[Pulmonary hypertension complicating portal hypertension: portopulmonary hypertension].
Portopulmonary hypertension is a condition with a poor prognosis, which is defined as precapillary pulmonary hypertension complicating portal hypertension mainly due to cirrhosis of various etiologies. A mean pulmonary arterial pressure greater than 25 mmHg at rest with a pulmonary capillary wedge pressure less than 15 mmHg and a pulmonary vascular resistance greater than 120 dynes.sec.cm-5, in the setting of the presence of portosystemic shunting has been proposed as hemodynamic criteria for portopulmonary hypertension. Prevalence of pulmonary hypertension ascertained by right cardiac catheterization was 2% among patients with cirrhosis, and reached to 4% particularly among candidates for liver transplantation. Hyperdynamic systemic circulation seen commonly in patients with cirrhosis appeared to be normalized by complication of pulmonary hypertension with a contraction of circulating plasma volume. Long term treatment by epoprostenol administration or nitric oxide inhalation could induce a gradual decline in pulmonary arterial pressure in patients with poor response to acute vasodilator administration.
Katsuta
Y
Y
First Department of Internal Medicine, Nippon Medical School.
Zhang
X J
XJ
Aramaki
T
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006521:Hepatitis, Chronic / Q000150:complications; D006801:Humans; D006975:Hypertension, Portal / Q000150:complications* / Q000188:drug therapy; D006976:Hypertension, Pulmonary / Q000188:drug therapy / Q000209:etiology*; D008103:Liver Cirrhosis / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011652:Pulmonary Circulation; D014665:Vasodilator Agents / Q000627:therapeutic use
D014665:Vasodilator Agents