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Artigos de revistas sobre o tema "Hypertension portopulmonaire"

Autor: Grafiati

Publicado: 25 de janeiro de 2025

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1

Chabot, F., E. Gomez, L. Boyer, A. Kheir, J. Le Pavec, O. Sitbon e P. Herve. "Hypertension portopulmonaire". Revue des Maladies Respiratoires 23, n.º 6 (dezembro de 2006): 629–41. http://dx.doi.org/10.1016/s0761-8425(06)72078-2.

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2

Magois, E., J. C. Glerant, I. Mayeux, B. Toublanc, D. Mispelaere e V. Jounieaux. "134 Hypertension artérielle portopulmonaire (HTTP) et opacités pseudotumorales". Revue des Maladies Respiratoires 21 (janeiro de 2004): 61. http://dx.doi.org/10.1016/s0761-8425(04)71760-x.

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3

Halim, A., A. O. Daher, M. N. Guèye, S. Diallo, M. Bodian, M. P. Fall, M. A. Thioubou, M. L. Bassène, S. Fall e M. L. Diouf. "Hypertension portopulmonaire révélant une cirrhose d’origine auto-immune : à propos d’un cas". Journal Africain d'Hépato-Gastroentérologie 10, n.º 4 (16 de setembro de 2016): 217–19. http://dx.doi.org/10.1007/s12157-016-0677-1.

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4

Saleemi, Sarfraz. "Portopulmonary hypertension". Annals of Thoracic Medicine 5, n.º 1 (2010): 5. http://dx.doi.org/10.4103/1817-1737.58953.

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5

Hopps, Eugenia, Amelia Valenti e Gregorio Caimi. "Portopulmonary Hypertension". Clinical & Investigative Medicine 34, n.º 3 (1 de junho de 2011): 111. http://dx.doi.org/10.25011/cim.v34i3.15182.

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Portopulmonary hypertension (PPHT) is a respiratory complication of portal hypertension, defined as an increase in mean pulmonary artery pressure (PAP) of > 25 mmHg with an increase in pulmonary vascular resistance of > 240 dyn.s/cm-5 and a normal pulmonary capillary wedge pressure ( < 15 mmHg), which often occurs in subjects with liver cirrhosis. Histopathological features of PPHT are endothelial and smooth-muscle cell proliferation and fibrosis leading to luminal obstruction in the resistance arteries. The pathogenesis of PPHT may result from an imbalance between vasoconstrictor and vasodilating factors. The most common pulmonary symptom is exertional dyspnea; fatigue, chest pain and syncope occur more often at an advanced stage. Edema, ascites and prominent jugular veins are signs of both decompensated hepatic cirrhosis and right ventricular failure. Right heart catheterisation is the gold standard for the diagnosis and defines PPHT in mild disease with PAP less than 35 mmHg, moderate disease with PAP between 35 and 45 mmHg, and severe disease with PAP of 45 mmHg or higher. The medical treatment of portopulmonary hypertension is based on the treatment of other forms of pulmonary arterial hypertension, including vasomodulating pharmacologic agents. Liver transplantation is accompanied by high risk of mortality, generally due to acute right ventricular failure and cardiovascular collapse. The prognosis of PPHT is poor with mean survival of 15 months.

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6

Lv, Yong, Guohong Han e Daiming Fan. "Portopulmonary hypertension". Scandinavian Journal of Gastroenterology 51, n.º 7 (22 de março de 2016): 795–806. http://dx.doi.org/10.3109/00365521.2016.1157895.

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7

Mukhtar, Nizar A., e Oren K. Fix. "Portopulmonary Hypertension". Journal of Clinical Gastroenterology 45, n.º 8 (setembro de 2011): 703–10. http://dx.doi.org/10.1097/mcg.0b013e31820656bd.

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8

Le Pavec, Jérôme, Rogério Souza, Philippe Herve, Didier Lebrec, Laurent Savale, Colas Tcherakian, Xavier Jaïs et al. "Portopulmonary Hypertension". American Journal of Respiratory and Critical Care Medicine 178, n.º 6 (15 de setembro de 2008): 637–43. http://dx.doi.org/10.1164/rccm.200804-613oc.

