{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T23:33:41Z","timestamp":1725579221134},"reference-count":96,"publisher":"Georg Thieme Verlag KG","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pneumologie"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Die pulmonale Hypertonie in Verbindung mit Linksherzerkrankungen (PH-LHD) bildet in der klinischen Klassifikation die Gruppe 2 der pulmonalen Hypertonie ab. H\u00e4modynamisch z\u00e4hlt zu dieser Gruppe die isoliert postkapill\u00e4re pulmonale Hypertonie (IpcPH) und die gemischt post- und pr\u00e4kapill\u00e4re pulmonale Hypertonie (CpcPH). Die PH-LHD ist durch einen mPAP &gt;\u200a20\u200ammHg und einen PAWP &gt;\u200a15\u200ammHg definiert, zur Differenzierung zwischen IpcPH und CpcPH wird der pulmonalvaskul\u00e4re Widerstand (PVR) mit dem Grenzwert von 2 Wood Units (WU) herangezogen. Ein PVR von gr\u00f6\u00dfer 5\u200aWU weist auf eine dominierende pr\u00e4kapill\u00e4re Komponente hin. Die PH-LHD ist die h\u00e4ufigste Form der pulmonalen Hypertonie, urs\u00e4chlich f\u00fchrend ist die Linksherzinsuffizienz mit erhaltener (HFpEF) oder reduzierter Ejektionsfraktion (HFmrEF, HFrEF), Herzklappenerkrankungen und seltener angeborene Herzfehler. Das Vorhandensein eines pulmonalen Hypertonus geht im gesamten Spektrum der Linksherzerkrankungen mit einer erh\u00f6hten Symptomlast und schlechterem Outcome einher. Eine besondere Herausforderung stellt die Differenzierung zwischen der pulmonalen Hypertonie der Gruppe 1 mit kardialen Komorbidit\u00e4ten und der PH-LHD, besonders infolge der HFpEF dar. Therapeutisch kann zum jetzigen Zeitpunkt noch keine generelle Empfehlung f\u00fcr den Einsatz von PDE-5-Inhibitoren bei HFpEF-assoziierter CpcPH gegeben werden. F\u00fcr die Anwendung von PAH-Medikamenten bei der IpcPH gibt es aktuell keine belastbare Rationale, ebenso wird die Therapie mit Endothelin-Rezeptor-Antagonisten oder Prostazyklin-Analoga bei allen Formen der PH-LHD nicht empfohlen.<\/jats:p>","DOI":"10.1055\/a-2145-4792","type":"journal-article","created":{"date-parts":[[2023,11,14]],"date-time":"2023-11-14T23:32:45Z","timestamp":1700004765000},"page":"926-936","source":"Crossref","is-referenced-by-count":1,"title":["Pulmonale Hypertonie assoziiert mit Linksherzerkrankungen (Gruppe 2)"],"prefix":"10.1055","volume":"77","author":[{"given":"Kai Helge","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Zentrum f\u00fcr Kardiologie, Kardiologie I, Universit\u00e4tsmedizin Mainz, Mainz, Deutschland"},{"name":"Centrum f\u00fcr Thrombose und H\u00e4mostase (CTH), Universit\u00e4tsmedizin Mainz, Mainz, 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Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Rieth","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Kardiologie, Kerckhoff-Klinik Bad Nauheim, Bad Nauheim, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Schmeisser","sequence":"additional","affiliation":[{"name":"Zentrum f\u00fcr Innere Medizin, Universit\u00e4tsklinik f\u00fcr Kardiologie und Angiologie Magdeburg, Magdeburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Schnitzler","sequence":"additional","affiliation":[{"name":"Zentrum f\u00fcr Kardiologie, Kardiologie I, Universit\u00e4tsmedizin Mainz, Mainz, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Stadler","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin II, Universit\u00e4tsklinikum Regensburg, Regensburg, 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