cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2024.12.n2784cardio-2784Research ArticleОБЗОРЫREVIEWSМедикаментозное лечение хронической тромбоэмболической легочной гипертензииChronic Thromboembolic Pulmonary Hypertension Drug TreatmentИвановС. Н.IvanovS. N.

Врач-детский кардиолог    Консультативно-диагностическое отделение № 1, д.м.н., ведущий научный сотрудник

Новосибирск, Россия

Pediatric cardiologist Consultative and diagnostic department No. 1

Novosibirsk, Russia

ivanov0557@mail.ruЧернявскийА. М.ChernyavskyA. M.

Генеральный директор ФГБУ «НМИЦ им. ак. Е.Н. Мешалкина» Минздрава России,  член-корр. РАН, д.м.н., профессор

Новосибирск, Россия

Director General, Corresponding Member of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor

Novosibirsk, Russia

ЕдемскийА. Г.EdemskyA. G.

Врач-сердечно-сосудистый хирург,  Кардиохирургическое отделение № 2 ,  ФГБУ «НМИЦ им. ак. Е.Н. Мешалкина» Минздрава России, к.м.н.

Новосибирск, Россия

Cardiovascular surgeon Cardiac surgery department No. 2

PhD

Novosibirsk, Russia

ВасильцеваО. Я.VasiltsevaO. Ya.

Ведущий научный сотрудник, Научно-исследовательский отдел хирургии аорты, коронарных и периферических артерий института  патологии кровообращения , ФГБУ «НМИЦ им. ак. Е.Н. Мешалкина» Минздрава России,   д.м.н.

Новосибирск, Россия

Leading researcher Research Department of Aortic Surgery, Coronary and Peripheral Arteries of the Institute of Circulatory PathologyDoctor of Medical Sciences.

Novosibirsk, Russia

ФГБУ «Национальный медицинский исследовательский центр им. академика Е. Н. Мешалкина» Минздрава РФРоссияMeshalkin National Medical Research CenterRussian Federation20242512202464127785Copyright © Kardiomag, 20242024KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/2784

Основным методом лечения пациентов с хронической тромбоэмболической легочной гипертензией (ХТЭЛГ) является радикальное хирургическое вмешательство – легочная тромбэндартерэктомия (ЛЭЭ). Однако около 40% больных с ХТЭЛГ неоперабельны в связи с дистальным поражением легочного сосудистого русла или тяжестью гемодинамических нарушений. Почти у 30% пациентов с ХТЭЛГ после хирургического вмешательства отмечается персистирующая или рецидивирующая легочная гипертензия, требующая медикаментозного лечения ЛАГ-специфическими препаратами. В настоящем обзоре приведены актуальные данные по применению таргетной терапии у пациентов с ХТЭЛГ. Обсуждаются место, показания и доказательная база по применению основных групп специфических препаратов, в том числе стимуляторов растворимой гуанилатциклазы, ингибиторов фосфодиэстеразы пятого типа, антагонистов рецепторов эндотелина, аналогов простациклина.

 

The main treatment of patients with chronic thromboembolic pulmonary hypertension (CTEPH) is radical surgery, pulmonary thromboendarterectomy (PEA). However, about 40% of patients with CTEPH are inoperable due to distal pulmonary vascular lesions or the severity of hemodynamic disorders. Almost 30% of patients with CTEPH experience persistent or recurrent pulmonary hypertension after surgery, that requires a drug treatment with PAH-specific drugs. This review presents current data on the use of targeted therapy in patients with CTEPH. The review addresses the place, indications, and the evidence base for using the main groups of specific drugs, including stimulators of soluble guanylate cyclase, phosphodiesterase type 5 inhibitors, endothelin receptor antagonists, and prostacyclin analogues.

 

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The authors declare that there are no conflicts of interest present.