Therapiealgorithmus der pulmonalarteriellen Hypertonie

Zusammenfassung

Die gezielte Therapie der pulmonalarteriellen Hypertonie hat einen positiven Einfluss auf die Symptomatik und Prognose der Erkrankung. Eine gezielte und früh eingesetzte Kombinationstherapie zeigt dabei größere Verbesserungen im Vergleich zu einer Monotherapie. Für Therapieentscheidungen ist die Einschätzung des Mortalitätsrisikos anhand der Risikostratifikation sowie das Vorhandensein von Komorbiditäten essenziell. Ein niedriger Risikostatus ist anzustreben, sichert jedoch nicht immer einen langfristigen klinisch stabilen Verlauf. Zur Kontrolle des Therapieansprechens sollten daher frühzeitige und regelmäßige Reevaluationen erfolgen, bei denen die therapeutischen Konsequenzen im Sinne einer Therapieanpassung eruiert werden.

Neuartige Wirkstoffe und die Erschließung neuer Wirkmechanismen haben die Therapiemöglichkeiten sehr erweitert und verbessert, müssen aber in Langzeitstudien weiter evaluiert werden. Die Definition neuer Therapieziele, z. B. Erreichen einer Remission der PAH, sollten unter den neuen therapeutischen Optionen kritisch diskutiert und durch prospektive Studien weiter evaluiert werden [1].

Abstract

Targeted therapy for pulmonary arterial hypertension has a positive impact on the symptoms and prognosis of the disease. Targeted and early combination therapy demonstrates greater improvements compared to monotherapy. For treatment decisions, assessing the mortality risk based on risk stratification and the presence of comorbidities is essential. A low-risk status is desirable, but does not always guarantee long-term clinically stable disease. Therefore, early and regular reevaluations should be performed to monitor treatment response, determining the therapeutic consequences for treatment adjustment.

Novel agents and the discovery of new mechanisms of action have greatly expanded and improved treatment options, but require further evaluation in long-term studies. The definition of new treatment goals, such as achieving remission of PAH, should be critically discussed among the new therapeutic options and further evaluated through prospective studies [1].

Schlüsselwörter

pulmonale Hypertonie - Therapie - Rechtsherzdysfunktion

Keywords

pulmonary hypertension - therapy - right heart insufficiency

^* Letztautor

Publication History

Article published online:
06 October 2025

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