Синдром сдавления ствола левой коронарной артерии при легочной артериальной гипертензии. Первый клинический опыт

Автор: Быков Александр Николаевич, Архипов Михаил Викторович, Климушева Наталия Федоровна, Иофин Александр Ильич

Журнал: Евразийский кардиологический журнал @eurasian-cardiology-journal

Статья в выпуске: 4, 2018 года.

Бесплатный доступ

Боль в груди является частым симптомом у пациентов с легочной артериальной гипертензией (ЛАГ). Компрессия коронарных артерий является редким осложнением ЛАГ, что иногда является причиной стенокардических болей у пациентов с ЛАГ в стадии прогрессии заболевания. Стеноз ствола левой коронарной артерии (ЛКА) расширенным стволом легочной артерии зачастую ассоциирован со стенокардией, при этом общепринятых подходов к диагностике и лечению данного состояния в настоящее время нет. В данной работе представлен клинический случай пациентки (38 лет) с диагностированной идиопатической ЛАГ, у которой наблюдалась ишемия миокарда ввиду сдавления ствола ЛКА расширенным стволом легочной артерии. Синдром стеноза ствола ЛКА был подтвержден по данным коронарной ангиографии и мультиспиральной компьютерной томографии. Стентирование ствола ЛКА и применение ЛАГ-специфических препаратов (с целью фармакотерапии ЛАГ) позволили существенно улучшить состояние пациента, включая улучшения функции сердца и качества жизни. Чрезкожное коронарное вмешательство, по-видимому, является эффективным и безопасным методом коррекции синдрома сдавления ствола ЛКА расширенным стволом ЛА

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Идиопатическая легочная артериальная гипертензия, ствол левой коронарной артерии, расширение ствола легочной артерии, легочная гипертензия

Короткий адрес: https://sciup.org/143170022

IDR: 143170022

Список литературы Синдром сдавления ствола левой коронарной артерии при легочной артериальной гипертензии. Первый клинический опыт

