Pulmonary hypertension in left heart and lung diseases

Postgraduate Thesis uoadl:2864296 106 Read counter

Κατεύθυνση Καρδιοπνευμονική Αποκατάσταση και Αποκατάσταση Πασχόντων ΜΕΘ
Library of the School of Health Sciences
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Andriopoulou Maria
Supervisors info:
Κωνσταντίνος Π. Τούτουζας, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Πέτρος Μπακάκος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Νικόλαος Κουλούρης, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Pulmonary hypertension in left heart and lung diseases
Translated title:
Pulmonary hypertension in left heart and lung diseases
Pulmonary hypertension (PH) is a heterogeneous condition defined by elevated mean pulmonary pressure ≥ 20 mmHg measured with right heart catheterization. Left-sided cardiac and lung diseases are the most common causes.
Symptoms in early stages include exertional dyspnea, fatigue and reduced exercise tolerance. With the progression of the disease, symptoms of right ventricular failure such as exertional chest pain, syncope and peripheral congestion may be manifested.
Patients presented with heart failure with reduced or preserved ejection fraction and left- sided valvular diseases are predisposed to manifest pulmonary hypertension.
There are two subgroups in left cardiac disease.
1) It refers to isolated post-capillary pulmonary hypertension which is due to a primary elevation of pressure in the pulmonary arterial system alone.
2) It is called combined post- and pre-capillary pulmonary hypertension with the post-capillary component due to elevation of pressure in the pulmonary venous and pulmonary capillary system (pulmonary venous hypertension). In practice, some patients have mixed pre- and post-capillary features. These patients have poorer prognosis than those of the first subgroup.
Patients with chronic obstructive pulmonary disease in combination with comorbidities and old age have a higher possibility to manifest pulmonary hypertension.
Survival rates seem to be lower in PH due to idiopathic pulmonary fibrosis and combined pulmonary fibrosis with emphysema.
This may be explained by the increased burden of parenchymal lung disease and the pulmonary vascular disease resulting in vascular remodeling.
This review reports pulmonary hypertension as result of left heart and lung diseases.
Main subject category:
Health Sciences
Pulmonary hypertension; Left heart diseases; Lung diseases; Cardiac rehabilitation; Pulmonary rehabilitation
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