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9

Watherald, Jason, Olivier Sitbon e Laurent Savale. "Portopulmonary Hypertension". Seminars in Respiratory and Critical Care Medicine 38, n.º 05 (outubro de 2017): 651–61. http://dx.doi.org/10.1055/s-0037-1606251.

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AbstractPortal hypertension may have major consequences on the pulmonary vasculature due to complex pathophysiological interactions between liver and lungs. Portopulmonary hypertension (PoPH) is characterized by the association of portal hypertension and pulmonary arterial hypertension (PAH). As progressive elevation of right ventricular afterload can lead to right heart failure, PoPH is a serious complication of portal hypertension, affecting functional status and prognosis of patients. Early detection by transthoracic echocardiography must be performed in symptomatic patients and in candidates for liver transplantation (LT). Right heart catheterization remains mandatory to confirm the diagnosis and exclude all other causes of elevated pulmonary pressures. The management of PoPH includes PAH-targeted therapies although few studies have evaluated these medications in this specific indication. The impact of LT on PoPH outcome remains complex and must be specified by future collaborative investigation. Although uncontrolled PoPH is associated with higher risk of postoperative right heart failure and death, stabilization, improvement, or normalization of pulmonary hemodynamics after LT seem to be achievable goals in selected patients with PoPH.

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10

DuBrock, Hilary M., Reena J. Salgia, Norman L. Sussman, Sonja D. Bartolome, Zakiyah Kadry, David C. Mulligan, Sarah Jenkins et al. "Portopulmonary Hypertension". Transplantation Direct 5, n.º 6 (junho de 2019): e456. http://dx.doi.org/10.1097/txd.0000000000000900.

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11

Sakuma, Masahito, Shinko Souma, Osamu Kitamukai, Jun Demachi, Tohru Takahashi, Jun Suzuki, Jun Nawata et al. "Portopulmonary Hypertension". Circulation Journal 69, n.º 11 (2005): 1386–93. http://dx.doi.org/10.1253/circj.69.1386.

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12

Krowka, Michael. "Portopulmonary Hypertension". Seminars in Respiratory and Critical Care Medicine 33, n.º 01 (fevereiro de 2012): 17–25. http://dx.doi.org/10.1055/s-0032-1301731.

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13

Sokol, Ronald J. "Portopulmonary Hypertension". Journal of Pediatric Gastroenterology and Nutrition 61, n.º 3 (setembro de 2015): 268–69. http://dx.doi.org/10.1097/mpg.0000000000000892.

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14

Budhiraja, Rohit, e Paul M. Hassoun. "Portopulmonary Hypertension*". Chest 123, n.º 2 (fevereiro de 2003): 562–76. http://dx.doi.org/10.1378/chest.123.2.562.

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15

Nayak, Ravi P., Dechun Li e George M. Matuschak. "Portopulmonary hypertension". Current Gastroenterology Reports 11, n.º 1 (17 de janeiro de 2009): 56–63. http://dx.doi.org/10.1007/s11894-009-0009-3.

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16

Halank, Michael, Ralf Ewert, Hans-Juergen Seyfarth e Gert Hoeffken. "Portopulmonary hypertension". Journal of Gastroenterology 41, n.º 9 (16 de outubro de 2006): 837–47. http://dx.doi.org/10.1007/s00535-006-1879-x.

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17

Halank, Michael, Ralf Ewert, Hans-Juergen Seyfarth e Gert Hoeffken. "Portopulmonary hypertension". Journal of Gastroenterology 41, n.º 11 (8 de dezembro de 2006): 1133. http://dx.doi.org/10.1007/s00535-006-1971-2.

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18

Passarella, Michael, Michael B. Fallon e Steven M. Kawut. "Portopulmonary Hypertension". Clinics in Liver Disease 10, n.º 3 (agosto de 2006): 653–63. http://dx.doi.org/10.1016/j.cld.2006.08.023.

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19

Cartin-Ceba, Rodrigo, e Michael J. Krowka. "Portopulmonary Hypertension". Clinics in Liver Disease 18, n.º 2 (maio de 2014): 421–38. http://dx.doi.org/10.1016/j.cld.2014.01.004.

