Document Detail


Pulmonary arterial hypertension: need to treat.
MedLine Citation:
PMID:  19075794     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pulmonary Arterial Hypertension (PAH) is defined by a persistent elevation in pulmonary artery pressure with normal left-sided pressures. It is characterized by increased pulmonary vascular resistance due to increased vascular tone and structural remodeling of pulmonary vessels. PAH is a quite rare condition, thus considering the rarity, subtle presentation, and diagnostic dilemma commonly posed by this disease, underdiagnosis and underreporting are probably widespread. In order to reach a diagnosis the use of echocardiography, right-heart catheterization and the six-minute walk test is essential. As far as therapy is concerned, the patient should be supported by oxygen, diuretics, anticoagulants, digoxin and suggest life-style changes. After diagnosing the condition ca-blockers should be administered to those who respond positively in acute vasodilation test. Other agents used, target the endothelin pathway (ET-1 blockers such as bosentan), the NO pathway (sildenafil, inhaled NO, L-arginine) and the prostacyclin pathway (prostacyclin analogues). In some cases surgical treatment is essential (atrial septestomy, pulmonary endarterectomy, lung and heart transplantation). Finally, future therapies include administration of VIP and SSRIs. The goals of evaluating pulmonary hypertension are detection, definition of severity and the nature of the hemodynamic lesion and its consequences, diagnosis of causal or associated conditions, and determination of optimal therapy.
Authors:
Dimosthenis Lykouras; Fotis Sampsonas; Alex Kaparianos; Georgios Efremidis; Kiriakos Karkoulias; George Tsoukalas; Kostas Spiropoulos
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Inflammation & allergy drug targets     Volume:  7     ISSN:  1871-5281     ISO Abbreviation:  Inflamm Allergy Drug Targets     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-16     Completed Date:  2009-01-16     Revised Date:  2011-11-10    
Medline Journal Info:
Nlm Unique ID:  101266886     Medline TA:  Inflamm Allergy Drug Targets     Country:  United Arab Emirates    
Other Details:
Languages:  eng     Pagination:  260-9     Citation Subset:  IM    
Affiliation:
University of Patras, University Hospital of Patras, Department of Internal Medicine, Division of Pneumonology, Rio, Patras, Greece.
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MeSH Terms
Descriptor/Qualifier:
Animals
Cardiovascular Diseases / complications
Combined Modality Therapy
Humans
Hypertension, Pulmonary / complications,  diagnosis*,  drug therapy,  epidemiology,  pathology,  therapy*

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