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肺动脉高压使右室后负荷增加,进而右室做功增加,导致右室肥厚。尽管不同原因引起肺动脉高压的发病机制各不相同,且目前尚未全部了解,但它是各种原发病导致肺源性心脏病的共同结局。肺动脉高压尚可引起肺循环本身结构改变,首先产生肺动脉中层肥厚,随后导致内膜增生和纤维化,使肺血管阻力进一步增高,右心负荷进一步加重。 肺动脉高压和肺心病的病因(表1)
Pulmonary hypertension makes the right ventricular afterload increase, thereby increasing the work of the right ventricle, resulting in right ventricular hypertrophy. Although the pathogenesis of PAH varies from one cause to another and has not yet been fully understood, it is a common outcome of various primary diseases leading to pulmonary heart disease. Pulmonary hypertension can cause changes in the structure of the pulmonary circulation itself, first of all produce middle pulmonary artery hypertrophy, followed by intimal hyperplasia and fibrosis, pulmonary vascular resistance further increased, further aggravating the right heart load. Causes of Pulmonary Hypertension and Pulmonary Heart Disease (Table 1)