Naslov
Pulmonary arterial hypertension - new trends in therapy

Autori
Manojlović, Dragan ; Drenjančevič, I

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
HINEKA Official Journal of the Croatian Society of Hypertension No 25, Year 12, November 2010 / Jelaković, Bojan - Zagreb, 2010, 55-55

Skup
Second International Symposium on Hypertension Translational Medicine in Hypertension

Mjesto i datum
Osijek, Hrvatska, 18.11.2010. - 21.11.2010

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
pulmonary arterial hypertension

Sažetak
Introduction: Pulmonary arterial hypertension (PAH) is an elevation in pulmonary arterial pressure, characterized by symptoms of dyspnea, chest pain, fatigue, syncope, and if untreated, finalizing in right heart failure. The incidence of PAH is 1-2/per million, affecting twice as many female as males and having median survival approximately 2.8 years. Materials and Methods: The recent literature search on Medline including MESH-terms: pulmonary arterial hypertension, pathophysiology, definition, clinical assessment, therapy was conducted. Results: The disease results from an imbalance between mediators of vasodilation and vasoconstrictor (e.g. nitric oxide and prostacycline - potent vasodilators, platelet inhibitor and antimitogens are decreased in PAH, while tromboxane, vasoconstrictor and platelet activator is increased in PAH, resulting in small vessels smoth muscle hypertrophy, adventitial and intimal proliferation, and plexiform vascular lesions with vascular thrombosis). Diagnosis: physical examination, pulmonary function testing, radiographic imaging, transthoracic echocardiography, right heart catheterization - gold standard for PAH and pulmonary venous hypertension. Current drugs include synthetic prostanoids - vasodilators and antiplatelet agents (iloprost, epoprostenil, beraprost, treprostinil) which decrease mean pumlonary artery pressure (PAP) and increase the cardiac index in patients with PAH, prolonging survival. Phosphodiesterase-5 inhibitors decrease the breakdown of cGMP, increasing intracellular levels of this vasorelaxing agent. Leukotriene receptor antagonist - Zafirlukast decreases PAP by inhibiting the action of leukotriens and reduces PAP and pulmonary venous pressure. Endothelin receptor blockers - Bosentan decrease pulmonary vascular resistance improving results of functional tests. Anticoagulants are indicated in thrombosis in situ (found in 25 to 50% of these patients). Calcium channel blockers may be effective in 5% of patients, prolonging survival. Other treatments include positive airway pressure therapy or oxygen and surgery: atrial septostomy, pulmonary endarterectomy (in patients with chronic thromboembolic disease and large central clots) and lung transplantation. Conclusions: Although there are some promising drugs in therapy of PAH, there is a need to develope new ones, together with surgical approaches, in order to increase survival of the patients with PAH.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti

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