title: Pulmonary arterial hypertension in adults: novel drugs and catheter ablation techniques show promise? Systematic review on pharmacotherapy and interventional strategies.
abstract: This systematic review aims to provide an update on pharmacological and interventional strategies for the treatment of pulmonary arterial hypertension in adults. Currently US Food and Drug Administration approved drugs including prostanoids, endothelin-receptor antagonists, phosphodiesterase type-5 inhibitors, and soluble guanylate-cyclase stimulators. These agents have transformed the prognosis for pulmonary arterial hypertension patients from symptomatic improvements in exercise tolerance ten years ago to delayed disease progression today. On the other hand, percutaneous balloon atrioseptostomy by using radiofrequency perforation, cutting balloon dilatation, or insertion of butterfly stents and pulmonary artery catheter-based denervation, both associated with very low rate of major complications and death, should be considered in combination with specific drugs at an earlier stage rather than late in the progression of pulmonary arterial hypertension and before the occurrence of overt right-sided heart failure.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, University of North Texas Health Science Center, 855 Montgomery Street, PCC Room 315, Fort Worth, TX 76107, USA.
authors.forename: Salvatore
authors.identifier: 0000-0003-3405-5512
authors.initials: S
authors.lastname: Rosanio
authors.affiliation: Department of Heart and Great Vessels "Attilio Reale", La Sapienza University, Rome, Italy.
authors.forename: Francesco
authors.identifier: 0000-0003-1260-1308
authors.initials: F
authors.lastname: Pelliccia
authors.affiliation: Department of Heart and Great Vessels "Attilio Reale", La Sapienza University, Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Gaudio
authors.affiliation: Department of Heart and Great Vessels "Attilio Reale", La Sapienza University, Rome, Italy.
authors.forename: Cesare
authors.initials: C
authors.lastname: Greco
authors.affiliation: Division of Cardiology, Department of Internal Medicine, University of North Texas Health Science Center, 855 Montgomery Street, PCC Room 315, Fort Worth, TX 76107, USA.
authors.forename: Abdul M
authors.initials: AM
authors.lastname: Keylani
authors.affiliation: Division of Cardiology, Department of Internal Medicine, University of North Texas Health Science Center, 855 Montgomery Street, PCC Room 315, Fort Worth, TX 76107, USA.
authors.forename: Darrin C
authors.initials: DC
authors.lastname: D'Agostino
mesh_terms: D017115:Catheter Ablation; D065128:Endothelin Receptor Antagonists / Q000627:therapeutic use; D006162:Guanylate Cyclase / Q000627:therapeutic use; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D058986:Phosphodiesterase 5 Inhibitors / Q000627:therapeutic use; D011453:Prostaglandins / Q000627:therapeutic use; D011651:Pulmonary Artery / Q000187:drug effects / Q000473:pathology / Q000601:surgery*; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D065128:Endothelin Receptor Antagonists; D058986:Phosphodiesterase 5 Inhibitors; D011453:Prostaglandins; D006162:Guanylate Cyclase