Zeynep Pınar ÖNEN, Gülseren KARABIYIKOĞLU

Güncel verilerle kronik obstrüktif akciğer hastalığında pulmoner hipertansiyon

Kronik solunum hastalıklarına ikincil pulmoner hipertansiyon (PH), uzun yıllardır çok iyi bilinmektedir. Görülme sıklığı nedeniyle kronik obstrüktif akciğer hastalığı ise, bu grupta karşılaşılan en sık PH nedenidir. Bu konuda yapılan çalışmalarda PHnin uyku, atak ve egzersiz sırasında belirginleşmesine karşın ortalama pulmoner arter basıncı (PAB)nın 20-35 mmHg arasında değiştiği görülür. Sadece sınırlı sayıdaki hastada, ortalama PAB değeri > 35 veya 40 olan, ağır PH görülür. Ayrıca bir diğer hasta grubu vardır ki hava yolu obstrüksiyonu sınırlı olmasına karşın, PAB değerleri çok yüksektir, bu nedenle orantısız PH olarak tanımlanırlar. Her iki grubun da tanıdan tedaviye kadar, daha dikkatli incelenip idiyopatik pulmoner arteryel hipertansiyon gibi değerlendirilmesi uygun olacaktır

Update on pulmonary hypertension in chronic obstructive pulmonary disease

Secondary pulmonary hypertension (PH) is a well known possible feature in patients with chronic respiratory diseases. Owing to its frequency advanced chronic obstructive pulmonary disease is the most common cause of PH. The studies that have focused on this topic have shown that PH is frequent during sleep, exacerbations or exercise but mean pulmonary artery pressure (PAP) is usually between 20 to 35 mmHg. Limited number of patients have severe PH, which is defined as > 35 or 40 mmHg. Unfortunately, there is another subset of patients whom have minimal airway obstruction with greater PAP values called as out of proportion. These two groups need special interest for further evaluation diagnosis and treatment strategy

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