- 期刊
2023 Taiwan Society of Cardiology (TSOC) and Taiwan College of Rheumatology (TCR) Joint Consensus on Connective Tissue Disease-Associated Pulmonary Arterial Hypertension
摘要
Background: Pulmonary arterial hypertension (PAH), defined as the presence of a mean pulmonary artery pressure >20 mmHg, pulmonary artery wedge pressure ≤ 15 mmHg, and pulmonary vascular resistance (PVR) > 2 Wood units based on expert consensus, is characterized by a progressive and sustained increase in PVR, which may lead to right heart failure and death. PAH is a well-known complication of connective tissue diseases (CTDs), such as systemic sclerosis, systemic lupus erythematosus, Sjogren's syndrome, and other autoimmune conditions. In the past few years, tremendous progress in the understanding of PAH pathogenesis has been made, with various novel diagnostic and screening methods for the early detection of PAH proposed worldwide. Objectives: This study aimed to obtain a comprehensive understanding and provide recommendations for the management of CTD-PAH in Taiwan, focusing on its clinical importance, prognosis, risk stratification, diagnostic and screening algorithm, and pharmacological treatment. Methods: The members of the Taiwan Society of Cardiology (TSOC) and Taiwan College of Rheumatology (TCR) reviewed the related literature thoroughly and integrated clinical trial evidence and real-world clinical experience for the development of this consensus. Conclusions: Early detection by regularly screening at-risk patients with incorporations of relevant autoantibodies and biomarkers may lead to better outcomes of CTD-PAH. This consensus proposed specific screening flowcharts for different types of CTDs, the risk assessment tools applicable to the clinical scenario in Taiwan, and a recommendation of medications in the management of CTD-PAH.
延伸閱讀
- Huang, C. C., & Chen, J. W. (2019). Risk factor control and medical therapy of coronary artery disease in Taiwan - Review and Recommendations - Part II: Blood pressure management for patients with coronary artery disease. 海峽循環醫學雜誌, 1(3), 9-13. https://doi.org/10.6907/SCJ.201911_1(3).0002
- Wang, C. C., Wu, C. K., Tsai, M. L., Lee, C. M., Huang, W. C., Chou, H. H., Huang, J. L., Chi, N. H., Yen, H. W., Tzeng, B. H., Chang, W. T., Chang, H. Y., Wang, C. H., Lu, Y. Y., Tsai, J. P., Su, C. H., Cherng, W. J., Yin, W. H., Tsai, C. T., Wu, Y. W., Lin, J. L., & Hwang, J. J. (2019). 2019 Focused Update of the Guidelines of the Taiwan Society of Cardiology for the Diagnosis and Treatment of Heart Failure. Acta Cardiologica Sinica, 35(3), 244-283. https://doi.org/10.6515/ACS.201905_35(3).20190422A
- Chiang, C. E., Wang, T. D., Lin, T. H., Yeh, H. I., Liu, P. Y., Cheng, H. M., Chao, T. H., Chen, C. H., Shyu, K. G., Ueng, K. C., Chen, C. Y., Chu, P. H., Sung, S. H., Wang, K. L., Li, Y. H., Wang, K. Y., Chiang, F. T., Lai, W. T., Chen, J. H., Chen, W. J., Yeh, S. J., Chen, M. F., Lin, S. J., & Lin, J. L. (2017). The 2017 Focused Update of the Guidelines of the Taiwan Society of Cardiology (TSOC) and the Taiwan Hypertension Society (THS) for the Management of Hypertension. Acta Cardiologica Sinica, 33(3), 213-225. https://doi.org/10.6515/ACS20170421A
- Chiang, C. E., Hung, C. L., Wu, Y. W., Lin, T. H., Ueng, K. C., Sung, S. H., Wu, C. K., Chao, T. H., Lin, H. J., Lin, Y. H., Huang, J. L., Chen, M. Y. C., Lin, P. L., Chao, T. F., Cheng, H. M., Liu, M. E., Wang, T. D., Yeh, H. I., Li, Y. H., Liu, P. Y., Yin, W. H., Hsieh, I. C., Wang, C. C., Chen, C. H., Chu, P. H., Lin, S. J., Yeh, S. J., Lin, J. L., Hwang, J. J., Hung, H. F., Chen, W. J., & Hou, C. J. Y. (2023). 2023 Consensus of Taiwan Society of Cardiology on the Pharmacological Treatment of Chronic Heart Failure. Acta Cardiologica Sinica, 39(3), 361-390. https://doi.org/10.6515/ACS.202305_39(3).20230301A
- Cheng, H. M., Chuang, S. Y., Sung, S. H., Wu, C. C., Wang, J. J., Hsu, P. F., Chao, C. L., Hwang, J. J., Wang, T. D., & Chen, C. H. (2019). 2019 Consensus of the Taiwan Hypertension Society and Taiwan Society of Cardiology on the Clinical Application of Central Blood Pressure in the Management of Hypertension. Acta Cardiologica Sinica, 35(3), 234-243. https://doi.org/10.6515/ACS.201905_35(3).20190415B