[1]刘瑶 张丽娟 雍永宏 孙海建.斜卧呼吸-直立性低氧血症综合征机制与诊疗研究进展[J].心血管病学进展,2023,(8):752.[doi:10.16806/j.cnki.issn.1004-3934.2023.08.018]
 LIU Yao,ZHANG Lijuan,YONG Yonghong,et al.Progress on the Mechanism,Diagnosis and Treatment of Platypnea-Orthodeoxia Syndrome[J].Advances in Cardiovascular Diseases,2023,(8):752.[doi:10.16806/j.cnki.issn.1004-3934.2023.08.018]
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斜卧呼吸-直立性低氧血症综合征机制与诊疗研究进展()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2023年8期
页码:
752
栏目:
综述
出版日期:
2023-08-25

文章信息/Info

Title:
Progress on the Mechanism,Diagnosis and Treatment of Platypnea-Orthodeoxia Syndrome
作者:
刘瑶1 张丽娟 1 雍永宏2 孙海建 3
(1.南京医科大学第四附属医院超声医学科,江苏 南京 210031;2.南京医科大学第一附属医院心内科,江苏 南京 210029;3.江南大学无锡医学院,江苏 无锡 214028)
Author(s):
LIU Yao1ZHANG Lijuan1YONG Yonghong2SUN Haijian3
(1.Department of Ultrasound Medicine,The Fourth Affiliated Hospital of Nanjing Medical University,Nanjing 210031,Jiangsu,China;2.Department of Cardiology,The First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China;3.Wuxi School of Medicine,Jiangnan University,Wuxi 214028,Jiangsu,China)
关键词:
斜卧呼吸-直立性低氧血症综合征分流卵圆孔未闭肺动静脉畸形
Keywords:
Platypnea-orthodeoxia syndromeShuntPatent foramen ovalePulmonary arterio-venous malformation
DOI:
10.16806/j.cnki.issn.1004-3934.2023.08.018
摘要:
斜卧呼吸-直立性低氧血症综合征的特征是站立位时引发呼吸困难和低氧血症,仰卧位可缓解。目前该疾病的具体机制尚未明确,但大多数已报道的病例都和心内分流或肺内分流相关,前者主要包括房间隔解剖学缺损,伴随其他解剖异常和右心压力升高,后者主要包括通气/血流不匹配和血管畸形。诊断该疾病通常需充分的临床评估和完善的相关检查,对于大多数心内分流和部分肺内分流患者,手术治疗后效果尚可。现就该疾病的机制及诊疗相关研究进展进行综述。
Abstract:
Platypnea-orthodeoxia syndrome is characterized by dyspnea and hypoxemia in the standing position and resolved in the supine position. The mechanism of this disease is not clear,but most reported cases are associated with intracardiac shunts and intrapulmonary shunts. The former mainly includes gaps in the atrial septum,accompanying other anatomical abnormalities,and elevated right heart pressure. The latter mainly included ventilation/perfusion mismatch and vascular abnormalities. Adequate clinical evaluation and comprehensive related examinations are helpful for the diagnosis of this disease. Interventional and surgical treatments are beneficial for most patients with intracardiac shunts and some patients with intrapulmonary shunts. This article reviews the research progress in the pathophysiological mechanism,diagnosis and treatment of this disease

参考文献/References:

[1] Michael A,Robin ED. Platypnea (diffuse zone ⅰ phenomenon?)[J]. N Engl J Med,1969,281(24):1347-1348.

[2] Robin ED,Laman D,Horn BR,et al. platypnea related to orthodeoxia caused by true vascular lung shunts[J]. N Engl J Med,1976,294(17):941-943.

[3]Seward JB,Hayes DL,Smith HC,et al. Platypnea-orthodeoxia:clinical profile,diagnostic workup,management,and report of seven cases[J]. Mayo Clin Proc,1984,59(4):221-231.

[4] Agrawal A,Palkar A,Talwar A. The multiple dimensions of platypnea-orthodeoxia syndrome:a review[J]. Respir Med,2017,129:31-38.

