Динамика дистанции шестиминутной ходьбы как показатель эффективности специфических легочных вазодилататоров

Легочная гипертензия – тяжелое, и часто – быстро прогрессирующее заболевание с фатальным исходом. Современная специфическая терапия пятью классами лекарственных препаратов – простаноидами, антагонистами рецепторов эндотелина, ингибиторами фосфодиэстеразы-5, стимуляторами растворимой гуанилатциклазы и агонистами рецепторов простациклина позволила существенно улучшить прогноз пациентов. Доступный и воспроизводимый критерий переносимости физической нагрузки – дистанция, проходимая в тесте шестиминутной ходьбы (6МХ), занимает в ряду показателей эффективности (клинических, эхокардиографических и гемодинамических) специфических легочных вазодилататоров одно из центральных мест. Отражая клиническую тяжесть легочной гипертензии и, по некоторым данным – ее долгосрочный прогноз, динамика дистанции 6МХ служит неотъемлемой составляющей комбинированных первичных конечных точек рандомизированных контролируемых исследований. В рекомендациях CHEST-2019 динамика дистанции 6МХ применена для стандартизации рандомизированных контролируемых исследований. Дистанция 6МХ незаменима при наблюдении пациентов и принятии решений о дальнейшей тактике лечения.

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