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20

Sitbon, Olivier, Dermot S. O'Callaghan e Laurent Savale. "Portopulmonary Hypertension". Chest 141, n.º 4 (abril de 2012): 840–42. http://dx.doi.org/10.1378/chest.11-2378.

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21

Krowka, Michael J., e Michael D. McGoon. "Portopulmonary Hypertension". Chest 112, n.º 4 (outubro de 1997): 869–70. http://dx.doi.org/10.1378/chest.112.4.869.

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22

Krowka, Michael J., Dave P. Miller, Robyn J. Barst, Darren Taichman, Raed A. Dweik, David B. Badesch e Michael D. McGoon. "Portopulmonary Hypertension". Chest 141, n.º 4 (abril de 2012): 906–15. http://dx.doi.org/10.1378/chest.11-0160.

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23

Golbin, Jason M., e Michael J. Krowka. "Portopulmonary Hypertension". Clinics in Chest Medicine 28, n.º 1 (março de 2007): 203–18. http://dx.doi.org/10.1016/j.ccm.2006.11.004.

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24

Al-Naamani, Nadine, e Kari E. Roberts. "Portopulmonary Hypertension". Clinics in Chest Medicine 34, n.º 4 (dezembro de 2013): 719–37. http://dx.doi.org/10.1016/j.ccm.2013.08.008.

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25

Wells, J. T., J. R. Runo e M. R. Lucey. "Portopulmonary hypertension". Hepatology 48, n.º 1 (julho de 2008): 13–15. http://dx.doi.org/10.1002/hep.22378.

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26

Thévenot, Thierry, Delphine Weil, Marie-France Seronde, Sarah Raevens e Laurent Savale. "Portopulmonary hypertension". Hépato-Gastro & Oncologie Digestive 30, n.º 6 (junho de 2023): 605–14. http://dx.doi.org/10.1684/hpg.2023.2601.

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27

Chooklin, S. M., S. S. Chuklin, M. M. Posivnych e S. A. Krystopchuk. "Portopulmonary hypertension: peculiarities of diagnosis and treatment". EMERGENCY MEDICINE 20, n.º 3 (17 de maio de 2024): 146–58. http://dx.doi.org/10.22141/2224-0586.20.3.2024.1686.

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Portopulmonary hypertension is defined as the development of pulmonary hypertension secondary to portal one. Its exact prevalence is difficult to determine due to the lack of routine screening in patients with portal hypertension. Hemodynamic changes associated with portal hypertension, including the hyperdynamic state, portosystemic shunts, and splanchnic vasodilation, cause significant disturbances in the pulmonary vasculature and play a key role in the pathogenesis of the disease. Without treatment, portopulmonary hypertension leads to progressive right ventricular failure with a poor prognosis. Although Doppler echocardiography is the best initial screening tool for symptomatic patients and candidates for liver transplant, right heart catheterization remains the gold standard for disease diagnosis. Treatment of patients with portopulmonary hypertension is aimed at improving cardiac function, reducing pulmonary vascular resistance, and optimizing functional capacity. Pulmonary hypertension-specific therapy, which includes prostacyclin and its receptor agonists, endothelin receptor antagonists, phosphodiesterase inhibitors, and guanylate cyclase stimulators, plays a key role in the treatment of patients with portopulmonary hypertension. Small uncontrolled and recent single randomized controlled trials have reported promising results of vasodilator therapy in terms of clinical and hemodynamic improvement in patients, allowing certain patients to undergo liver transplantation. This review discusses the epidemiology, approach to diagnosis and treatment of patients with portopulmonary hypertension. We used MEDLINE database on the PubMed platform and the Cochrane library to search for literature sources using the keywords: portopulmonary hypertension, portal hypertension, pulmonary hypertension, liver cirrhosis, pulmonary complications.

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28

Fisher, Jolene H., Sindhu R. Johnson, Cathy Chau, Amie T. Kron e John T. Granton. "Effectiveness of Phosphodiesterase-5 Inhibitor Therapy for Portopulmonary Hypertension". Canadian Respiratory Journal 22, n.º 1 (2015): 42–46. http://dx.doi.org/10.1155/2015/810376.

