),2016,27(3):395-404.
[21]Anderson C,Majeste A,Hanus J,et al.E-Cigarette Aerosol Exposure Induces Reactive Oxygen Species, DNA Damage, andCell Death in Vascular Endothelial Cells[J]. Toxicological Sci-ences,2016,154(2):332-340.
[22]Jernigan NL,Naik JS,Weise-Cross L,et al.Contribution of reactive oxygen species to the pathogenesis of pulmonary arterialhypertension[J].PLoS One,2017,12(6):e0180455.
[23]Jessup JA,Wang H,MacNamara LM,et al.Estrogen therapy,independent of timing, improves cardiac structure and functionin oophorectomized mRen2.Lewis rats[J].Menopause,2013,20(8):860-868.
[24]Aboulhoda BE.Age-related remodeling of the JAK/STAT/SOCS signaling pathway and associated myocardial changes:Fromhistological to molecular level[J].Ann Anat,2017,214(7):21-30.
[2]Stone IS,Barnes NC,Petersen SE.Chronic obstructive pulmonary disease:a modifiable risk factor for cardiovascular dis-ease?[J].Heart(British Cardiac Society),2012,98(14):1055-1062.
[3]葛均波,徐永健.内科学[M].第8版.北京:人民卫生出版社,2013.
[4]Xu W,Yao J,Chen L.Anxiety in Patients with Chronic Cor Pulmonale and Its Effect on Exercise Capacity[J].Iranian Journalof Public Health,2016,45(8):1004-1011.
[5]Nojiri T,Yamamoto K,Maeda H,et al.Effects of inhaled tiotropium on left ventricular diastolic function in chronic ob-structive pulmonary disease patients after pulmonary resection[J].Ann Thorac Cardiovasc Surg,2012,18(3):206-211.
[6]Lopez-Sanchez M,Munoz-Esquerre M,Huertas D,et al.High Prevalence of Left Ventricle Diastolic Dysfunction in SevereCOPD Associated with A Low Exercise Capacity:A Cross-Sectional Study[J].PLoS One,2013,8(6):e68034.
[7]Caram LM,Ferrari R,Naves CR,et al.Association between left ventricular diastolic dysfunction and severity of chronic obstruc-tive pulmonary disease[J].Clinics(Sao Paulo),2013,68(6):772-776.
[8]Jeong EM,Dudley SC Jr.Diastolic dysfunction[J].Circ J,2015,79(3):470-477.
[9]Nicoara A,Jones-Haywood M.Diastolic heart failure:diagnosis and therapy[J].Curr Opin Anaesthesiol,2016,29(1):61-67.
[10]Aljaroudi W,Alraies MC,Halley C,et al.Impact of progression of diastolic dysfunction on mortality in patients with normalejection fraction[J].Circulation,2012,125(6):782-788.
[11]Gurudevan SV,Malouf PJ,Auger WR,et al.Abnormal left ventricular diastolic filling in chronic thromboembolic pul-monary hypertension:true diastolic dysfunction or left ventricularunderfilling?[J].Journal of the American College of Cardiology,2007,49(12):1334-1339.
[12]Rosenkranz S,Gibbs JS,Wachter R,et al.Left ventricular heart failure and pulmonary hypertension[J].European HeartJournal,2016,37(12):942-954.
[13]Voelkel NF,Bogaard HJ,Gomez-Arroyo J.The need to recognize the pulmonary circulation and the right ventricle as anintegrated functional unit:facts and hypotheses(2013 GroverConference series)[J].Pulmonary Circulation,2015,5(1):81-89.
[14]Khan NA,Daga MK,Ahmad I,et al.Evaluation of BODE index and its relationship with systemic inflammation mediated byproinflammatory biomarkers in patients with COPD[J].Journal ofInflammation Research,2016(9):187-198.
[15]Paulus WJ,Tschope C.A novel paradigm for heart failure with preserved ejection fraction:comorbidities drive myocardialdysfunction and remodeling through coronary microvascular en-dothelial inflammation[J].Journal of the American College ofCardiology,2013,62(4):263-271.
[16]Majewska-Pulsakowska M,Wytrychowski K,Rozek-Piechura K.The Role of Inspiratory Muscle Training in theProcess of Rehabilitation of Patients with Chronic ObstructivePulmonary Disease[J].Adv Exp Med Biol,2016,885(1):47-51.
[17]Florea VG,Cohn JN.The autonomic nervous system andheart failure[J].Circulation Research,2014,114(11):1815-1826.
[18]Wang C,Xu J,Yang L,et al.Prevalence and risk factors ofchronic obstructive pulmonary disease in China(the ChinaPulmonary Health[CPH] study):a national cross-sectional study[J].Lancet,2018,391(10131):1706-1717.
[19]Murray LA,Dunmore R,Camelo A,et al.Acute cigarette smoke exposure activates apoptotic and inflammatory programsbut a second stimulus is required to induce epithelial to mes-enchymal transition in COPD epithelium[J].Respiratory Re-search,2017,18(1):82.
[20]Lubin JH,Couper D,Lutsey PL,et al.Risk of Cardiovascular Disease from Cumulative Cigarette Use and the Impact ofSmoking Intensity[J].Epidemiology(Cambridge, Mass.),2016,27(3):395-404.
[21]Anderson C,Majeste A,Hanus J,et al.E-Cigarette Aerosol Exposure Induces Reactive Oxygen Species, DNA Damage, andCell Death in Vascular Endothelial Cells[J]. Toxicological Sci-ences,2016,154(2):332-340.
[22]Jernigan NL,Naik JS,Weise-Cross L,et al.Contribution of reactive oxygen species to the pathogenesis of pulmonary arterialhypertension[J].PLoS One,2017,12(6):e0180455.
[23]Jessup JA,Wang H,MacNamara LM,et al.Estrogen therapy,independent of timing, improves cardiac structure and functionin oophorectomized mRen2.Lewis rats[J].Menopause,2013,20(8):860-868.
[24]Aboulhoda BE.Age-related remodeling of the JAK/STAT/SOCS signaling pathway and associated myocardial changes:Fromhistological to molecular level[J].Ann Anat,2017,214(7):21-30.