Hypertension pulmonaire des fibroses pulmonaires : quelle approche diagnostique et thérapeutique en 2011 ? - Université Claude Bernard Lyon 1 Accéder directement au contenu
Article Dans Une Revue La Presse Médicale Année : 2011

Pulmonary hypertension in interstitial lung diseases: diagnostic and therapeutic approach in 2011?

Hypertension pulmonaire des fibroses pulmonaires : quelle approche diagnostique et thérapeutique en 2011 ?

Résumé

Pulmonary hypertension is frequent in late-stage idiopathic pulmonary fibrosis, and is associated with a shorter survival. It should be suspected in case of dyspnea or hypoxemia disproportionate with the degree of parenchymal lung disease. It is particularly frequent in patients with the syndrome of combined pulmonary fibrosis and emphysema, and associated with a short survival (median survival less than 1 year). Pulmonary hypertension associated with chronic infiltrative lung diseases can be detected by echocardiography and must be confirmed by right-sided heart catheterization, especially to rule out post-capillary pulmonary hypertension frequent in this context. Management is mainly palliative and based on supplemental nasal oxygen. Therapy specific for pulmonary arterial hypertension, poorly evaluated in pulmonary hypertension associated with infiltrative lung diseases, is occasionally proposed to patients with disproportionate pulmonary hypertension (mean PAP > 35 mmHg), with often limited efficacy, and requiring careful follow-up (risk of increased hypoxemia) and invasive evaluation. Pulmonary transplantation should be considered in the absence of contra-indication.

Dates et versions

hal-02643042 , version 1 (28-05-2020)

Identifiants

Citer

Vincent Cottin, Lize Kiakouama, Julie Traclet, Jean-François Cordier. Hypertension pulmonaire des fibroses pulmonaires : quelle approche diagnostique et thérapeutique en 2011 ?. La Presse Médicale, 2011, 40 (1), pp.1S39-1S45. ⟨10.1016/S0755-4982(11)70006-9⟩. ⟨hal-02643042⟩
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