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BACKGROUND: Portopulmonary hypertension is associated with significant morbidity and mortality. Phosphodiesterase-5 inhibitor therapy is efficacious in other causes of WHO group I pulmonary arterial hypertension.OBJECTIVE: To evaluate the efficacy and safety of phosphodiesterase-5 inhibitor therapy in patients with portopulmonary hypertension.METHODS: A single-centre retrospective cohort study that included patients with a diagnosis of portopulmonary hypertension was performed. The primary outcome was change in pulmonary vascular resistance after six months of phosphodiesterase-5 inhibitor therapy. A secondary evaluation investigated the effect on other hemodynamic measurements, 6 min walk distance, functional class, safety outcomes and survival.RESULTS: Of 1385 patients screened, 25 patients with portopulmonary hypertension were identified, of whom 20 received a phosphodiesterase-5 inhibitor. After six months, there was a significant decrease in pulmonary vascular resistance (−236 dyn·s·cm−5[95% CI −343 dyn·s·cm−5to −130 dyn·s·cm−5]; P<0.001), mean pulmonary artery pressure (−8.9 mmHg [95% CI −13.7 mmHg to −4.2 mmHg]; P=0.001) and an increase in Fick cardiac output (0.9 L/min [95% CI 0.1 L/min to 1.6 L/min]; P=0.02). There was no change in 6 min walk distance. The proportion of subjects with a WHO functional class III or IV was significantly reduced at six months compared with baseline (18% versus 61%; P=0.002). Safety outcomes did not reveal any adverse events.CONCLUSIONS: Phosphodiesterase-5 inhibitor therapy improved hemodynamics and functional class at six months in a cohort of patients with portopulmonary hypertension.

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29

Gossage, James R. "Primary Pulmonary Hypertension or Portopulmonary Hypertension?" Chest 114, n.º 4 (outubro de 1998): 1224–25. http://dx.doi.org/10.1378/chest.114.4.1224-a.

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30

VV, Potii, Kiriienko VT, Potii DA, Glukhova EI e Kunickaya OS. "Portopulmonary Hypertension (Literature Review)". Acta Scientific Gastrointestinal Disorders 5, n.º 1 (1 de janeiro de 2022): 67–73. http://dx.doi.org/10.31080/asgis.2022.05.0371.

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31

Porres-Aguilar, Mateo, e Debabrata Mukherjee. "Portopulmonary hypertension: An update". Respirology 20, n.º 2 (18 de dezembro de 2014): 235–42. http://dx.doi.org/10.1111/resp.12455.

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32

Stauber, Rudolf E., e Horst Olschewski. "Portopulmonary hypertension: short review". European Journal of Gastroenterology & Hepatology 22, n.º 4 (abril de 2010): 385–90. http://dx.doi.org/10.1097/meg.0b013e3283337130.

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33

Koek, G. "Portopulmonary hypertension; treatment experience". Journal of Hepatology 34 (abril de 2001): 54. http://dx.doi.org/10.1016/s0168-8278(01)80181-1.

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34

Koek, G. H., F. Yurd, E. Haagsma, A. Boonstra, M. Delcroix e J. Pirenne. "Portopulmonary hypertension; treatment experience". Journal of Hepatology 34 (abril de 2001): 54. http://dx.doi.org/10.1016/s0168-8278(01)81056-4.

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35

Maruyama, Toru, Kohichi Ohsaki, Shinji Shimoda, Yoshikazu Kaji e Mine Harada. "Thromboxane-dependent portopulmonary hypertension". American Journal of Medicine 118, n.º 1 (janeiro de 2005): 93–94. http://dx.doi.org/10.1016/j.amjmed.2004.11.007.

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36

Perkins, James D. "Screening for portopulmonary hypertension". Liver Transplantation 13, n.º 3 (2007): 463–67. http://dx.doi.org/10.1002/lt.21105.

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37

Safdar, Zeenat, Sonja Bartolome e Norman Sussman. "Portopulmonary hypertension: An update". Liver Transplantation 18, n.º 8 (24 de julho de 2012): 881–91. http://dx.doi.org/10.1002/lt.23485.