[5] Glenny RW. Teaching ventilation/perfusion relationships in the lung[J]. Adv Physiol Educ,2008,32(3):192-195.

[6] Othman F,Bailey B,Collins N,et al. Platypnea-orthodeoxia syndrome in the setting of patent foramen ovale without pulmonary hypertension or major lung disease[J]. J Am Heart Assoc,2022,11(15):e024609.

[7] Naganuma M,Itagaki K,Suzuki N,et al. Severe hypoxia caused by ascending aorta elongation due to aortic arch aneurysm[J]. Asian Cardiovasc Thorac Ann,2020,28(3):172-174.

[8] Teupe CH,Groenefeld GC. Platypnea-orthodeoxia due to osteoporosis and severe kyphosis:a rare cause for dyspnea and hypoxemia[J]. Heart Int,2011,6(2):e13.

[9] Sakagianni K,Evrenoglou D,Mytas D,et al. Platypnea-orthodeoxia syndrome related to right hemidiaphragmatic elevation and a ‘stretched’ patent foramen ovale[J]. BMJ Case Rep,2012,2012:bcr-2012-007735.

[10] Mojadidi MK,Ruiz JC,Chertoff J,et al. Patent foramen ovale and hypoxemia[J]. Cardiol Rev,2019,27(1):34-40.

[11] Mas JL. Patent foramen ovale,atrial septal aneurysm and ischaemic stroke in young adults[J]. Eur Heart J,1994,15(4):446-449.

[12] Eicher JC,Bonniaud P,Baudouin N,et al. Hypoxaemia associated with an enlarged aortic root:a new syndrome?[J]. Heart,2005,91(8):1030-1035.

[13]Shakur R,Ryding A,Timperley J,et al. Late emergence of platypnea orthodeoxia:Chiari network and atrial septal hypertrophy demonstrated with transoesophageal echocardiography[J]. Eur J Echocardiogr,2008,9(5):694-696.

[14] Larsen JH,Poulsen MK,Oevrehus KA,et al. Platypnea-orthodeoxia syndrome in patient with patent foramen ovale,dilated ascending aorta and persisting eustachian valve:a case report[J]. J Cardio Case Rep,2021,4:1-3.

[15] Hill AJ,Ahlberg SE,Wilkoff BL,et al. Dynamic obstruction to coronary sinus access:the Thebesian valve[J]. Heart Rhythm,2006,3(10):1240-1241.

[16] Hsu PF,Leu HB,Lu TM,et al. Platypnea-orthodeoxia syndrome occurring after a blunt chest trauma with acute tricuspid regurgitation[J]. Am J Med,2004,117(11):890-891.

[17] Bokhari SSI,Willens HJ,Lowery MH,et al. Orthodeoxia platypnea syndrome in a patient with lipomatous hypertrophy of the interatrial septum due to long-term steroid use[J]. Chest,2011,139(2):443-445.

[18] Vallurupalli S,Lodha A,Kupfer Y,et al. Platypnea-orthodeoxia syndrome after repair of a paraesophageal hernia[J]. BMJ Case Rep,2013,2013:bcr2012007444.

[19] Patakas D,Pitsiou G,Philippou D,et al. Reversible platypnoea and orthodeoxia after surgical removal of an hydatid cyst from the liver[J]. Eur Respir J,1999,14(3):725-727.

[20] Bohren Y,Lopez M,Santelmo N,et al. Diagnostic pitfall of platypnea-orthodeoxia syndrome caused by atrial septal defect after right pneumonectomy[J]. Case Rep Crit Care,2020,2020:4257185.

[21]Aigner C,Lang G,Taghavi S,et al. Haemodynamic complications after pneumonectomy:atrial inflow obstruction and reopening of the foramen ovale[J]. Eur J Cardiothorac Surg,2008,33(2):268-271.

[22] Anthonisen NR,Milic-Emil J. Distribution of pulmonary perfusion in erect man[J]. J Appl Physiol,1966,21(3):760-766.

