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首页> 外文期刊>Pulmonary Circulation >Pulmonary Vascular Wall Stiffness: An Important Contributor to the Increased Right Ventricular Afterload with Pulmonary Hypertension:
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Pulmonary Vascular Wall Stiffness: An Important Contributor to the Increased Right Ventricular Afterload with Pulmonary Hypertension:

机译：肺血管壁刚度：肺动脉高压导致右心室后负荷增加的重要原因：

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摘要

Pulmonary hypertension (PH) is associated with structural and mechanical changes in the pulmonary vascular bed that increase right ventricular (RV) afterload. These changes, characterized by narrowing and stiffening, occur in both proximal and distal pulmonary arteries (PAs). An important consequence of arterial narrowing is increased pulmonary vascular resistance (PVR). Arterial stiffening, which can occur in both the proximal and distal pulmonary arteries, is an important index of disease progression and is a significant contributor to increased RV afterload in PH. In particular, arterial narrowing and stiffening increase the RV afterload by increasing steady and oscillatory RV work, respectively. Here we review the current state of knowledge of the causes and consequences of pulmonary arterial stiffening in PH and its impact on RV function. We review direct and indirect techniques for measuring proximal and distal pulmonary arterial stiffness, measures of arterial stiffness including elastic modulus, incremental elastic modulus, stiffness coefficient β and others, the changes in cellular function and the extracellular matrix proteins that contribute to pulmonary arterial stiffening, the consequences of PA stiffening for RV function and the clinical implications of pulmonary vascular stiffening for PH progression. Future investigation of the relationship between PA stiffening and RV dysfunction may facilitate new therapies aimed at improving RV function and thus ultimately reducing mortality in PH.
机译：肺动脉高压（PH）与肺血管床的结构和机械变化有关，从而增加右心室（RV）后负荷。这些变化以变窄和变硬为特征，发生在近端和远端的肺动脉（PA）中。动脉狭窄的重要后果是肺血管阻力（PVR）增加。动脉硬化可能发生在近端和远端的肺动脉中，是疾病进展的重要指标，并且是导致PH后RV后负荷增加的重要原因。特别是，动脉狭窄和僵硬分别通过增加稳定的和摆动性的RV功来增加RV后负荷。在这里，我们回顾了有关PH中肺动脉僵硬的原因和后果及其对RV功能的影响的当前知识状态。我们回顾了测量近端和远端肺动脉僵硬度的直接和间接技术，包括弹性模量，增量弹性模量，刚度系数β等在内的动脉僵硬度的测量方法，细胞功能的变化以及有助于肺动脉硬化的细胞外基质蛋白的变化， PA硬化对RV功能的影响以及肺血管硬化对PH进展的临床意义。未来对PA僵硬与RV功能障碍之间关系的研究可能会促进旨在改善RV功能并最终降低PH死亡率的新疗法。

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