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Nichtmedikamentöse Therapie bei pulmonaler Hypertonie

Training, operative und interventionelle Therapie

Non-drug-based treatment of pulmonary hypertension

Training, surgical and interventional therapies

  • Leitthema
  • Published:
Der Pneumologe Aims and scope

Zusammenfassung

Neben der medikamentösen Therapie haben eine spezifische Atem- und Bewegungstherapie sowie chirurgische und seit Kurzem auch interventionelle Verfahren ihren festen Platz in der Behandlung von Patienten mit pulmonaler Hypertonie (PH). Ein speziell für PH-Patienten entwickeltes Trainingsverfahren kann die Beschwerden, körperliche Belastbarkeit, Lebensqualität und das Langzeitüberleben deutlich verbessern. Bei Patienten mit chronisch thromboembolischer pulmonaler Hypertonie ist die pulmonale Endarteriektomie die Therapie der Wahl. Für inoperable Patienten ist die sog. pulmonale Ballonangioplastie eine neue Therapieoption. Im Endstadium einer PH ist die Lungentransplantation ein effektives Verfahren zur Verbesserung von Lebensqualität und Lebenserwartung.

Abstract

Besides drug-based treatment, specific breathing and exercise training, as well as surgical and, more recently, interventional methods are established or evolving treatment options for patients with pulmonary hypertension (PH). An exercise and rehabilitation program developed specifically for PH patients has been shown to improve symptoms, exercise capacity, quality of life and long-term survival. For patients with chronic thromboembolic pulmonary hypertension (CTEPH), pulmonary endarterectomy (PEA) is the treatment of choice. Pulmonary balloon angioplasty (BPA) is a promising new therapeutic option for inoperable CTEPH patients. For patients with end-stage PH, lung transplantation is an effective procedure for improving quality of life and extending lifespan.

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Abbreviations

CTEPH:

Chronisch thromboembolische pulmonale Hypertonie

HLM:

Herz-Lungen-Maschine

ECMO:

Extrakorporale Membranoxygenierung

PEA:

Pulmonale Endarteriektomie

mPAP:

Mittlerer pulmonalarterieller Druck

PAOP:

Pulmonalarterieller Okklusionsdruck (Wedge-Druck)

PVR:

Pulmonalvaskulärer Widerstand

BPA:

Pulmonale Ballonangioplastie

LTX:

Lungentransplantation

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Einhaltung ethischer Richtlinien

Interessenkonflikt. S. Guth hat Vortragshonorare der Firmen Actelion, Bayer und Pfizer erhalten.

N. Ehlken: Kein Interessenkonflikt.

T. Kramm: Vortragshonorare der Firmen Actelion und Bayer.

C. Wiedenroth: Kein Interessenkonflikt.

E. Grünig: Kein Interessenkonflikt.

E. Mayer: Vortragshonorare der Firmen Actelion, Bayer, GSK und Pfizer.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Abteilung für Thoraxchirurgie, Herz- und Lungenzentrum, Kerckhoff Klinik gGmbH, Benekestr. 2–8, 61231, Bad Nauheim, Deutschland

    S. Guth, T. Kramm, C. Wiedenroth & E. Mayer

  2. Zentrum für pulmonale Hypertonie, Thoraxklinik-Heidelberg gGmbH, Heidelberg, Deutschland

    N. Ehlken & E. Grünig

Authors
  1. S. Guth
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  2. N. Ehlken
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  3. T. Kramm
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  4. C. Wiedenroth
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  5. E. Grünig
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  6. E. Mayer
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Correspondence to S. Guth.

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Guth, S., Ehlken, N., Kramm, T. et al. Nichtmedikamentöse Therapie bei pulmonaler Hypertonie. Pneumologe 12, 401–409 (2015). https://doi.org/10.1007/s10405-015-0882-4

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  • DOI: https://doi.org/10.1007/s10405-015-0882-4

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