Research article summary (published 26 Aug 2009):

[Update: Current clinical developments in pulmonary hypertension]

(Update: Aktuelle klinische Entwicklungen bei pulmonaler Hypertonie.)

Full Abstract

During the last years, therapeutic options for the treatment of pulmonary arterial hypertension (PAH) have significantly improved. However, the therapeutic concept depends on the etiology of the disease, so that an exact classification is mandatory. Currently, three substance classes are approved for the treatment of PAH (Group I of the Venice Classification): Endothelin receptor antagonists, phosphodiesterase type-5 inhibitors, and prostanoids. After the World Conference in Dana Point (2008), recent changes in therapeutic strategies comprise the early treatment of the disease, as well as the increased importance of an early use of combination therapy if treatment goals are not met. Several new substances are currently evaluated in clinical trials. The soluble guanylate cyclase (sGC) stimulators achieve potent, NO-independent vasodilation. Another promising pathophysiological approach is currently evaluated by the use of tyrosine kinase inhibitors - anti-proliferative drugs which inhibit or even may reverse the pulmonary vascular remodeling process. Serotonin receptor antagonists are also reported to have anti-proliferative, anti-thrombotic and anti-fibrotic effects. Other forms of pulmonary hypertension (Groups II-V) are strictly separated from PAH. Evidence on treatment with PAH specific agents is strongly needed for these groups. Patients with non-PAH pulmonary hypertension should be referred to PAH expert centers, and preferably treated in controlled studies. Georg Thieme Verlag KG Stuttgart, New York.

Author information

Author/s: Dumitrescu, D (D); Ghofrani, H A (HA); Grimminger, F (F); Hoeper, M M (MM); Rosenkranz, S (S);

Affiliation: Klinik III für Innere Medizin, Herzzentrum der Universität zu Köln.

Journal and publication information

Publication Type: English Abstract; Journal Article; Review

Journal: Deutsche medizinische Wochenschrift (1946) (Dtsch Med Wochenschr), published in Germany. (Language: ger)

Reference: 2009-Aug; vol 134 Suppl 5 (issue ) : pp S160-3

Dates: Created 2009/08/31; Completed 2009/09/23;

PMID: 19718605, status: MEDLINE (last retrieval date: 9/23/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Antihypertensive Agents - classification; therapeutic use Cyclic Nucleotide Phosphodiesterases, Type 5 - antagonists & inhibitors Drug Therapy, Combination Endarterectomy Guanylate Cyclase - drug effects; metabolism Heart Failure - complications Humans Hypertension, Pulmonary - classification; drug therapy; etiology Phosphodiesterase Inhibitors - therapeutic use

Phosphodiesterase Inhibitors - therapeutic use Prostaglandins - therapeutic use Protein-Tyrosine Kinases - antagonists & inhibitors Pulmonary Disease, Chronic Obstructive - complications Pulmonary Embolism - complications; surgery Pulmonary Fibrosis - complications Receptors, Endothelin - antagonists & inhibitors Serotonin Antagonists - pharmacology; therapeutic use Vasodilator Agents - pharmacology; therapeutic use

Associated Chemicals: Antihypertensive Agents (0) ; Phosphodiesterase Inhibitors (0) ; Prostaglandins (0) ; Receptors, Endothelin (0) ; Serotonin Antagonists (0) ; Vasodilator Agents (0) ; Protein-Tyrosine Kinases (EC 2.7.1.112) ; Cyclic Nucleotide Phosphodiesterases, Type 5 (EC 3.1.4.35) ; Guanylate Cyclase (EC 4.6.1.2)

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