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38

Ruggiero, Rosechelle M., e Sonja D. Bartolome. "Portopulmonary Hypertension: A Review". Advances in Pulmonary Hypertension 21, n.º 4 (1 de outubro de 2022): 123–29. http://dx.doi.org/10.21693/1933-088x-21.4.123.

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Portopulmonary hypertension (POPH) is a rare complication of liver disease occurring when pulmonary arterial hypertension develops in the setting of portal hypertension. It increases the morbidity and mortality compared to patients with cirrhosis alone. POPH is classified in Group 1 pulmonary arterial hypertension, which has important implications on treatment. After aggressive treatment and in carefully selected patients, liver transplantation can be performed; this can be curative of not only their liver disease but also of their POPH. Treatment and patient selection for optimum results continues to evolve. This article provides updates on the definition, clinical course, and treatment of patients with POPH. We will also discuss the evolving data in treatment and liver transplantation in POPH.

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39

Jasso-Baltazar, Erick A., Gonzalo A. Peña-Arellano, Jonathan Aguirre-Valadez, Isaac Ruiz, Bruno Papacristofilou-Riebeling, Jose Victor Jimenez, Cristian J. García-Carrera et al. "Portopulmonary Hypertension: An Updated Review". Transplantation Direct 9, n.º 8 (21 de julho de 2023): e1517. http://dx.doi.org/10.1097/txd.0000000000001517.

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Portal hypertension may have major consequences on the pulmonary vasculature due to the complex pathophysiological interactions between the liver and lungs. Portopulmonary hypertension (PoPH), a subset of group 1 pulmonary hypertension (PH), is a serious pulmonary vascular disease secondary to portal hypertension, and is the fourth most common subtype of pulmonary arterial hypertension. It is most commonly observed in cirrhotic patients; however, patients with noncirrhotic portal hypertension can also develop it. On suspicion of PoPH, the initial evaluation is by a transthoracic echocardiogram in which, if elevated pulmonary pressures are shown, patients should undergo right heart catheterization to confirm the diagnosis. The prognosis is extremely poor in untreated patients; therefore, management includes pulmonary arterial hypertension therapies with the aim of improving pulmonary hemodynamics and moving patients to orthotopic liver transplantation (OLT). In this article, we review in detail the epidemiology, pathophysiology, process for diagnosis, and most current treatments including OLT and prognosis in patients with PoPH. In addition, we present a diagnostic algorithm that includes the current criteria to properly select patients with PoPH who are candidates for OLT.

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40

Huang, Li, Wen Li, Tao Yang, Changming Xiong, Xinhai Ni, Qing Gu e Jianguo He. "Association between splenectomy and portal hypertension in the development of pulmonary hypertension". Pulmonary Circulation 10, n.º 1 (janeiro de 2020): 204589401989542. http://dx.doi.org/10.1177/2045894019895426.

