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Publication
Hipertensão Pulmonar Em Cães
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Abstract(s)
A Hipertensão Pulmonar é caracterizada pelo aumento da pressão nos vasos sanguíneos pulmonares, geralmente superior a 25 mmHg em repouso, devido a fatores como maior fluxo sanguíneo, resistência vascular elevada ou aumento da pressão venosa pulmonar. As manifestações clínicas incluem síncope, dificuldade respiratória em repouso, falta de oxigenação e sinais decorrentes de insuficiência cardíaca direita. O prognóstico para animais com hipertensão pulmonar é reservado, sendo tanto mais favorável quanto mais cedo a condição for diagnosticada.
Em 2020, o American College of Veterinary Medicine publicou um Consenso que visa orientar a classificação, diagnóstico, tratamento e prognóstico da HP em cães. Este documento, que reúne o parecer de um painel de especialistas do tema, propõe uma classificação em seis grupos, baseada na causa de base da Hipertensão Pulmonar. Consoante a etiologia e a apresentação clínica do animal é estabelecido o procedimento de diagnóstico mais aconselhado. O tratamento baseia-se principalmente em inibidores da fosfodiesterase-5, como sildenafil ou tadalafil, que dilatam as artérias pulmonares e inibem a proliferação das células musculares lisas no tecido pulmonar.
Após a publicação do Consenso, em 2020, foram publicados diversos artigos com a intenção de atualizar os melhores procedimentos de diagnóstico e tratamento. No campo do diagnóstico, existem vários artigos que estudam a validade de diferentes biomarcadores na previsão da probabilidade de existir hipertensão pulmonar bem como atualizam e validam diferentes parâmetros ecográficos. Relativamente ao tratamento, vários estudos investigam a eficácia de tratamentos com fármacos adjuvantes ao sildenafil e ao tadalafil e propõem uma correlação entre os mesmos e o prognóstico observado.
Com este trabalho, pretende-se realizar um resumo do conhecimento científico relevante sobre hipertensão pulmonar obtido até à publicação do Consenso e uma revisão bibliográfica dos estudos sobre diagnóstico, tratamento e prognóstico publicados após essa data. O objetivo é produzir um documento científico que permita a atualização para as novas informações sobre o tema.
Pulmonary Hypertension is characterized by increased pressure in the pulmonary blood vessels, generally exceeding 25 mmHg at rest, due to factors such as increased blood flow, elevated vascular resistance, or increased pulmonary venous pressure. Clinical manifestations include syncope, dyspnea at rest, lack of oxygenation, and clinical signs of right heart failure. The prognosis for animals with pulmonary hypertension is guarded. In 2020, the American College of Veterinary Medicine published a Consensus aimed at guiding the classification, diagnosis, treatment, and prognosis of PH in dogs. This document, which brings together the opinions of a panel of experts on the subject, proposes a classification into six groups based on the underlying cause of Pulmonary Hypertension. Depending on the etiology and clinical presentation of the animal, the most recommended diagnostic procedure is established. Treatment is mainly based on phosphodiesterase-5 inhibitors, such as sildenafil or tadalafil, which dilate the pulmonary arteries and prevent abnormal cell growth in the lungs. Following the publication of the Consensus in 2020, several articles have been published with the intent of updating the best diagnostic and treatment procedures. In the field of diagnosis, various articles study the validity of different biomarkers in predicting the likelihood of pulmonary hypertension as well as update and validate different echocardiographic parameters. Regarding treatment, several studies investigate the efficacy of adjunctive drug treatments with sildenafil and tadalafil and propose a correlation between those treatments and the observed prognosis. With this work, we aim to provide a summary of the relevant scientific knowledge on pulmonary hypertension obtained up to the publication of the Consensus and a literature review of studies on diagnosis, treatment, and prognosis published after that date. The goal is to produce a scientific document that allows for updating with new information on the subject.
Pulmonary Hypertension is characterized by increased pressure in the pulmonary blood vessels, generally exceeding 25 mmHg at rest, due to factors such as increased blood flow, elevated vascular resistance, or increased pulmonary venous pressure. Clinical manifestations include syncope, dyspnea at rest, lack of oxygenation, and clinical signs of right heart failure. The prognosis for animals with pulmonary hypertension is guarded. In 2020, the American College of Veterinary Medicine published a Consensus aimed at guiding the classification, diagnosis, treatment, and prognosis of PH in dogs. This document, which brings together the opinions of a panel of experts on the subject, proposes a classification into six groups based on the underlying cause of Pulmonary Hypertension. Depending on the etiology and clinical presentation of the animal, the most recommended diagnostic procedure is established. Treatment is mainly based on phosphodiesterase-5 inhibitors, such as sildenafil or tadalafil, which dilate the pulmonary arteries and prevent abnormal cell growth in the lungs. Following the publication of the Consensus in 2020, several articles have been published with the intent of updating the best diagnostic and treatment procedures. In the field of diagnosis, various articles study the validity of different biomarkers in predicting the likelihood of pulmonary hypertension as well as update and validate different echocardiographic parameters. Regarding treatment, several studies investigate the efficacy of adjunctive drug treatments with sildenafil and tadalafil and propose a correlation between those treatments and the observed prognosis. With this work, we aim to provide a summary of the relevant scientific knowledge on pulmonary hypertension obtained up to the publication of the Consensus and a literature review of studies on diagnosis, treatment, and prognosis published after that date. The goal is to produce a scientific document that allows for updating with new information on the subject.
Description
Keywords
Cão Ecocardiografia Hipertensão Pulmonar Inibidores Fosfodiesterase-5 Sildenafil Dog Echocardiography Phosphodiesterase-5 Inhibitors Pulmonary Hypertension Sildenafil