Changing the prognosis of pulmonary arterial hypertension: impact of medical therapy.
Pulmonary arterial hypertension (PAH) is a progressive arteriopathy of the pulmonary circulation that can affect a wide group of patients. Presentation and natural history of PAH are intimately linked to progressive right ventricular failure. Historically, survival in PAH has been poor, especially for patients with PAH associated with progressive systemic sclerosis and human immunodeficiency virus. Oral, subcutaneous, and intravenous therapies that have emerged during the last decade can improve symptoms and hemodynamics. This review explores the impact of these therapies on prognosis in PAH, which ultimately rests on the ability to reverse the pulmonary arteriopathy and preserve right ventricular function.
Chakinala
Murali M
MM
Department of Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA. chakinalam@wustl.edu
D000925:Anticoagulants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D000077300:Bosentan; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D011464:Epoprostenol / Q000627:therapeutic use; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy*; D010879:Piperazines / Q000627:therapeutic use; D011379:Prognosis; D011687:Purines; D000068677:Sildenafil Citrate; D013449:Sulfonamides / Q000627:therapeutic use; D013450:Sulfones; D016019:Survival Analysis; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D010879:Piperazines; D011687:Purines; D013449:Sulfonamides; D013450:Sulfones; D014859:Warfarin; D000068677:Sildenafil Citrate; D011464:Epoprostenol; D000077300:Bosentan