Galie et al. Guidelines for the diagnosis and treatment of pulmonary hypertension: the Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). Eur Heart J 2009;30:2493-537.
McLaughlin et al. ACCF/AHA 2009 expert consensus document on pulmonary hypertension a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association. J Am Coll Cardiol 2009; 53:1573-619.
De Alonzo GE et al. Survival in patients with primary pulmonary hypertension. Results from a national prospective registry. Intern Med 1991;115:343-9.
Humbert et al. Survival in patients with idiopathic, familial and anorexigen-associated pulmonary arterial hypertension in the modern management era. Circulation 2010;122:156-163.
Montani et al. Pulmonary arterial hypertension. Orphanet Journal of Rare Diseases 2013; 8:97.
Benza et al. An evaluation of long-term survival from time of diagnosis in pulmonary arterial hypertension from the REVEAL Registry. Chest 2012;142:448-56.
И.Е. Чазова, С.Н. Авдеев, Н.А. Царева, А.В. Волков, Т.В. Мартынюк, С.Н. Наконечников. Клинические рекомендации по диагностике и лечению легочной гипертонии. Терапевтический архив 2014; 9:4-23.
Galie N, Humbert M, Vachiery JL, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). Eur Respir J. 2015; 46(4): 903-75.
Gali N et al. Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J 2009; 30:2493-537.
Rosenblum WD. Pulmonary arterial hypertension: pathobiology, diagnosis, treatment, and emerging therapies. Cardiol Rev 2010; 18:58-63.
Rosenkranz S. Pulmonary hypertension: current diagnosis and treatment Clin Res Cardiol 2007; 96:527-541.
Humbert M. Pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: pathophysiology. Eur Respir Rev 2010;19:115,59-63.
Мартынюк Т.В. Легочная гипертензия: диагностика и лечение, Москва, 2018, 148./T.V. Martynyuk. Pulmonary hypertension: diagnostics and treatment, Moscow, 2018,148. .
Hoeper M, Bogaard H, Condliffe R, et al. Definitions and Diagnosis of Pulmonary Hypertension. J Am Coll Cardiology 2013; Vol. 62, Suppl D: сЛ42-50.
Беленков Ю.Н., Чазова И.Е. Первичная легочная гипертензия. М.: Нолидж, 1999 г. с. 141./Belenkov Yu.N., Chazova I.Ye. Primary pulmonary hypertension. Moscow: Nolidge, 1999. p. 141. .
Galie N, Simonneau G. The Fifth World Symposium on Pulmonary Hypertension. J Am Coll Cardiol 2013; 62: D1-3.
Galiè N, Saia F, et al. Left Main Coronary Artery Compression in Patients With Pulmonary Arterial Hypertension and Angina. JACC. Vol. 69, NO. 2 3, June 13,2017:2 808-17.
Ling Y, Johnson M, Kiely D et al. Changing demographics, epidemiology, and survival of incident pulmonary arterial hypertension: results from the pulmonary hypertension registry of the United Kingdom and Ireland. Am J Respir Crit Care Med 2012; 186:790-6.
Rich S, Dantzker D, Ayres S et al. Primary pulmonary hypertension. A national prospective study. Ann Intern Med 1987; 107:216-23.
Brown L, Chen H et al. Delay in recognition of pulmonary arterial hypertension: factors identified from the REVEAL Registry. Chest 2011; 140:19-26.
Jing Z, Xu X, Han Z et al. Registry and Survival Study in Chinese Patients With Idiopathic and Familial Pulmonary Arterial Hypertension. Chest 2007; 132:373-9.
Gomez A., Bialostozky D., Zajarias A. et al. Right ventricular ischemia in patients with primary pulmonary hypertension. J Am Coll Cardiol 2001; 38:1137-42.
de Jesus Perez V.A., Haddad F.et al. Angina associated with left main coronary artery compression in pulmonary hypertension. J Heart Lung Transplant 2009; 28: 527-30.
Karrowni W., Sigurdsson G. et al. Left main coronary artery compression by an enlarged pulmonary artery. J Am Coll Cardiol Intv 2013; 6: e3-4.
Mesquita S., Castro C. et al. Likelihood of left main coronary artery compression based on pulmonary trunk diameter in patients with pulmonary hypertension. Am J Med 2004; 116:369-374.
Vaseghi M, Lee J et al. Acute myocardial infarction secondary to left main coronary artery compression by pulmonary artery aneurysm in pulmonary arterial hypertension. J Invasive Cardiol 2007; 19(12): 375-377.
Skoularigis J, Sareli P. Submitral left ventricular aneurysm compressing the left main coronary artery. Cathet Cardiovasc Diagn 1997; 40:173-5.
Demerouti E, Manginas A et al. Complications leading to sudden cardiac death in pulmonary arterial hypertension. Respir Care 2013; 58:1246-54.
Dodd J, Maree A, Palacios I, et al. Images in cardiovascular medicine. Left main coronary artery compression syndrome: evaluation with 64-slice cardiac multidetector computed tomography. Circulation 2007; 115: e7-8.
Kajita L, Martinez E, Ambrose J, et al. Extrinsic compression of the left main coronary artery by a dilated pulmonary artery: clinical, angiographic, and hemodynamic determinants. Catheter Cardiovasc Interv 2001; 52:49-54.
D'Alonzo GE, Barst R, Ayres S et al. Survival in patients with primary pulmonary hypertension. Results from a national prospective registry. Ann Intern Med 1991; 115:343-9.
