Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya3375410.26442/00403660.2019.12.000468Editorial articleПередовая статьяReview ArticleA systematic review as a method of gathering scientific evidence into clinical guidelines: CHEST-2019 guideline for the therapy pulmonary arterial hypertension in adultsСистематический обзор как основа клинических рекомендаций: рекомендации CHEST-2019 по терапии легочной артериальной гипертензии у взрослыхShmaltsA AШмальцА АGorbachevskyS VГорбачевскийС ВBakoulev Scientific Center for Cardiovascular SurgeryФГБУ «Национальный медицинский исследовательский центр сердечно-сосудистой хирургии им. А.Н. Бакулева» Минздрава РоссииRussian State Medical Postgraduate AcademyФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России151220199112VOL 91, NO12 (2019)ТОМ 91, №12 (2019)10511416042020Copyright ©; 2019, Consilium MedicumCopyright ©; 2019, ООО "Консилиум Медикум"2019Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/33754

The updated fourth version of the CHEST guideline presents the evidence base and treatment algorithm for pulmonary arterial hypertension in adults. The CHEST approach to creating clinical guidelines differs from the European one (ESC/ERS) and, in fact, consists in a systematic review of clinical trials and a sammary of their postulates.

Систематический обзор как основа клинических рекомендаций: рекомендации CHEST-2019 по терапии легочной артериальной гипертензии у взрослых В обновленной, четвертой, версии рекомендаций CHEST представлены доказательная база и алгоритм лечения легочной артериальной гипертензии у взрослых. Подход CHEST к созданию клинических рекомендаций отличается от европейского (ESC/ERS) и, по сути, заключается в систематическом обзоре клинических исследований и суммировании их постулатов.

