Abordagens Terapêuticas na Síndrome de Eisenmenger: Uma Revisão Sistemática / Therapeutic Approaches in Eisenmenger Syndrome: A Systematic Review
DOI:
https://doi.org/10.14295/idonline.v16i63.3594Palavras-chave:
Abordagens Terapêuticas. Síndrome de Eisenmenger. Revisão SistemáticaResumo
Resumo: Objetivou-se realizar uma revisão sistemática da literatura sobre as repercussões de terapias nos âmbitos farmacológicas, cirúrgicas e alternativas para os pacientes acometidos pela síndrome de Eisenmenger (SE). Metodologia: Realizamos uma busca sistemática nas bases de dados eletrônicos PubMed e Scopus para a seleção de artigos publicados sobre a indicações terapêuticas voltadas aos pacientes acometidos pela síndrome de Eisenmenger (SE), seguindo os itens de Diretrizes para Revisões Sistemáticas e Metanálises (PRISMA). Resultados: Identificamos 497 trabalhos nas bases pesquisadas (109 do PubMed, 388 do Scopus). Após exclusão por título e resumo foram selecionados 58 artigos para análise em texto completo. Ao final, 22 artigos foram eleitos como relevantes para compor a síntese qualitativa. Conclusão: Os inibidores da fosfodiesterase mostraram-se eficazes em terapias combinadas. O antagonista do receptor de endotelina mostrou-se bem tolerado em pacientes com estágio leve da patologia, assim como em indivíduos que portadores de SE e SD. Dados preliminares indicam que análogos de Prostaciclina apresentam um alto potencial preditivo da manifestação de HAP. Quanto à perspectiva de intervenção cirúrgica no tratamento da SE observou-se a necessidade de mais estudos.Palavras-Chave: Abordagens Terapêuticas. Síndrome de Eisenmenger. Revisão Sistemática.
Abstract:The objective was to carry out a systematic review of the literature on the repercussions of therapies in the pharmacological, surgical and alternative scopes for patients affected by Eisenmenger syndrome (ES). Methodology: We performed a systematic search in the PubMed and Scopus electronic databases to select published articles on therapeutic indications for patients with Eisenmenger syndrome (ES), following the items of the Guidelines for Systematic Reviews and Meta-analyses (PRISMA). Results: We identified 497 works in the searched databases (109 from PubMed, 388 from Scopus). After exclusion by title and abstract, 58 articles were selected for full-text analysis. In the end, 22 articles were elected as relevant to compose the qualitative synthesis. Conclusion: Phosphodiesterase inhibitors were effective in combination therapies. The endothelin receptor antagonist was well tolerated in patients with a mild stage of the pathology, as well as in individuals with SE and SD. Preliminary data indicate that prostacyclin analogues have a high predictive potential of PAH manifestation. Regarding the perspective of surgical intervention in the treatment of ES, there was a need for further studies.
Keywords: Therapeutic Approaches. Eisenmenger syndrome. Systematic review.
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