Medical Management of Right Ventricular Dysfunction in Pulmonary Arterial Hypertension.
Afterload reduction
Combination therapies
Pulmonary arterial hypertension
Pulmonary vascular resistance
Right heart reverse remodeling
Right ventricular overload
Journal
Current heart failure reports
ISSN: 1546-9549
Titre abrégé: Curr Heart Fail Rep
Pays: United States
ID NLM: 101196487
Informations de publication
Date de publication:
08 2023
08 2023
Historique:
accepted:
12
06
2023
medline:
14
8
2023
pubmed:
24
7
2023
entrez:
24
7
2023
Statut:
ppublish
Résumé
The purpose of this review is to overview the most relevant and recent knowledge regarding medical management in pulmonary arterial hypertension (PAH). Evidence has shown that PAH patients' quality of life and prognosis depend on the capability of the RV to adapt to increased afterload and to fully recover in response to substantially reduced pulmonary vascular resistance obtained with medical therapy. Data from recent clinical studies show that more aggressive treatment strategies, especially in higher risk categories, determine larger afterload reductions, consequentially increasing the probability of achieving right heart reverse remodeling, therefore improving the patients' survival and quality of life. Remarkable progress has been observed over the past decades in the medical treatment of PAH, related to the development of drugs that target multiple biological pathways, strategies for earlier and more aggressive treatment interventions. New hopes for treatment of patients who are unable to achieve low-risk status have been derived from the phase 2 trial PULSAR and the phase 3 trial STELLAR, which show improvement in the hemodynamic status of patients treated with sotatercept on top of background therapy. Promising results are expected from several ongoing clinical trials targeting new pathways involved in the pathophysiology of PAH.
Identifiants
pubmed: 37486563
doi: 10.1007/s11897-023-00612-2
pii: 10.1007/s11897-023-00612-2
pmc: PMC10421820
doi:
Types de publication
Journal Article
Review
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
263-270Informations de copyright
© 2023. The Author(s).
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