Vaseghi M, Lee M et al. Percutaneous intervention of left main coronary artery compression by pulmonary artery aneurysm. Catheter Cardiovasc Interv 2010; 76:352-356.
Corday E, Gold H, Kaplan L. Coronary artery compression: an explanation for the cause of coronary insufficiency in pulmonary hypertension. Trans Am Coll Cardiol 1957 Jan; 7:93-103.
Ay§enurPaç, Deniz N. Çagda§ D, MahmutUlaç et al. Left main coronary artery and aortic root compression associated with atrial septal defect and pulmonary hypertension. International Journal of Cardiology 118,2007: e41-e43.
Amaral F, Lafaiete Alves Jr. et al. Extrinsic Compression of Left Main Coronary Artery from Aneurysmal Dilation of Pulmonary Trunk in an Adolescent. Involution after Surgery Occlusion of Sinus Venosus Atrial Septal Defect and Pulmonary Trunk Plasty for Reduction Arq Bras Cardiol 2007; 88(2): e39-e41.
Andjelkovic K, Kalimanovska-Ostric D et al. Two rare conditions in an Eisenmenger patient: Left main coronary artery compression and Ors syndrome due to pulmonary artery dilatation. Heart & Lung 42 (2013) 382e386.
Kothandam Sivakumar K, Maruthanayagam Rajan et al. Extrinsic Compression of the Left Coronary Ostium by the Pulmonary Trunk: Management in a Case of Eisenmenger Syndrome. TexHeartInstJ 2010; 37(1): 95-8.
Rich S, Dantzker DR, Ayres SM, et al. Primary pulmonary hypertension: a national prospective study. Ann Intern Med. 1987; 107:216-223.
Galie N et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). European Heart Journal (2016) 37, 67-119).
Luciana F. Seabra, Henrique B. Ribeiro et al. Left Main Ostial Compression in a Patient with Pulmonary Hypertension: Dynamic Findings by IVUS Am J Case Rep, 2015; 16:899-903.
Sonia M. F. Mesquita, MD, Claudia R. P. Castro et al. Likelihood of Left Main Coronary Artery Compression Based on Pulmonary Trunk Diameter in Patients with Pulmonary Hypertension. March 15,2004 THE AMERICAN JOURNAL OF MEDICINE, Vol. 116
D'Alonzo GE et al. Survival in Patients with Primary Pulmonary Hypertension Ann Intern Med 1991; 115:343-349.
Thenappan T et al. Survival in pulmonary arterial hypertension: a reappraisal of the NIH risk stratification equation. Eur Respir J 2010; 35:1079-1087.
Masataka Ogiso, Naoki Serizawa et al. Percutaneous Coronary Intervention for Left Main Compression Syndrome due to Severe Idiopathic Pulmonary Arterial Hypertension: One Year Follow-up Using Intravascular Imaging Intern Med 54:801-804,2015.
Khaled F. Salhab, Adil H. Al Kindi et al. Percutaneous coronary intervention of the left main coronary artery in a patient with extrinsic compression caused by massive pulmonary artery enlargement. J ThoracCardiovascSurg 2012; 144:1517-1518.
Vaseghi M, Lee M et al. Percutaneous Intervention of Left Main Coronary Artery Compression by Pulmonary Artery Aneurysm. Catheterization and Cardiovascular Interventions 76: 352-356 (2010)
Lee M, Oyama J et al. Left Main Coronary Artery Compression from Pulmonary Artery Enlargement Due to Pulmonary Hypertension: A Contemporary Review and Argument for Percutaneous Revascularization Catheterization and Cardiovascular Interventions 76:543-550 (2010).
Caldera A, Cruz-Gonzalez I et al. Endovascular Therapy for Left Main Compression Syndrome, Case Report and Literature Review CHEST 2009; 135:1648-1650.
Godfrey A, Cajigas H et al. A 55-Year-Old Woman With Pulmonary Hypertension, Worsening Dyspnea, and Chest Pain CHEST2014; 145 (3): 642 -645.
Albadri K, Jensen J et al. Left main coronary artery compression in pulmonary arterial hypertension. PulmCirc 2015; 5(4): 734736.
DOI: 10.1086/683690
Yoon-Jung Choi, Ung Kim et al. A Case of Extrinsic Compression of the Left Main Coronary Artery Secondary to Pulmonary Artery Dilatation. J Korean Med Sci 2013; 28:1543-1548.
Kawut S, Frank E. Silvestry et al. Extrinsic Compression of the Left Main Coronary Artery by the Pulmonary Artery in Patients With Long-Standing Pulmonary Hypertension. THE AMERICAN JOURNAL OF CARDIOLOGYT, 1999. Vol. 83.
Boerrigter B, Mauritz GJ, Marcus JT, Helderman F, Postmus PE, Westerhof N, Vonk-Noordegraaf A. Progressive dilatation of the main pulmonary artery is a characteristic of pulmonary arterial hypertension and is not related to changes in pressure. Chest 2010; 138(6): 1395-1401.
Mitsudo K, Fujino T, Matsunaga K et al. Coronary angiographic findings in the patients with atrial septal defect and pulmonary hypertension-compression of left main coronary artery by pulmoanry trunk. Kokyu To Junkan 1989; 37(6): 649-655. Article in Japanese.
Kothari S, Chatterjee S et al. Left main coronary artery compression by dilated main pulmonary artery in atrial septal defect. Indian Heart J 1994; 46(4): 165-167.
Lindsey JB, Brilakis ES, Banerjee S. Acute coronary syndrome due to extrinsic compression of the left main coronary artery in a patient with severe pulmonary hypertension: successful treatment with percutaneous coronary intervention. Cardiovasc Revasc Med 2008; 9(1): 47-51.
