Current pathophysiological concepts and management of pulmonary hypertension

Abstract Pulmonary hypertension (PH), increasingly recognized as a major health burden, remains underdiagnosed due mainly to the unspecific symptoms. Pulmonary arterial hypertension (PAH) has been extensively investigated. Pathophysiological knowledge derives mostly from experimental models. Paradox...

Full description

Saved in:
Bibliographic Details
Published in:International journal of cardiology 2012-03, Vol.155 (3), p.350-361
Main Authors: Lourenço, André P, Fontoura, Dulce, Henriques-Coelho, Tiago, Leite-Moreira, Adelino F
Format: Article
Language:English
Subjects:
Antihypertensive Agents - therapeutic use
Biological and medical sciences
Cardiology. Vascular system
Cardiovascular
Disease Management
Global Health
Humans
Hypertension, Pulmonary - drug therapy
Hypertension, Pulmonary - epidemiology
Hypertension, Pulmonary - physiopathology
Medical sciences
Morbidity - trends
Pathophysiology
Pneumology
Prognosis
Pulmonary arterial hypertension
Pulmonary hypertension
Pulmonary hypertension. Acute cor pulmonale. Pulmonary embolism. Pulmonary vascular diseases
Pulmonary Wedge Pressure - physiology
Treatment
Vasodilation - physiology
Vasodilator Agents - therapeutic use
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Pulmonary hypertension (PH), increasingly recognized as a major health burden, remains underdiagnosed due mainly to the unspecific symptoms. Pulmonary arterial hypertension (PAH) has been extensively investigated. Pathophysiological knowledge derives mostly from experimental models. Paradoxically, common non-PAH PH forms remain largely unexplored. Drugs targeting lung vascular tonus became available during the last two decades, notwithstanding the disease progresses in many patients. The aim of this review is to summarize recent advances in epidemiology, pathophysiology and management with particular focus on associated myocardial and systemic compromise and experimental therapeutic possibilities. PAH, currently viewed as a panvasculopathy, is due to a crosstalk between endothelial and smooth muscle cells, inflammatory activation and altered subcellular pathways. Cardiac cachexia and right ventricular compromise are fundamental determinants of PH prognosis. Combined vasodilator therapy is already mainstay for refractory cases, but drugs directed at these new pathophysiological pathways may constitute a significant advance.
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2011.05.066