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Both portal hypertension and splenectomy are risk factors for pulmonary hypertension. However, the interactions between portal hypertension and splenectomy in the development of pulmonary hypertension remain unclear. Twelve newly diagnosed pulmonary hypertension patients with a previous history of splenectomy induced by portal hypertension were recruited between November 2008 and May 2017. We compared their clinical features, hemodynamics, and prognosis with idiopathic pulmonary arterial hypertension patients, who were matched by cardiac index, mean pulmonary arterial pressure, and pulmonary vascular resistance. We also compared the clinical characteristics of portal hypertension-post-splenectomy-pulmonary hypertension patients with eight portopulmonary hypertension patients. Compared with the matched idiopathic pulmonary arterial hypertension patients, the portal hypertension-post-splenectomy-pulmonary hypertension patients showed significantly wider red blood cell distribution width (16.7 ± 2.8% versus 13.3 ± 1.7%, p = 0.004), higher total bilirubin concentration (31.0 ± 13.8 µmol/l versus 18.9 ± 10.0 µmol/l, p = 0.010), and higher lactate dehydrogenase concentration (321.5 ± 41.2 IU/l versus 229.2 ± 69.4 IU/l, p = 0.001). Kaplan–Meier survival analyses showed that the portal hypertension-post-splenectomy-pulmonary hypertension patients tended to have poorer prognosis than the matched idiopathic pulmonary arterial hypertension patients (log-rank test: p = 0.010). Compared with the portal hypertension-post-splenectomy-pulmonary hypertension patients, the portopulmonary hypertension cohort appeared to exhibit poorer clinical conditions, including significantly lower mixed venous oxygen saturation (62.9 ± 8.0% versus 73.9 ± 6.5%, p = 0.004) and a significantly higher proportion of pericardial effusion (75.0% versus 8.3%, p = 0.004), even though the two cohorts showed similar hemodynamics. The mean intervals from diagnosis of portal hypertension to pulmonary hypertension in portopulmonary hypertension patients were significantly shorter than the intervals from splenectomy to diagnosis of pulmonary hypertension in portal hypertension-post-splenectomy-pulmonary hypertension patients (5.5 ± 5.2 years versus 13.1 ± 5.9 years, p = 0.008). Splenectomy might be involved in the initiation and development of pulmonary hypertension in patients with portal hypertension, although the precise mechanisms involved remain unknown. Portal hypertension-post-splenectomy-pulmonary hypertension patients might have poorer prognosis even with mild hemodynamics.

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41

Akahane, Takemi. "Factors associated with portopulmonary hypertension". Hepatology Research 51, n.º 12 (30 de novembro de 2021): 1179–80. http://dx.doi.org/10.1111/hepr.13721.

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42

Restrepo, Ricardo, Esmé F. Singer e Michael Baram. "Hepatopulmonary Syndrome and Portopulmonary Hypertension". Hospital Practice 41, n.º 2 (abril de 2013): 62–71. http://dx.doi.org/10.3810/hp.2013.04.1049.

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43

Aldenkortt, Florence. "Portopulmonary hypertension and hepatopulmonary syndrome". World Journal of Gastroenterology 20, n.º 25 (2014): 8072. http://dx.doi.org/10.3748/wjg.v20.i25.8072.

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44

Auzinger, Georg, e Julia A. Wendon. "Hepatopulmonary Syndrome and Portopulmonary Hypertension". Critical Care Medicine 33, n.º 2 (fevereiro de 2005): 470–71. http://dx.doi.org/10.1097/01.ccm.0000153598.84976.e9.

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45

Wiklund, Richard A. "Hepatopulmonary Syndrome and Portopulmonary Hypertension". Critical Care Medicine 33, n.º 2 (fevereiro de 2005): 471. http://dx.doi.org/10.1097/01.ccm.0000153601.32819.b0.

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46

Hoeper, M. M. "Bosentan therapy for portopulmonary hypertension". European Respiratory Journal 25, n.º 3 (1 de março de 2005): 502–8. http://dx.doi.org/10.1183/09031936.05.00080804.

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47

Reichenberger, F., R. Voswinckel, E. Steveling, B. Enke, A. Kreckel, H. Olschewski, F. Grimminger, W. Seeger e H. A. Ghofrani. "Sildenafil treatment for portopulmonary hypertension". European Respiratory Journal 28, n.º 3 (28 de junho de 2006): 563–67. http://dx.doi.org/10.1183/09031936.06.00030206.

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48

Ioachimescu, O. C., A. C. Mehta e J. K. Stoller. "Hepatopulmonary syndrome following portopulmonary hypertension". European Respiratory Journal 29, n.º 6 (1 de março de 2007): 1277–80. http://dx.doi.org/10.1183/09031936.00140306.

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49

KAMATH, PATRICK S. "Portopulmonary hypertension and hepatopulmonary syndrome". Journal of Gastroenterology and Hepatology 17 (dezembro de 2002): S253—S255. http://dx.doi.org/10.1046/j.1440-1746.17.s3.9.x.

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50

Fuhrmann, Valentin, e Daniel Benten. "Hepatopulmonales Syndrom und portopulmonale Hypertension". Gastroenterologie up2date 11, n.º 01 (10 de março de 2015): 27–38. http://dx.doi.org/10.1055/s-0034-1391648.

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