pulmonary hypertensionpulmonary arterial hypertensionspecific therapyguidelineлегочная гипертензиялегочная артериальная гипертензияспецифическая терапиярекомендацииGalie N, Humbert M, Vachiery J.L, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J. 2016;37(1):67-119. doi: 10.1093/eurheartj/ehv317Galie N, Humbert M, Vachiery J.L, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC),International Society for Heart and Lung Transplantation (ISHLT). Eur Respir J. 2015;46(4):903-75. doi: 10.1183/13993003.01032-2015Galiè N, Channick R.N, Frantz R.P, et al. Risk stratification and medical therapy of pulmonary arterial hypertension. Eur Respir J. 2019;53(1). pii: 1801889. doi: 10.1183/13993003.01889-2018Легочная гипертензия. Российские клинические рекомендации, 2016. Доступно по ссылке: http://cr.rosminzdrav.ru /schema.html?id=136#/textKlinger J.R, Elliott C.G, Levine D.J, et al. Therapy for Pulmonary Arterial Hypertension in Adults: Update of the CHEST Guideline and Expert Panel Report. Chest. 2019;155(3):565-86. doi: 10.1016/j.chest.2018.11.030Mc Crory D.C, Coeytaux R.R, Schmit K.M, et al. AHRQ Comparative Effectiveness Reviews. Pulmonary Arterial Hypertension: Screening, Management, and Treatment. Rockville (MD): Agency for Healthcare Research and Quality (US), 2013.Taichman D.B, Ornelas J, Chung L, et al. Pharmacologic therapy for pulmonary arterial hypertension in adults: CHEST guideline and expert panel report. Chest. 2014;146(2):449-75. doi: 10.1378/chest.14-0793Мартынюк Т.В., Чазова И.Е. Стратегия медикаментозного лечения легочной артериальной гипертензии в свете современных зарубежных рекомендаций. Системные гипертензии. 2016;13(2):46-64. doi: 10.26442/2075-082x_13.2.46-64Andrews J, Guyatt G, Oxman A.D, et al. GRADE guidelines: 14. Going from evidence to recommendations: the significance and presentation of recommendations. J Clin Epidemiol. 2013;66(7):719-25. doi: 10.1016/j.jclinepi.2012.03.013Balshem H, Helfand M, Schünemann H.J, et al. GRADE guidelines: 3. Rating the quality of evidence. J Clin Epidemiol. 2011;64(4):401-6. doi: 10.1016/j.jclinepi.2010.07.015Simonneau G, Torbicki A, Hoeper M.M, et al. Selexipag: an oral, selective prostacyclin receptor agonist for the treatment of pulmonary arterial hypertension. Eur Respir J. 2012;40(4):874-80. doi: 10.1183/ 09031936.00137511Sitbon O, Channick R, Chin K.M, et al. Selexipag for the treatment of pulmonary arterial hypertension. N Engl J Med. 2015;373(26):2522-33. doi: 10.1056/nejmoa1503184Jing Z.C, Parikh K, Pulido T, et al. Efficacy and safety of oral treprostinil monotherapy for the treatment of pulmonary arterial hypertension: a randomized, controlled trial. Circulation. 2013;127(5):624-33. doi: 10.1161/circulationaha.112.124388Mc Laughlin V, Channick R.N, Ghofrani H.A, et al. Bosentan added to sildenafil therapy in patients with pulmonary arterial hypertension. Eur Respir J. 2015;46(2):405-13. doi: 10.1183/13993003.02044-2014Galie N, Barbera J.A, Frost A.E, et al. Initial use of ambrisentan plus tadalafil in pulmonary arterial hypertension. N Engl J Med. 2015;373(9):834-44. doi: 10.1056/nejmoa1413687Zhuang Y, Jiang B, Gao H, Zhao W. Randomized study of adding tadalafil to existing ambrisentan in pulmonary arterial hypertension. Hypertens Res. 2014;37(6):507-12. doi: 10.1038/hr.2014.28Tapson V.F, Jing Z.C, Xu K.F, et al. Oral treprostinil for the treatment of pulmonary arterial hypertension in patients receiving background endothelin receptor antagonist and phosphodiesterase type 5 inhibitor therapy (the FREEDOM-C2 study): a randomized controlled trial. Chest. 2013;144(3):952-8. doi: 10.1378/chest.12-2875Hoeper M.M, Simonneau G, Corris P.A, et al. RESPITE: switching to riociguat in pulmonary arterial hypertension patients with inadequate response to phosphodiesterase-5 inhibitors. Eur Respir J. 2017;50(3):1602425. doi: 10.1183/13993003.02425-2016Chia K.S, Wong P.K, Faux S.G, et al. The benefit of exercise training in pulmonary hypertension: a clinical review. Intern Med J. 2017;47(4):361-9. doi: 10.1111/imj.13159Inagaki T, Terada J, Tanabe N, et al. Home - based pulmonary rehabilitation in patients with inoperable or residual chronic thromboembolic pulmonary hypertension: a preliminary study. Respir Investig. 2014;52(6):357-64. doi: 10.1016/j.resinv.2014.07.002Zafrir B. Exercise training and rehabilitation in pulmonary arterial hypertension: rationale and current data evaluation. J Cardiopulm Rehabil Prev. 2013;33(5):263-73. doi: 10.1097/hcr.0b013e3182a0299aGanderton L, Jenkins S, Gain K, et al. Short term effects of exercise training on exercise capacity and quality of life in patients with pulmonary arterial hypertension: protocol for a randomized controlled trial. BMC Pulm Med. 2011;11:25. doi: 10.1186/1471-2466-11-25Weinstein A.A, Chin L.M, Keyser R.E, et al. Effect of aerobic exercise training on fatigue and physical activity in patients with pulmonary arterial hypertension. Respir Med. 2013;107(5):778-84. doi: 10.1016/j.rmed.2013.02.006Ehlken N, Lichtblau M, Klose H, et al. Exercise training improves peak oxygen consumption and haemodynamics in patients with severe pulmonary arterial hypertension and inoperable chronic thromboembolic pulmonary hypertension: a prospective, randomized, controlled trial. Eur Heart J. 2016;37(1):35-44. doi: 10.1093/eurheartj/ehv337Morris N.R, Kermeen F.D, Holland A.E. Exercise - based rehabilitation programmes for pulmonary hypertension. Cochrane Database Syst Rev. 2017;1:CD011285. doi: 10.1002/14651858.cd011285.pub2Saglam M, Arikan H, Vardar-Yagli N, et al. Inspiratory muscle training in pulmonary arterial hypertension. J Cardiopulm Rehabil Prev. 2015;35(3):198-206. doi: 10.1097/hcr.0000000000000117Ezedunukwe I.R, Enuh H, Nfonoyim J, Enuh Collins U. Anticoagulation therapy versus placebo for pulmonary hypertension. Cochrane Database Syst Rev. 2014;(6):CD010695. doi: 10.1002/ 14651858.cd010695.pub2Olsson K.M, Delcroix M, Ghofrani H.A, et al. Anticoagulation and survival in pulmonary arterial hypertension: results from the Comparative, Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension (COMPERA). Circulation. 2014;129(1):57-65. doi: 10.1161/CIRCULATIONAHA.113.004526Preston I.R, Roberts K.E, Miller D.P, et al. Effect of warfarin treatment on survival of patients with pulmonary arterial hypertension (PAH) in the Registry to Evaluate Early and Long-Term PAH Disease Management (REVEAL). Circulation. 2015;132(25):2403-11. doi: 10.1161/circulationaha.115.018435Kang B.J, Oh Y-M, Lee S-D, Lee J.S. Survival benefits of warfarin in Korean patients with idiopathic pulmonary arterial hypertension. Korean J Intern Med. 2015;30(6):837-45. doi: 10.3904/kjim.2015. 30.6.837Kawut S.M, Bagiella E, Lederer D.J, et al. Randomized clinical trial of aspirin and simvastatin for pulmonary arterial hypertension: ASASTAT. Circulation. 2011;123(25):2985-93. doi: 10.1161/circulationaha.110.015693Kawut S.M, Horn E.M, Berekashvili K.K, et al. Selective serotonin reup - take inhibitor use and outcomes in pulmonary arterial hypertension. Pulm Pharmacol Ther. 2006;19(5):370-4. doi: 10.1016/ j.pupt.2006.01.001Sitbon O, Gomberg-Maitland M, Granton J, et al. Clinical trial design and new therapies for pulmonary arterial hypertension. Eur Respir J. 2019;53(1). pii: 1801908. doi: 10.1183/13993003.01908-2018Mc Laughlin V.V, Badesch D.B, Delcroix M, et al. End points and clinical trial design in pulmonary arterial hypertension. J Am Coll Cardiol. 2009;54(1 Suppl):S97-S107. doi: 10.1016/j.jacc.2009.04.007Шмальц А.А., Горбачевский С.В. Биохимический путь оксида азота в терапиилегочной артериальной гипертензии и результаты исследования RESPITE. Системные гипертензии. 2018;15(2):72-6. doi: 10.26442/ 2075-082x_2018.2.72-76Шмальц А.А., Горбачевский С.В. Риоцигуат и силденафил в лечении легочной гипертензии: сходства и различия. Пульмонология. 2016;26(1):85-91.REPLACE. Riociguat replacing PDE-5i therapy evaluated against continued PDE-5i therapy. Сlinical Trials.gov Identifier: NCT02891850.