Tespili M, Saino A, Personeni D et al. Life-threatening left main stenosis induced by compression from a dilated pulmonary artery J Cardiovasc Med (Hagerstown) 2009; 10(2): 183-187.
Fujiwara K, Naito Y et al. Left main coronary trunk compression by dilated main pulmonary artery in atrial septal defect. Report of three cases. J Thorac Cardiovasc Surg 1992; 104(2): 449-452.
Ngaage D, Lapeyre A et al. Left main coronary artery compression in chronic thromboembolic pulmonary hypertension. Eur J Cardiothorac Surg 2005; 27(3): 512.
Pin'a Y, Exaire J et al. Left main coronary artery extrinsic compression syndrome: a combined intravascular ultrasound and pressure wire. J Invasive Cardiol 2006; 18:102-104.
Bonderman D, Fleischmann D et al. Images in cardiovascular medicine. Left main coronary artery compression by the pulmoarny trunk in pulmonary hypertension. Circulation 2002; 105(2): 265.
Safi M, Eslami V, Shabestari A et al. Extrinsic compression of left main coronary artery by the pulmoarny trunk secondary to pulmonary hypertension documented using 64-slice multidetector computed tomography coronary angiography. Clin Cardiol 2009; 32(8): 426-428.
Jodocy D, Friedrich G et al. Left main compression syndrome by idiopathic pulmonary artery aneurysm caused by medial necrosis Erdheim-Gsell combined with bicuspid pulmonary valve. J Thorac Cardiovasc Surg 2009; 138(1): 234-236.
Rich S, McLaughlin V et al. Stenting to reverse left ventricular ischemia due to left main coronary artery compression in primary pulmonary hypertension. Chest 2001; 120(4): 1412-1415.
Go 'mez Varela S, Montes Orbe P et al. Stenting in primary pulmonary hypertension with compression of the left main coronary artery. Rev Esp Cardiol 2004; 57(7): 695-698. Article in Spanish.
Dubois CL, Dymarkowski S et al. Compression of the left main pulmaorny artery in a patient with the Eisenmenger syndrome. Eur Heart J 2007; 28(16): 1945.
Badagliacca R, Poscia R et al. Pulmonary arterial dilatation in pulmonary hypertension: prevalence and prognostic relevance. Cardiology, 2012; 121(2): 76-82.
Liu WH, Luo Q, Liu ZH et al. Pulmonary function differences in patients with chronic right heart failure secondary to pulmonary arterial hypertension and chronic left heart failure. Med Sci Monit, 2014; 20:960-66.
Taylor A, Rogan K, Virmani R et al. Sudden cardiac death associated with isolated congenital coronary artery anomalies. J Am Coll Cardiol, 1992; 20:640-47.
Hernândez V, Ruiz-Cano M et al. Complications of proximal pulmonary artery aneurysms in patients with severe pulmonary arterial hypertension. Rev Esp Cardiol, 2010; 63:612-620.
Chaikriangkrai K, Polsani V, Wei L et al. Stenting of a left main coronary artery compressed by a dilated main pulmonary artery. Catheter Cardiovasc Interv, 2013; 82: E684-87.
Humbert M et al. Pulmonary Arterial Hypertension in France. Results from a National Registry. Am J Respir Crit Care Med 2006;173:1023-1030.
Escribano-Subias P et al. Survival in pulmonary hypertension in Spain: insights from the Spanish registry. Eur Respir J 2012; 40: 596-603.
Peacock A et al. An epidemiological study of pulmonary arterial hypertension. Eur Respir J 2007; 30:104-109.
Kirson N et al. Prevalence of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension in the United States. Curr Med Res Opin 2011; 27:1763-1768.
Ghofrani HA, Voswinckel R, Gall H et al. Riociguat for pulmonary hypertension. Future Cardiol 2010; 6:155-166.
Stasch JP, Pacher P, Evgenov Ov. Soluble guanylate cyclase as an emerging therapeutic target in cardiopulmonary disease. Circulation 2011; 123:2263-73.
А.А. Шмальц, С.В. Горбачевский. Риоцигуат и силденафил в лечении легочной гипертензии: сходства и различия. Пульмонология. 2016; 26 (1): 85-91./A.A. Shmalts, S.V. Gorbachevskiy. Riociguat and sildenafil in treatment of pulmonary hypertension: similarities and differences. Pulmonology. 2016; 26 (1): 85-91. .
Guha M. First-in-class guanylate cyclase stimulator approved for PAH. Nat. Biotechnol. 2013; 31:1064.
Hemnes AR, Champion hC. Sildenafil, a PDE5 inhibitor, in the treatment of pulmonary hypertension. Exp Rev Cardiovasc Ther 2006; 4:293-300.
Ghofrani HA, Hoeper MM, Halank M, et al. Riociguat for chronic Thromboembolic pulmonary hypertension and pulmonary arterial hypertension: A phase II study. Eur Respir J. 2010; 36:792-799.
Мершин К.В., Мартынюк Т.В. Место медикаментозной терапии в лечении хронической тромбоэмболической легочной гипертензии. Евразийский кардиологический журнал. 2014; 1:113-118.
Gall H. et al. Real-World Switching to Riociguat: Management and Practicalities in Patients with PAH and CTEPH. Lung (2018) 196:305-312.
Kawase T, Ueda H et al. A case of acute coronary syndrome caused by extrinsic compression of the left main coronary artery due to pulmonary hypertension. Journal of Cardiology Cases (2010) 2, e154-e158.
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