[23] Shovlin CL. Pulmonary arteriovenous malformations[J]. Am J Respir Crit Care Med,2014,190(11):1217-1228.

[24] Takhar R,Biswas R,Arora A,et al. Platypnoea-orthodeoxia syndrome:novel cause for a known condition[J]. BMJ Case Rep,2014,2014:bcr2013201284.

[25] Hussain SF,Mekan SF. Platypnea-orthodeoxia:report of two cases and review of the literature[J]. South Med J,2004,97(7):657-662.

[26] Katsoulis K,Minasidis I,Vainas A,et al. Platypnea and orthodeoxia associated with Pneumocystis jiroveci and Cytomegalovirus pneumonia:a case report[J]. J Med Case Rep,2009,3:9319.

[27] Dodson BK,Major CK,Grant M,et al. Platypnea orthodeoxia due to a patent foramen ovale and intrapulmonary shunting after severe COVID-19 pneumonia[J]. Am J Case Rep,2021,22:e933975.

[28] Salvotti F,Poiatti F,Bressa S,et al. Platypnoea-orthodeoxia syndrome in COVID-19[J]. Eur J Case Rep Intern Med,2021,8(10):002849.

[29]Raevens S,Boret M,Fallon MB. Hepatopulmonary syndrome[J]. JHEP Rep,2022,4(9):100527.

[30] Rodríguez-Roisin R,Krowka MJ. Hepatopulmonary syndrome—A liver-induced lung vascular disorder[J]. N Engl J Med,2008,358(22):2378-2387.

[31] Kapur S,Paik E,Rezaei A,et al. Where there is blood,there is a way:unusual collateral vessels in superior and inferior vena cava obstruction[J]. Radiographics,2010,30(1):67-78.

[32] Lopez Gaston OD. [Platypnea-orthodeoxia syndrome][J]. Medicina (B Aires),2005,65(3):268-272.

[33] Papiris SA,Maniati MA,Manoussakis MN,et al. Orthodeoxia in amiodarone-induced acute reversible pulmonary damage[J]. Chest,1994,105(3):965-966.

[34] Awan AN,Ashraf R,Meyerson MB,et al. Radiation-induced bronchial stenosis:a new cause of platypnea-orthodeoxia[J]. South Med J,1999,92(7):720-724.

[35]Odell JA,Keller CA,Erasmus DB,et al. Traumatic bronchial rupture and platypnea-orthodeoxia[J]. Ann Thorac Surg,2012,93(2):662-664.

[36] Gacad G,Akhtar N,Cohn JN. Orthostatic hypoxemia in a patient with bronchogenic carcinoma[J]. Arch Intern Med,1974,134(6):1113-1115.

[37]王浩,吴伟春,施怡声,等. 卵圆孔未闭右心声学造影中国专家共识[J]. 中国循环杂志,2022,37(5):449-458.

[38] Tellapuri S,Park HS,Kalva SP. Pulmonary arteriovenous malformations[J]. Int J Cardiovasc Imaging,2019,35(8):1421-1428.

[39] Hayek A,Rioufol G,Bochaton T,et al. Prognosis after percutaneous foramen ovale closure among patients with platypnea-orthodeoxia syndrome[J]. J Am Coll Cardiol,2021,78(18):1844-1846.

[40] Shah AH,Osten M,Leventhal A,et al. Percutaneous intervention to treat platypnea-orthodeoxia syndrome:the?Toronto experience[J]. JACC Cardiovasc Interv,2016,9(18):1928-1938.

[41] Latson L,Briston D. Atrial septal defect:transcatheter closure is not bad,but there is more to the story[J]. JACC Cardiovasc Interv,2021,14(5):576-577.

[42] 国家卫生健康委员会国家结构性心脏病介入质量控制中心,国家心血管病中心结构性心脏病介入质量控制中心,中华医学会心血管病学分会先心病经皮介入治疗指南工作组,等. 常见先天性心脏病经皮介入治疗指南(2021版)[J]. 中华医学杂志,2021,101(38):3054-3076.

更新日期/Last Update: 2023-09-21